Feasibility and Reproducibility of Transvaginal, Transabdominal, and 3D Volume Reconstruction Sonography for Measurement of the Corpus Callosum at Different Gestational Ages

Abstract

Objective: To compare the feasibility and reproducibility of transvaginal and transabdominal approaches, and 3D volume reconstruction sonography for measurement of corpus callosum (CC) length at different gestational ages. Methods: Forty-six normal fetuses were examined by 2D and 3D ultrasound at 23-25, 27-28 and 31-32 weeks of gestation. Direct mid-sagittal views were obtained by either a transabdominal and/or transvaginal approach. 3D reconstructed mid-sagittal views were obtained by 3D multiplanar manipulations and Volume Contrast Imaging in the C-plane technique (VCI-C) from volumes acquired in axial planes. Results: The CC could be measured in 91% of transvaginal acquisitions, in 52% of transabdominal acquisitions, in 92% of multiplanar reconstructions, and in 86% of VCI-C reconstructions. The success rate was independent of gestational age for transvaginal acquisition and slightly dependent on gestational age for 3D reconstruction techniques. Transabdominal acquisition was dependent on gestational age and fetal presentation. Inter- and intra-observer agreement was slightly better for measurements obtained from direct mid-sagittal views with either transvaginal or transabdominal acquisition than in views obtained by volume reconstruction. The reproducibility of measurements taken in reconstructed mid-sagittal views decreased with gestational age. Conclusion: 3D volume reconstruction techniques allow visualization and measurement of the CC in a high percentage of cases, with good reproducibility.

Neurosonographic Assessment of the Corpus Callosum as Imaging Biomarker of Abnormal Neurodevelopment in Late-Onset Fetal Growth Restriction

“…Ultrasonographic assessment of the CC can be obtained with low inter-observer variation in experienced hands [18,19]. Indeed, the mid-sagittal plane of the fetal brain is an easily available view in standard NSG.…”

“…CC can be reliably assessed by fetal neurosonography (NSG), which represents a cheaper and more readily available imaging technique than MRI [17]. In expert hands and by using multiplanar approaches, brain ultrasound may provide an excellent visualization of the CC after 18 weeks [18,19]. However, the potential value of fetal NSG to assess CC morphometry as a biomarker of brain development in fetal smallness has not been explored.…”

3-D Volume Assessment of the Corpus Callosum and Cerebellar Vermis Using Various Volume Acquisition and Post-Processing Protocols

“…Using this technique, clear differentiation between the CC and cavum septi pellucidi is limited due to the resolution in the reconstructed planes [12,14,15,19]. Although good correlation between measurements of the CC in a direct 2-D midsagittal plane and a reconstructed 3-D midsagittal plane has been described [29], several authors have recommended the acquisition of a sagittal 3-D volume dataset using transfrontal or transfontanel views, as the visualization of the midline of the fetal brain is improved using this approach [14,16,19].…”

Role of 3-D Ultrasound in Clinical Obstetric Practice: Evolution Over 20 Years

“…Bornstein et al (2010a) performed off-line analysis using a transabdominal 3-D gray-scale and power Doppler volumes of the fetal brain acquired in 102 consecutive normal fetuses at 20 to 23 wk. Miguelote et al (2012) compared the feasibility and reproducibility of 3-D volume reconstruction ultrasound when used for measuring corpus callosum length in 46 normal fetuses examined by 2-DUS and 3-DUS at 23 to 32 wk of gestation. Direct midsagittal views were obtained by either the transabdominal or transvaginal approach, and 3-D reconstructed midsagittal views were obtained by 3-D multiplanar manipulations and the volume contrast image through the C-plane (VCI-C) technique from volumes acquired in axial planes.…”