Growth of the fetal forehead and normative dimensions developed by three-dimensional ultrasonographic technology.

Abstract

Sonographic imaging of the fetal face is important since a number of chromosomal aberrations are associated with facial malformations. In the past, imaging of the fetal forehead and diagnosis of frontal bossing had been based on subjective evaluation using two‐dimensional ultrasonography. The purpose of this study was to evaluate quantitatively the fetal forehead using three‐dimensional technology to generate normative data throughout gestation. This should allow the objective diagnosis of abnormal growth of the fetal forehead, such as frontal bossing. We also report a case of a fetus with frontal bossing in whom the generated nomogram was applied. A cross‐sectional study was performed in 130 normal healthy singleton pregnancies between 16 and 38 weeks' gestation. Using three‐dimensional ultrasonography, a line connecting the apex of the philtrum and the nasion was drawn across the anterior forehead, which delineated the area of the forehead for analysis. The forehead length, forehead height, and forehead area under the curve were measured and the forehead index was calculated. A second order polynomial growth function was noted throughout gestation for the forehead length (r = 0.93), forehead height (r = 0.97), and forehead area (r = 0.97). The fetal forehead index remained relatively constant throughout gestation. The results of this study provide normative data of fetal forehead length, width, and area using three‐dimensional ultrasonographic technology. Normative dimensions of the fetal forehead developed and presented herein are expected to serve as a basis for the objective assessment of presumed fetal facial abnormalities and may facilitate the detection of the associated syndromes. This is demonstrated in our case report of an achondroplastic fetus in whom all forehead dimensions were above the 95th percentile.

Congenital Epulis

“…Cleft lips, micrognathia, malformed ears, and frontal bossing have all been reported to be better displayed by 3DUS. [16][17][18][19][20][21][22][23] To our knowledge, the use of 3DUS in a fetus with congenital epulis has not been reported. In addition to providing a surface-rendered display of the mass, which facilitated parental counseling, the 3DUS images showed a high likelihood of functional impairment of the nasal airway because the mass was seen obstructing both nares.…”

Three-dimensional ultrasound imaging and its use in quantifying organ and pathology volumes

“…The plaque is heterogeneous, with calcified regions casting a shadow on the common carotid artery. (b) The same image has been volume rendered to obtain a view of the vessel wall and the surface of the plaque (arrows) Volume measurement accuracy with three-dimensional ultrasound An important advantage of 3D US imaging is that it provides the ability to measure organs or lesions in arbitrary orientations [19,20]. Since conventional US imaging produces only 2D images, the volume is estimated from measurements of diameter in a few user-selected planes and assuming some idealized shape, resulting in inaccuracy and variability.…”

Three‐dimensional ultrasonographic imaging in obstetrics: present and future applications.

“…Cleft lips, micrognathia, malformed ears, and frontal bossing have all been reported to be better displayed and analyzed by 3DUS. [39][40][41][42][43][44][45][46][47][48] Cleft lip and palate is the most common craniofacial malformation; the value of 3DUS, compared with 2DUS, for the detection of this anomaly has been studied. 45,46,49,50 Investigators have shown that multiplanar imaging is best used to evaluate the extent of cleaving into the anterior alveolar ridge (Fig.…”