Sonographic anatomy of the developing cerebellum: normal embryology can resemble pathology.

Babcook, Catherine J.; Chong, Brian W.; Salamat, M. Shahriar; Ellis, William G.; Goldstein, Ruth B.

doi:10.2214/ajr.166.2.8553961

Cited by 77 publications

(46 citation statements)

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“…These embryologic studies are supported by ultrasonographic studies. 13 Comparing imaging of the fetal posterior fossa by ultrasonography and MRI, Babcook et al 14 concluded that the ultrasonographic appearance of normal cerebellar development can resemble abnormalities early in the second trimester. On the basis of ultrasonographic studies, 13,15 the diagnosis of vermian agenesis (especially partial agenesis) cannot be made before 18 weeks' gestation; therefore, we began vermis measurements at this time.…”

Section: Discussionmentioning

confidence: 99%

Three‐Dimensional Ultrasonography of the Fetal Vermis at 18 to 26 Weeks' Gestation

Zalel

Yagel

Achiron

et al. 2009

J of Ultrasound Medicine

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Objective. The purpose of this study was to establish the normality of the fetal vermis, ie, the time of appearance of the primary fissure, as well as its measurements between 18 and 26 weeks' gestation, using 3-dimensional (3D) ultrasonography. Methods. A prospective cross-sectional study of normal singleton pregnancies was conducted. Examinations were performed with high-resolution transabdominal ultrasonography using the axial plane in 173 fetuses between 18 and 26 weeks' gestation. Postprocessing measurements of the fetal vermis were done with 4-dimensional software using static volume contrast imaging and tomographic ultrasound imaging in the C-plane. Detection of the primary fissure was evaluated in all cases, and the time of appearance was documented. Results. Adequate vermis measurements were obtained in 173 fetuses. Vermian length as a function of gestational age was expressed by regression equations, and the correlation coefficients were found to be highly statistically significant (P < .001). The normal mean ± 2 SD for each gestational week was defined. The primary fissure was observed at 24 weeks' gestation in all cases, at 22 weeks in 94% of cases, and as early as 18 weeks in 40%. Conclusions. This 3D study documents the appearance of the primary fissure and presents the normal range of vermian measurements, confirming normal development of the fetal vermis starting as early as 18 weeks' gestation. It also shows an easy method for visualizing the vermis with 3D ultrasonography at every gestational week regardless of fetal presentation.

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Section: Discussionmentioning

confidence: 99%

Three‐Dimensional Ultrasonography of the Fetal Vermis at 18 to 26 Weeks' Gestation

Zalel

Yagel

Achiron

et al. 2009

J of Ultrasound Medicine

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“…Porém, devemos tomar cuidado em diagnosticar precocemente anomalias da fossa posterior antes da 18 a semana. Certamente, até essa época algumas estruturas da fossa posterior, como 4º ventrículo, cisterna magna, vermis e hemisférios cerebelares, ainda não estão complemente desenvolvidos e, portanto, podem simular uma imagem anômala 19 . Em nosso estudo identificamos o cerebelo na fossa posterior na maioria dos exames ultra-sonográficos.…”

Section: Resultsunclassified

Avaliação Ultra-Sonográfica do Crescimento Fetal com uso do Diâmetro Transverso do Cerebelo

Nery¹,

Moron²,

Kulay³

2000

Rev. Bras. Ginecol. Obstet.

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“…5 Identification of the fetal fourth ventricle is essential for the characterization of abnormalities of the posterior fossa, cystic masses, hydro-cephaly, and enlarged fourth ventricles. However, little information is found in the English literature 2,[6][7][8][9][10][11][12] regarding the normal size of the fourth ventricle throughout gestation, and no nomograms could be found in the published works.…”

Section: Discussionmentioning

confidence: 99%

“…13 The superior and inferior portions of the cerebellar vermis do not achieve their mature appearance until week 18. 9,10 Transvaginal ultrasonography allows a better evaluation of the posterior fossa and therefore is an important tool for a precise diagnosis of posterior fossa malformations. 11 An isolated enlarged fourth ventricle found in the early second trimester should be followed, but no decisions should be based solely on this isolated finding.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic Nomograms of the Fetal Fourth Ventricle

Goldstein

Makhoul

Tamir

et al. 2002

J of Ultrasound Medicine

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Objective. To characterize normal growth of the fetal fourth ventricle on ultrasonography throughout pregnancy. Methods. Consecutive biometric measurements and fetal organ scans were obtained from 299 patients undergoing fetal anatomic surveys between 13 and 40 weeks' gestation. Using 7-and 3.5-MHz transducers for early (13-to 17-week) and late (>17-week) examinations, respectively, we scanned the fetal head in the axial plane with special focus on the posterior fossa of the brain. The fourth ventricle was identified, and its anteroposterior diameter and width were measured. A "triangle" formula was used for calculating its circumference and area. Results. The fourth ventricle was shown as a hypoechoic triangle below the level of the cerebellum. A linear regression line of the fourth ventricle was observed across gestational age, and a first-degree correlation was found between gestational age and anteroposterior diameter of the fourth ventricle (r = 0.894; P < .0001; y = -0.84 + 0.23 × gestational age), its width (r = 0.657; P < .0001; y = 3.82 + 0.14 × gestational age), its circumference (r = 0.843; P < .0001; y = 5.11 + 0.58 × gestational age), and its area (r = 0.844; P < .0001; y = -10.11 + 1.17 × gestational age). Twelve enlarged fourth ventricles were found between 14 and 16 weeks, but results of follow-up scans at 20 weeks were normal. Conclusions. An isolated enlarged fourth ventricle in the early second trimester might represent a normal variant; it should be followed, but decisions about the fate of the pregnancy should not be based solely on this finding. Key words: central nervous system; fetus; fourth ventricle; prenatal diagnosis; ultrasonography.Received December 27, 2001, from the Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel (I.G., I.R.M., B.-S.R.); Department of Epidemiology, Technion Faculty of Medicine, Haifa, Israel (A.T.); and Department of Obstetrics and Gynecology, Hospital Dr R. A. Calderon, San Jose, Costa Rica (D.N.) he fourth ventricle is derived from the rhomboencephalon, the most caudal primary vesicle formed after complete fusion of the neural folds and closure of the caudal neuropore.1 Anatomically, the fourth ventricle is considered a fluid-filled cavity that extends from the aqueduct of Sylvius to the foramen of Magendie and separates the brain stem from the cerebellum. It has a "tentlike" appearance, and the lateral walls are formed by the cerebellar peduncles. The roof is formed by the cerebellar peduncles, the medullary velum, and the cerebellar nodules; the floor is delineated by the surface of the pons and the medulla oblongata. The posterolateral extensions of the fourth ventricle are known as the posterior superior recesses.

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Sonographic anatomy of the developing cerebellum: normal embryology can resemble pathology.

Cited by 77 publications

References 0 publications

Three‐Dimensional Ultrasonography of the Fetal Vermis at 18 to 26 Weeks' Gestation

Three‐Dimensional Ultrasonography of the Fetal Vermis at 18 to 26 Weeks' Gestation

Avaliação Ultra-Sonográfica do Crescimento Fetal com uso do Diâmetro Transverso do Cerebelo

Ultrasonographic Nomograms of the Fetal Fourth Ventricle

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