www.medicinafetalbarcelona.org/

Advanced brain ultrasound

Elisenda Eixarch

Maternal Fetal Medicine Research Group

Hospital Clinic-University of Barcelona, Spain

12th World Congress in Fetal Medicine

www.medicinafetalbarcelona.org/

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basic examination CNS

Sonographic examination of the fetal central nervous system: guidelines for performing the ‘basic examination’ and the ‘fetal neurosonogram’.UOG.2007

www.medicinafetalbarcelona.org/

basic examination CNS

Sylvian fissure

Appears 18 w

Identified 22 w

Parieto-occipital fissure

Appears 18 w

Identified 23 w

LR. Pistorius Ultrasound Obstet Gynecol 2010; 36: 700

Superior temporal sulcus

Appears 23 w

Identified 26 w

www.medicinafetalbarcelona.org/ Sonographic examination of the fetal central nervous system: guidelines for performing the ‘basic examination’ and the ‘fetal neurosonogram’.UOG.2007

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advanced examination CNS

midsagittal parasagittal transfrontal transcaudate transthalamic transcerebellar

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Coronal planes

transfrontal transcaudate transthalamic transcerebellar

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Interhemispheric fissure

Anterior horns

Ocular orbits

Sphenoidal bone

Transfrontal plane

Sagittal sinus

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Transcaudate plane

Anterior horns

Cavum septum pellucidum

Caudate nuclei

Genu corpus callosum

Subarachnoid space

Sinocortical space

Craniocortical space

Anterior horns

Sondhi et al. Acta Pædiatrica. 2008; 97: 738–44; Malinger et al. Prenat Diagn. 2000; 20: 890-3

Interhemispheric fissure

Sagittal sinus

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Transcaudate plane

Sondhi et al. Acta Pædiatrica. 2008; 97: 738–44; Malinger et al. Prenat Diagn. 2000; 20: 890-3

Anterior hors

Agenesia corpus callosum

Hyperecogenicity

Anterior horns

Cavum septum pellucidum

Caudate nuclei

Genu corpus callosum

Subarachnoid space

Interhemispheric fissure

Sagittal sinus

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Thalami

Sylvian fissure

Insula

Body corpus callosum

Transthalamic plane

Cortical displasia

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Occipital horns

Cerebellar hemispheres Vermis

Calcarine fissure Choroid plexus

Transcerebellar plane

Posterior fossa cyst

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Coronal planes

midsagittal parasagittal

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Cavum septum pellucidum

Body Corpus callosum

Cingulate fissure

Fornix

Vermis Pons

IV ventricle

Splenium Corpus

callosum

Midsagittal plane

Cerebellar tentorium

Cavum vergae

III ventricle

Cisterna magna

Genu Corpus

callosum

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Midsagittal plane

Achiron et al. Ultrasound Obstet Gynecol 2001; 18: 343–347

Genu Corpus

callosum

Cavum septum pellucidum

Body Corpus callosum

Fornix

Vermis Pons

IV ventricle

Splenium Corpus

callosum

Cerebellar tentorium

Cavum vergae

III ventricle

Cisterna magna

Cingulate fissure

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Midsagittal plane

Corpus Callosum agenesis

Corpus callosum digenesis

Body Corpus callosum Cingulate fissure

Splenium Corpus

callosum

Genu Corpus

callosum

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Midsagittal plane

Malinger et al. Prenat Diagn. 2001; 21: 687–92

Genu Corpus

callosum

Cavum septum pellucidum

Body Corpus callosum

Fornix

Vermis Pons

IV ventricle

Splenium Corpus

callosum

Cerebellar tentorium

Cavum vergae

III ventricle

Cisterna magna

Cingulate fissure

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Midsagittal plane

primary

fissure

secondary

fissure

fastigium

tentorium

Dandy Walker malformation

Blake’s pouch cyst

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Frontal horn

Cerebellar hemisfere

Temporal horn

Caudate

Choroid plexus

Parasagittal plane

Occipital horn

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advanced examination CNS

Calcarine fissure

Appears 18 w

Identified 23 w

Cingulate fissure

Appears 22 w

Identified 26 w

LR. Pistorius Ultrasound Obstet Gynecol 2010; 36: 700

www.medicinafetalbarcelona.org/

Axial planes are not enough for complete evaluation of CNS pathology

Coronal and sagittal planes are essential for diagnosis of corpus callosum and

posterior fossa anomalies

Neurosonography tips:

Be systematic

Bear in mind gestational age

Take home messages

eixarch@clinic.ub.es

Thank you

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