Role of Three and Four-Dimensional Ultrasound in Diagnosis of Neurologicalfetalcongenital Anomalies
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 2
Abstract
Objective: The present work is designed to review the role of three dimensional and four dimensional (3D and 4D) ultrasound in diagnosis of neurological fetal congenital malformations. Patients and methods: Over the study period (June 2017 to September 2018), about200 fetuses were evaluated by ultrasound. Out of the total number of women scanned with 2D & 3D/4D ultrasound; 11 neurological anomalies (5.5%) were detected and analyzed in 11 women with 11 fetuses. Inclusion criteria included US findings suggestive of neurological fetal anomalies.Initially, traditional 2DUS was routinely performed.The patients were then evaluated by 3DUS to determine whether data obtained by 3D imaging correlated to the 2D findings. Our protocol also included 4DUS while fetal movements were monitored in real time. The 3D images were compared with the 2D images and the ultrasound data given a score and analyzed to determine whether the same, additional or conflicting information was found. The results obtained with 2D and 3D US were compared; whereby the 3D technique was defined as advantageous when the malformation was identified or appreciated more rapidly or better regarding localization, size and depth or when a malformation undetected with 2D US was found. Outcome: the accuracy of diagnosis was ascertained by pathology of terminated pregnancies, post natal clinical examination, imaging & surgery performed in some cases Results: 3D/4D ultrasound showed equal results such as 2DUS in 7 out of 11 anomalies (63.6%), while it was advantageous than 2DUS in 4 anomalies (36.4%). The advantage results were obtained for spina bifida myelomeningocele (MMC) and encephalocele; while it was equal as regard to hydranencephaly, anencephaly, agenesis of the corpus callosum, porencephalic cyst, intraventricular hemorrhage and holoprosencephaly. Conclusion: According to our findings, 3D/4D US has shown advantage over 2DUS in demonstrating some anomalies of nervous system. Currently, the gold standard for evaluation of fetal anomalies remains by 2D US assessment, with 3D/4D US having an adjunctive role.
Authors and Affiliations
Ahmed F. El- Deek, Maged M. Ghanem, Waled Ayad
Keywords
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- EP ID EP464313
- DOI 10.9790/0853-1802017276.
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