REVISTA DE EDUCATIE MEDICALA CONTINUA DEDICATA GINECOLOGILOR,
OBSTETRICENILOR, MOASELOR SI ASISTENTILOR MEDICALI DIN ROMANIA

<- Home <- Arhive <- Anul 7, Nr. 24, Mai 2019



RevistaGinecologia7(24)8-12(2019)
© VERSA PULS MEDIA, S.R.L.


Extending the basic fetal CNS examination at the second and third trimester scan

MC Comănescu, EM Barbu, N Cernea, AC Comănescu


Rezumat: Introduction. The basic guidelines provide the diagnosis of most anomalies or at least help the examiner observe there is something wrong and refer the case to a specialised unit. Fetal neurosonography is a complex examination that needs time and making it routinely in a complete form (with multiple coronal and sagittal sections) may not be cost-efficient. We analyzed if some elements of advanced neurosonography, together with color Doppler, would improve the examination, increase the diagnostic rate and decrease the referred case percentage, but also if they are feasible or prolong the examination time with minimal benefits. Materials and method. The new parameters used in our protocol were: sagittal image with the corpus callosum and vermis; color Doppler evaluation on a median approach with the pericallosal artery and Galen’s vein, and an axial approach with the circle of Willis, targeting the evaluation of vascular anomalies; acquiring a 3D volume of the fetal head for diagnostic purposes, but also for storing in a “3D volumes library”. Result. After the evaluation of 763 cases, we noticed an extension of the examination of about three minutes, and the target was achieved in over 90% of the cases, the most difficult being the vascular median view. The use of new techniques helped us demonstrate more anomalies or anatomic variants, among which a Galen’s vein aneurysm, and also offered the possibility of using the 3D volume library and offline examination for retrospective evaluation of certain cases. Conclusions. We believe that the new parameters had a good feasibility, they did not prolong the examination time, and brought new and more precise diagnosis. The benefits for the pathological cases were proved by the cases reported. Also, the existence of an ultrasound volume data base allows retrospective evaluation of cases and allows for new, sometimes better images, for later in pregnancy or even postnatally.
Cuvinte cheie: neurosonography, color Doppler, 3D ultrasound.

Full Text in PDF
© 2008-2019 revistaginecologia.ro. All rights reserved
created by if else factory