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Ultrasound Obstet Gynecol ; 38(6): 620-4, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-21308843

RESUMEN

OBJECTIVES: To describe the sonographic appearance of the structures of the posterior cranial fossa in fetuses at 11 + 3 to 13 + 6 weeks of pregnancy and to determine whether abnormal findings of the brain and spine can be detected by sonography at this time. METHODS: This was a prospective study including 692 fetuses whose mothers attended Innsbruck Medical University Hospital for first-trimester sonography. In 3% (n = 21) of cases, measurement was prevented by fetal position. Of the remaining 671 cases, in 604 there was either a normal anomaly scan at 20 weeks or delivery of a healthy child and in these cases the transcerebellar diameter (TCD) and the anteroposterior diameter of the cisterna magna (CM), measured at 11 + 3 to 13 + 6 weeks, were analyzed. In 502 fetuses, the anteroposterior diameter of the fourth ventricle (4V) was also measured. In 25 fetuses, intra- and interobserver repeatability was calculated. RESULTS: We observed a linear correlation between crown-rump length (CRL) and CM (CM = 0.0536 × CRL - 1.4701; R2 = 0.688), TCD (TCD = 0.1482 × CRL - 1.2083; R2 = 0.701) and 4V (4V = 0.0181 × CRL + 0.9186; R2 = 0.118). In three patients with posterior fossa cysts, measurements significantly exceeded the reference values. One fetus with spina bifida had an obliterated CM and the posterior border of the 4V could not be visualized. CONCLUSIONS: Transabdominal sonographic assessment of the posterior fossa is feasible in the first trimester. Measurements of the 4V, the CM and the TCD performed at this time are reliable. The established reference values assist in detecting fetal anomalies. However, findings must be interpreted carefully, as some supposed malformations might be merely delayed development of brain structures.


Asunto(s)
Biometría/métodos , Cerebelo/diagnóstico por imagen , Cisterna Magna/diagnóstico por imagen , Fosa Craneal Posterior/diagnóstico por imagen , Cuarto Ventrículo/diagnóstico por imagen , Columna Vertebral/diagnóstico por imagen , Ultrasonografía Prenatal/métodos , Abdomen , Cerebelo/embriología , Cisterna Magna/embriología , Fosa Craneal Posterior/embriología , Largo Cráneo-Cadera , Estudios de Factibilidad , Femenino , Cuarto Ventrículo/embriología , Edad Gestacional , Humanos , Embarazo , Primer Trimestre del Embarazo , Estudios Prospectivos , Valores de Referencia , Reproducibilidad de los Resultados , Columna Vertebral/embriología
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