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. 2019 May-Jun;52(3):176-181.
doi: 10.1590/0100-3984.2018.0056.

Ultrasonographic evaluation of the fetal central nervous system: review of guidelines

Hérbene José Figuinha Milani  1 , Enoch Quindere de Sá Barreto  1 , Edward Araujo Júnior  1 , Alberto Borges Peixoto  1   2 , Luciano Marcondes Machado Nardozza  1 , Antonio Fernandes Moron  1
Affiliations

Ultrasonographic evaluation of the fetal central nervous system: review of guidelines

Hérbene José Figuinha Milani et al. Radiol Bras. 2019 May-Jun.

Abstract
in English, Portuguese

Central nervous system malformations constitute the second most common group of anomalies in fetuses. Such malformations have assumed clinical importance because of their association with high rates of perinatal morbidity and mortality. Therefore, it is extremely important to assess the fetal central nervous system during the prenatal period, in order to identify any changes in its development and thereby gain sufficient information to advise parents about pregnancy follow-up, options for fetal therapy, and the timing/type of delivery, as well as the postnatal treatment and prognosis. The objective of this review was to describe the ultrasonographic evaluation of the fetal central nervous system as per the guidelines of the International Society of Ultrasound in Obstetrics and Gynecology.

Malformações do sistema nervoso central são o segundo mais frequente grupo de anomalias que afetam o feto. Elas têm adquirido grande importância em razão da sua associação com altas taxas de morbidade e mortalidade perinatal. Além do mais, é extremamente importante avaliar o sistema nervoso central fetal durante o período pré-natal, de modo a se diagnosticar possíveis mudanças no desenvolvimento e aconselhar os casais sobre o seguimento da gestação, possibilidades terapêuticas fetais, tempo e tipo de parto, tratamento pós-natal e prognóstico. O objetivo desta revisão foi descrever a avaliação do sistema nervoso central fetal por meio das recomendações da International Society of Ultrasound in Obstetrics and Gynecology.

Keywords: Central nervous system; Fetus; Practice guidelines as topic; Ultrasonography.

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Figures

Figure 1
Figure 1
Axial view of the fetal head in the transthalamic plane, showing the CSP (arrow), the thalami (arrowhead), and the hippocampal gyrus (asterisk).
Figure 2
Figure 2
Axial view of the fetal head in the transventricular plane, showing the CSP (arrow) and the posterior horn of the lateral ventricle (arrowhead).
Figure 3
Figure 3
Measurement of the atrium of the lateral ventricle in the axial and transventricular planes, with the calipers positioned on the inner walls of the atrium, at the level of the glomus of choroid plexus.
Figure 4
Figure 4
Axial view of the fetal head in the transcerebellar plane, showing the cerebellum (arrow) and the cisterna magna (CM).
Figure 5
Figure 5
Coronal view of the fetal head in the transfrontal plane, showing the interhemispheric fissure (IHF), the frontal cortex, and the ocular orbits (OC).
Figure 6
Figure 6
Coronal view of the fetal head in the transcaudate plane, showing the interhemispheric fissure (IHF), the CSP, the frontal horns of the lateral ventricles (FH), and the caudate nuclei (CN).
Figure 7
Figure 7
Coronal view of the fetal head in the transthalamic plane, showing the interhemispheric fissure (IHF), the CSP, the corpus callosum (CC), the frontal horns of the lateral ventricles (FH), and the thalami (Ta).
Figure 8
Figure 8
Coronal view of the fetal head in the transcerebellar plane, showing the posterior horns of the lateral ventricles (arrowhead) and the cerebellum (arrow). Note the differentiation between the cerebellar hemispheres and the vermis in the more echogenic central portion of the cerebellum.
Figure 9
Figure 9
Sagittal view of the fetal head in the median sagittal plane, showing the corpus callosum (CC), the CSP, the cerebellar vermis (arrowhead), the tentorium (arrow), the fourth ventricle (4V), and the brain stem (BT).
Figure 10
Figure 10
Sagittal view of the fetal head in the median sagittal plane, showing the pericallosal arteries and their branches.
Figure 11
Figure 11
Sagittal view of the fetal head in the parasagittal plane, showing the three-horn view, the choroid plexus (CP), and the periventricular parenchyma (arrow).
Figure 12
Figure 12
Sagittal view of the spine, showing the conus medullaris (arrow) located between the second and third vertebrae at 24 weeks of gestation.
See this image and copyright information in PMC

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