Sonographic Maturation of Third-Trimester Cerebellar Foliation after Birth

Abstract

ABSTRACT:The development of cerebellar folia of third-trimester preterms has not been described with ultrasound before. We set out to determine normal development of the pons and cerebellar folia for future measurements of hypoplasia and atrophy. Study sonograms were made in preterms admitted to the neonatal intensive care unit with postmenstrual age (PMA) from 25 wk until term. On a weekly basis, transcranial measurements were made in the axial and coronal planes at the asterion with high-frequency transducers (8.5 and 13 MHz). The axial images showed the pons and fourth ventricle. The coronal images showed cerebellar folia and white matter. In the same coronal plane, the depth of cerebellar fissures at the rostral cerebellar convexity could be observed. A total of 172 cranial sonograms were performed on 98 neonates. The development of folia could be measured with ultrasound through the asterion. We showed that pons area, mean of three fissure depths, hemisphere area, and number of folia in the horizontal fissure correlated significantly with PMA. Hemisphere area described the same trend of growth as the transverse cerebellar diameter used in fetal sonography.

Molecular and neuroimaging findings in pontocerebellar hypoplasia type 2 (PCH2): Is prenatal diagnosis possible?

“…Only at age 9 weeks (40 weeks post‐LMP) did a CT scan demonstrate discernible cerebellar hypoplasia. Nomograms for transverse cerebellar diameters during the second trimester have been in clinical use for several decades [Smith, 1986], with a subsequent report of measurements of cerebellar foliation in prematurely born infants at 27 and 34 weeks [Korsten et al, 2006]. Chavez et al 2003 reported a fetal transcerebellar diameter nomogram with special emphasis on the third trimester because the cerebellar structures develop late in gestation making prenatal diagnosis of cerebellar hypoplasia extremely difficult.…”

The clinical presentation of preterm cerebellar haemorrhage

“…Standard imaging was performed through the anterior fontanelle. However, if a lesion in the posterior fossa was suspected, additional imaging was performed at 12–13 MHz through the mastoid fontanelle, also known as the posterolateral fontanelle [8]. Sonograms were obtained using a Sequoia system (Siemens, Mountain View, California), and with Esaote system (Mylab 70, Genova Italy).…”