Three-dimensional ultrasonographic imaging of the neonatal brain in high-risk neonates: preliminary study.

Abstract

The aim of this investigation was to compare the utility of three‐dimensional ultrasonography versus two‐dimensional ultrasonography in imaging the neonatal brain. Thirty patients in the neonatal intensive care unit underwent two‐dimensional and three‐dimensional ultrasonography. The resultant two‐ and three‐dimensional images recorded on film and three‐dimensional volumes (reviewed on a workstation) were evaluated independently. Comparable numbers of normal and abnormal studies were diagnosed by each modality. Axial images were considered useful in approximately 50% of three‐dimensional cases. Image quality, overall and in the far‐field, was rated higher on two‐dimensional images. Three‐dimensional sonographic acquisition time in the neonatal intensive care unit (1.7 min+/‐0.7 standard deviation) was significantly shorter than that for two‐dimensional sonography (9.0+/‐4.5 min). The total time for evaluation on the three‐dimensional workstation (4.4+/‐1.1 min) was significantly less than that for two‐dimensional images on film (10.6+/‐4.7 min). In conclusion, three‐dimensional ultrasonography is a promising, diagnostically accurate, and efficient imaging tool for evaluation of the neonatal brain; however, visualization must improve before it can replace two‐dimensional ultrasonography.

Potential role of 3DUS in infants and children

“…However, these setbacks are partially outweighed by the potential diagnostic benefit and a shorter scan [10,19]. If significant additional diagnostic information can be retrieved from 3DUS, the additional time necessary for post-processing and datahandling at the workstation may be acceptable, as it currently is for CT and MRI.…”

“…The ability of 3DUS to show any particular structure in all three orthogonal planes allows an improved definition of individual structures and may prove valuable for differential diagnoses, both for fetal and neonatal applications (Fig. 3) [9,10,12,15]. The ventricles can be shown nicely; when enlarged, applying 3D-rendering techniques with grey-scale volumerendering 3DUS inversion, an intuitive visualization of the .…”

“…As the volume acquisition is quick and most of the imaging analysis is performed at the workstation or the US device, without having to be at the patient's bedside. This technique reduces the burden, especially on very sick neonates or preterm infants, by shortening the scan time [10]. However, a conventional two-dimensional US scan for first orientation, and also for adapting image parameters, remains essential.…”

“…It was initially used for gynecologic and obstetric imaging; other applications in adults followed [1][2][3][4][5]. With the introduction of transducers that are useful in children, the first efforts have been undertaken to evaluate its potential in pediatric imaging [6][7][8][9][10][11][12]. This review will (1) present basic methodical aspects of 3DUS to enable an understanding of the underlying physics with its implications for scan technique and results, (2) present some of our local experience, and (3) review the literature.…”

Potential applications of three-dimensional ultrasound in the pediatric urinary tract: pictorial demonstration based on preliminary results

“…In clinical and research settings 3DUS has been initially shown to be beneficial in obstetric and gynecologic applications [10,11]. Now, potential applications in cardiovascular imaging, oncology, neurology, neurosurgery, and interventional radiology are being evaluated, with a reported improvement of volume assessment accuracy, an improved and comprehensive anatomic visualization, and a superior standardization at a low interobserver variability [11,12,13,14,15,16,17,18]; yet, only preliminary reports exist on pediatric 3DUS mainly dealing with the neonatal brain [11,19,20,21,22,23,24].…”