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      Comparison of Fetal Cerebellum and Cisterna Magna Length by 2D and 3D Ultrasonography between 18 and 24 Weeks of Pregnancy

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          Abstract

          To compare the fetal cerebellum and cisterna magna length measurements by means of two- (2DUS) and three-dimensional (3DUS) ultrasonography using the three-dimensional extended imaging (3D XI), a cross-sectional study with 69 healthy pregnant women between 18 and 24 weeks was performed. For the measurements by 2DUS, the axial planes were used and for the 3DUS a sequence of adjacent axial slices (multislice view). To evaluate the difference between the two techniques, we used the Wilcoxon test. To evaluate the correlation between the cerebellum and cisterna magna length measurements and the gestational age, we used the Spearman correlation coefficient ( r). For the calculation of reproducibility, we used the intraclass correlation coefficient (ICC). The mean of the transverse and anterior-posterior diameter of cerebellum and cisterna magna by 3DUS was 9.23 and 6.62 mm, respectively. It was observed that the average of the measurements obtained by 3DUS was significantly higher, 0.76 and 1.02 mm for the length of the cerebellum and cisterna magna, respectively ( P < 0.001). There was a high correlation between the length measurement of the cerebellum 3D ( r = 0.940, P < 0.001), but low correlation of cisterna magna 3D ( r = 0.462, P = 0.080) with the gestational age. There was good intra- and interobserver reproducibility for the cerebellum and cisterna magna 3D with ICC = 0.792 , 0.668, 0.691, and 0.287, respectively. The measurements of the fetal cerebellum and cisterna magna length by 3DUS using the software 3D XI were significantly higher than those obtained by 2DUS.

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          Statistical methods for assessing agreement between two methods of clinical measurement.

          In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old. Such investigations are often analysed inappropriately, notably by using correlation coefficients. The use of correlation is misleading. An alternative approach, based on graphical techniques and simple calculations, is described, together with the relation between this analysis and the assessment of repeatability.
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            Neuro-Anatomia Funcional

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              Assessment of fetal cerebellar volume using three-dimensional ultrasound.

              The purposes of this study were to assess the fetal cerebellar volume during normal gestation using three-dimensional (3-D) ultrasound (US) and to establish a normal chart of fetal cerebellar volume using Altman's model of statistics. In total, 231 healthy fetuses were studied for assessment of cerebellar volume using a 3-D US volume scanner. The fetuses to be studied were selected to give a cross-sectional series (i.e., each fetus was examined only once). Polynomial regression analysis was calculated to find the best-fit model using gestational age as the independent variable and cerebellar volume as the dependent variable. Altman's model was used to calculate the age-related reference centiles for the variance of cerebellar volume. In addition, common fetal growth indices, such as biparietal diameter, occipitofrontal diameter, head circumference, abdominal circumference, femur length and estimated fetal weight, were also measured for the correlation between cerebellar volume and these indices. Our results indicated that the fetal cerebellar volume was highly correlated with gestational age in normal pregnancies with the best-fit polynomial regression equation of a second-order (r = 0.91, p < 0.0001). In addition, fetal cerebellar volume in normal gestation is also highly correlated with common fetal growth indices, such as biparietal diameter, occipitofrontal diameter, head circumference, abdominal circumference, femur length and estimated fetal weight (all p < 0.0001). Following the Altman's model, a normal growth chart of fetal cerebellar volume was established for clinical reference. In conclusion, with 3-D US, the assessment of fetal cerebellar volume becomes feasible. We believe that fetal cerebellar volume assessed by 3-D US may be useful in detecting cerebellar hypoplasia and relevant syndromes prenatally.
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                Author and article information

                Journal
                ISRN Obstet Gynecol
                ISRN Obstet Gynecol
                ISRN.OBGYN
                ISRN Obstetrics and Gynecology
                International Scholarly Research Network
                2090-4436
                2090-4444
                2012
                14 November 2012
                : 2012
                : 286141
                Affiliations
                1Department of Obstetrics and Gynecology, Medical Science College of Santa Casa of São Paulo (FCMSCSP), 05303-000 São Paulo, SP, Brazil
                2Department of Obstetrics, Federal University of São Paulo (UNIFESP), 05303-000 São Paulo, SP, Brazil
                Author notes
                *Edward Araujo Júnior: araujojred@ 123456terra.com.br

                Academic Editors: K. Chan and H. Rehder

                Article
                10.5402/2012/286141
                3504390
                23209923
                866c2568-ccbc-42da-a8ad-79055e1056e9
                Copyright © 2012 Fernanda Silveira Bello de Barros et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 August 2012
                : 8 October 2012
                Categories
                Research Article

                Obstetrics & Gynecology
                Obstetrics & Gynecology

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