Purpose or Case Report: The purpose of this exhibit is to describe 3D ultrasonography (3DUS) of the head in neonates. Traditionally, 2D ultrasonography has been used for evaluation of the neonatal brain. 3DUS is a more recent advanced technique in which a volume of tissue is scanned in a single acquisition, and the 3D data set is subsequently manipulated using specialized software. This exhibit reviews current literature relating to 3DUS, demonstrates basic technical aspects of 3DUS, describes 3DUS of normal brain, and illustrates 3DUS features of acquired and congenital neonatal brain disorders.
Methods & Materials: Our method for performing 3DUS of the neonatal head will be reviewed, including description of scanning technique and systematic demonstration of post-processing. Photographs and videos will be used to depict acquisition and reconstruction methods. A variety of cases, including normal brains and pathologic conditions will be used to illustrate these techniques. Comparison of 3DUS to CT and MRI will be provided when available.
Results: 3DUS allows rapid scanning of the entire brain as a volume of tissue using a single sweep. This data can be stored for later analysis, thereby reducing the scan time required at the bedside. Both grayscale and color Doppler 3DUS can be performed. Post-processing methods include multiplanar reformatting, tomographic ultrasound images (TUI), and volumetric reconstruction. Image rendering modes include minimum and maximum, transparency, and surface modes. Unlike 2D neurosonography, brain anatomy can be displayed in orientations other than the original scan plane; three planes can be viewed simultaneously. Data can be reconstructed into axial slices similar to CT and MRI, facilitating comparison between modalities. Volumetric images can be created, including surface and shell displays, and numerical volume analysis. The entities presented with 3DUS will include germinal matrix and intraventricular hemorrhage, parenchymal hemorrhage/infarct, periventricular leukoencephalomalacia, hydrocephalus, and structural malformations.
Conclusions: 3DUS has been shown to provide useful diagnostic information in multiple clinical applications. Our preliminary experience indicates that 3DUS may also be a powerful technique for evaluation of the neonatal brain. 3DUS decreases scan time, allows evaluation of brain anatomy in three dimensions, and allows ventricular volume analysis in hydrocephalus. Reconstruction of data in the axial plane allows comparison with CT and MRI.