(Ultrasound Review) In order to determine the benefit of 3-D ultrasonography in diagnosing vertebral defects, nine fetuses with known spina bifida were examined with 2-2-D and 3-D ultrasound. This research from William Beaumont Hospital in Royal Oak, MI was published in the Journal of Ultrasound in Medicine.
"Prenatal diagnosis of spina bifida has steadily improved as a result of maternal serum fetoprotein screening and widespread use of ultrasonography," they reported.
Other research has demonstrated that ultrasound successfully demonstrated spina bifida in 80-85% of cases and determined the defect level within one vertebral segment in 79% of cases. Parental counseling is facilitated through accurate data predicting clinical severity, and should include the level and extent of the vertebral defect. According to the authors, "the main ossification centers (two posterior and one anterior) can be shown by 16 menstrual weeks, although the distal spine may not be fully formed before 22 weeks."
Using Voluson technology, nine fetuses were evaluated using 2-D and 3-D at a mean gestational age of 22 weeks. The following information was obtained: standardized multiplanar views of the fetal spine, and surface rendered coronal views of the spine and ribs. The most superior vertebra with a visible rib was defined as the twelfth thoracic vertebra. Postnatal radiography or MRI was used to determine the true extent and level of the vertebral defect.
The authors reported that for 2-D ultrasound the spinal level agreed to within one vertebral segment in six of nine infants, while 3-D ultrasound agreed to within one vertebral segment in eight of nine fetuses. They concluded that "multiplanar views are generally more informative than rendered views for localizing bony defects of the fetal spine." Also, they reported that 3-D ultrasound improves the characterization of spina bifida by adding further information.
A diagnostic approach for the evaluation of spina bifida by three-dimensional ultrasonographyW Kee et al
Division of fetal imaging, department of obstetrics and gynecology, William Beaumont Hospital, Royal Oak, MI
J Ultrasound Med 2002 June, 21:619-626
By Ultrasound Review
July 19, 2002
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