Search

Die Arbeit bietet eine Ubersicht uber die Untersuchung des fetalen Gehirns mithilfe des 3-dimensionalen Ultraschalls und des multiplanaren rendering Modus. Die Routineuntersuchung des Gehirns erfolgt in Querschnittsebenen, bei einer gezielten fetalen Neurosonografie sollten jedoch zusatzlich koronare und sagittale Ebenen eingestellt werden, um ein gesamtes Bild der unterschiedlichen Hirnstrukturen zu erhalten. Da diese Ebenen haufig schwierig zuganglich sind, zeigt die Arbeit auf, wie aus einem digitalen Volumendatensatz ein oder mehrere rekonstruierte Bilder mittels 3D-Untersuchung mit multiplanarem Modus entstehen. Diese konnen entweder als orthogonale Ebenen, als tomografische Ebenen mit parallelen Schnittebenen oder als einzelne Ebene des zu untersuchenden Bereichs dargestellt werden. Dadurch konnen Strukturen wie Corpus callosum, Kleinhirnwurm, der Drei-Hornerblick oder der fetale Hippocampus in einfacher Weise demonstriert werden. Zusatzlich ermoglicht die fruhe Neurosonografie die Darstellung des sich entwickelnden fetalen Gehirns ab 7 Schwangerschaftswochen.

UNLABELLED A Methodical Study: AIM OF THE STUDY To analyse the feasibility of colour and spectral Doppler assessment of blood flow in the fetal right (RPA) and left (LPA) main pulmonary arteries in relation to fetal position and to gestational age. STUDY DESIGN The fetal position was a priori divided into 3 types, depending on whether the fetal heart was visualised apically (Type 1), from the right side (Type 2) or from the left side (Type 3). Three groups A (19-25 weeks gestation), B (26-32) and C (33-39) including 33 consecutive pregnancies each, were examined to document the fetal position as well as the rate of the successful Doppler examinations of the RPA and/or LPA. RESULTS The fetal position Type 2 was most common throughout gestation (in group A = 42%, B = 36%, C = 51%) followed by the type 3 and then type 1. The rate of successful Doppler records from the RPA and LPA depended on the fetal position: In Type 2 RPA in 98%; in Type 3, LPA in 100%; but the apical approach was not effective ( 85%), whereas successful examination of both vessels was unlikely (12%). CONCLUSIONS In the second half of pregnancy, independent of fetal position, Doppler examination of at least one pulmonary artery is successful in most cases, whereas the assessment of both vessels is rather difficult.

As a normal scan at 20 weeks of gestation a pregnant woman was referred at 36 weeks because of a cystic tumour in the fetal kidney. The cyst, 27 mm in diameter, was localised at the cranial pole of the right kidney. A fetal neuroblastoma was suspected. At the fourth day after birth adrenalectomy was performed and the histological finding confirmed the prenatal diagnosis. Two years later the child is healthy. In review of the literature we found that sonographic pattern and localisation of fetal neuroblastoma are different, but in all cases the detection was performed in the third trimester of gestation.