Human Embryonic Growth and Development of the Cerebellum Using 3-Dimensional Ultrasound and Virtual Reality

• Published in: Reproductive Sciences Vol. 20; no. 8; pp. 899 - 908
• Main Authors: Rousian, M., Groenenberg, I. A. L., Hop, W. C., Koning, A. H. J., van der Spek, P. J., Exalto, N., Steegers, E. A. P.
• Format: Book Review Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.08.2013; Springer International Publishing
• Subjects: Adult; Cerebellum - diagnostic imaging; Cerebellum - embryology; Crown-Rump Length; Embryology; Female; Gestational Age; Humans; Image Interpretation, Computer-Assisted; Imaging, Three-Dimensional; Longitudinal Studies; Medicine & Public Health; Observer Variation; Obstetrics/Perinatology/Midwifery; Original Article; Pregnancy; Pregnancy Trimester, First; Prospective Studies; Reproducibility of Results; Reproductive Medicine; Software; Ultrasonography, Prenatal - methods; User-Computer Interface; Young Adult; virtual reality; 4D view; first trimester; cerebellum; 3D ultrasound
• ISSN: 1933-7191; 1933-7205
• DOI: 10.1177/1933719112468950

The aim of our study was to evaluate the first trimester cerebellar growth and development using 2 different measuring techniques: 3-dimensional (3D) and virtual reality (VR) ultrasound visualization. The cerebellum measurements were related to gestational age (GA) and crown-rump length (CRL). Finally, the reproducibility of both the methods was tested. In a prospective cohort study, we collected 630 first trimester, serially obtained, 3D ultrasound scans of 112 uncomplicated pregnancies between 7 + 0 and 12 + 6 weeks of GA. Only scans with high-quality images of the fossa posterior were selected for the analysis. Measurements were performed offline in the coronal plane using 3D (4D view) and VR (V-Scope) software. The VR enables the observer to use all available dimensions in a data set by visualizing the volume as a “hologram.” Total cerebellar diameter, left, and right hemispheric diameter, and thickness were measured using both the techniques. All measurements were performed 3 times and means were used in repeated measurements analysis. After exclusion criteria were applied 177 (28%) 3D data sets were available for further analysis. The median GA was 10 + 0 weeks and the median CRL was 31.4 mm (range: 5.2-79.0 mm). The cerebellar parameters could be measured from 7 gestational weeks onward. The total cerebellar diameter increased from 2.2 mm at 7 weeks of GA to 13.9 mm at 12 weeks of GA using VR and from 2.2 to 13.8 mm using 3D ultrasound. The reproducibility, established in a subset of 35 data sets, resulted in intraclass correlation coefficient values ≥0.98. It can be concluded that cerebellar measurements performed by the 2 methods proved to be reproducible and comparable with each other. However, VR—using all three dimensions—provides a superior method for the visualization of the cerebellum. The constructed reference values can be used to study normal and abnormal cerebellar growth and development.