First-trimester fetal neurosonography: technique and diagnostic potential

Area of Science:

• Medical Imaging
• Fetal Medicine
• Neurosonography

Background:

• Most fetal brain abnormalities develop in the first trimester but are often not detected until the second trimester.
• Current first-trimester ultrasound guidelines for fetal head structures are limited, leading to missed diagnoses.
• Advanced neurosonography could improve early detection rates.

Purpose of the Study:

• To review the best practices for assessing the normal fetal brain using expert multiplanar neurosonography in the first trimester.
• To illustrate early sonographic findings of major fetal brain abnormalities.

Main Methods:

• Review of existing literature and guidelines on first-trimester fetal neurosonography.
• Description of advanced multiplanar techniques for detailed fetal brain assessment.
• Presentation of sonographic images and characteristics of common fetal brain anomalies.

Main Results:

• Current guidelines for first-trimester ultrasound visualize limited fetal head structures.
• Acrania, alobar holoprosencephaly, and cephalocele are often detected early.
• Many other significant fetal brain abnormalities are missed until the midtrimester.

Conclusions:

• Extending first-trimester ultrasound to include detailed neurosonography can significantly improve the detection of fetal brain abnormalities.
• Expert multiplanar neurosonography allows for earlier diagnosis and management of congenital brain anomalies.
• Enhanced early ultrasound assessment is vital for improved prenatal care and outcomes.