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Updated: Aug 16, 2025
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Cat-Ear-Line: A Sonographic Sign of Cortical Development?
Nana Matsuzawa1,2, Liona C Poon3, Megumi Machida1
1Fetal Brain Center, CRIFM Prenatal Medical Clinic, Osaka, Japan.
The "cat-ear-line" (CEL) is a normal fetal brain ultrasound finding visible from 19 weeks. Abnormal CEL patterns in utero may indicate a higher risk for malformations of cortical development (MCD).
Area of Science:
- Fetal neuroimaging
- Developmental neuroscience
- Prenatal diagnostics
Background:
- Diagonal echogenic lines, termed "cat-ear-line" (CEL), are common in normal fetal brain neurosonography.
- Abnormal CEL shapes have been observed in fetuses with malformations of cortical development (MCD).
Purpose of the Study:
- To compare the development and appearance of CEL in normal fetuses versus those with MCD.
- To establish CEL as a potential early indicator for MCD.
Main Methods:
- Retrospective analysis of transvaginal 3D neurosonography datasets from 575 control and 39 MCD cases (2014-2020).
- Definition of CEL, pre-CEL (lines within subplate), and abnormal CEL (across subplate and intermediate zone).
Main Results:
- CEL was visualized in 97.9% of control fetuses from 19-30 weeks.
- CEL visualization was significantly lower (40.0%) in the MCD group compared to controls (P < .001).
Conclusions:
- CEL is a typical ultrasound finding in normally developing fetuses from 19 weeks onward.
- Pre-CEL or abnormal CEL patterns at mid-trimester may suggest an increased risk of MCD.
- Maldeveloped CEL could aid in identifying fetuses at risk for MCD.
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