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Updated: Aug 7, 2026
10:02
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
First-trimester fetal neurosonography
Shreyasi Sharma1, Anindita Sanyal1, Asma Khalil2
1Fetal Medicine and Genetics Centre, Gurgaon, India.
Best Practice & Research. Clinical Obstetrics & Gynaecology
|August 5, 2026
Summary
First-trimester ultrasound now allows detailed fetal brain assessment, detecting major structural anomalies early. Advances enable earlier diagnosis of conditions like spina bifida and ventriculomegaly.
Area of Science:
- Medical Imaging
- Neuroembryology
- Fetal Medicine
Background:
- Historically, detailed fetal brain evaluation was limited to the mid-trimester due to developmental and technical constraints.
- Advances in ultrasound technology and understanding of early neuroembryology have enabled earlier neurosonographic assessments.
- Standardized scanning planes have been refined, shifting the paradigm for fetal brain anomaly detection.
Purpose of the Study:
- To evaluate the capability of first-trimester ultrasound for structured neurosonographic assessment of the developing fetal brain.
- To identify major structural anomalies and early intracranial markers detectable in the first trimester.
- To explore emerging markers for enhanced early detection of specific fetal brain abnormalities.
Main Methods:
- Utilizing advanced first-trimester ultrasound for structured neurosonographic assessment.
- Applying standardized scanning planes for intracranial anatomy evaluation.
- Assessing early indirect intracranial markers, including posterior fossa anatomy and quantitative indices (e.g., brainstem-to-occipital bone ratio).
- Investigating emerging markers like choroid plexus-to-ventricle ratios and Doppler evaluation of the pericallosal artery.
Main Results:
- Major structural anomalies (acrania-exencephaly sequence, holoprosencephaly, encephalocele) are reliably detectable in the first trimester.
- Early indirect intracranial markers significantly improve detection rates for open spina bifida and Chiari II malformation.
- Emerging markers aid in the early identification of ventriculomegaly and agenesis of the corpus callosum.
Conclusions:
- First-trimester ultrasound is effective for structured neurosonographic assessment, detecting significant early fetal brain anomalies.
- While many anomalies are detectable, some involving later-developing structures may remain undetected at this stage.
- The findings support a shift towards earlier, more comprehensive fetal neurosonography.
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