Download PDF
Ultrasound Int Open 2016; 02(04): E124-E128
DOI: 10.1055/s-0042-119952
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Fetal Cerebellar Vermis Circumference Measured by 2-Dimensional Ultrasound Scan: Reference Range, Feasibility and Reproducibility

M. Spinelli
1   Department of Clinical Research, Prenatal Medicine, Inselspital Bern Universitatsklinik fur Frauenheilkunde, Bern, Switzerland
,
C. Sica
2   Obstetrics and Gynecology, Private Centre "Diagnostica ecografica e prenatale Aniello Di Meglio s.r.l.", Naples, Italy
,
L. D. Meglio
2   Obstetrics and Gynecology, Private Centre "Diagnostica ecografica e prenatale Aniello Di Meglio s.r.l.", Naples, Italy
,
D. Bolla
3   OB/GYN, University of Bern, Bern, Switzerland
,
L. Raio
3   OB/GYN, University of Bern, Bern, Switzerland
,
D. Surbek
4   OB & GYN, Inselspital, Bern, Switzerland
› Author Affiliations
Further Information

Publication History

received 12 February 2016

accepted 04 October 2016

Publication Date:
24 November 2016 (online)

   Permissions and Reprints

Abstract

Purpose: To provide 2-dimensional ultrasonographic (2D-US) normograms of cerebellar vermis biometry, as well as to evaluate the feasibility and the reproducibility of these measurements in clinical practice.

Materials and Methods: A prospective cross-sectional study of 328 normal singleton pregnancies between 18 and 33 weeks of gestation. Measurements of the fetal cerebellar vermis circumference (VC) in the mid-sagittal plane were performed by both a senior and a junior operator using 2D-US. VC as a function of gestational age (GA) was expressed by regression equations. In 24 fetuses 3-dimensional (3D) reconstructed planes were obtained in order to allow comparisons with 2D-US measurements. The agreement between 2D and 3D measurements and the interobserver variability were assessed by interclass correlation coefficients (ICC).

Results: Satisfactory vermis measurements could be obtained in 89.9% of cases. The VC (constant= − 12.21; slope=2.447; r=0.887, p<0.0001) correlated linearly with GA. A high degree of consistency was observed between 2D and 3D ultrasound measurements (ICC=0.846 95% CI 679–0.930) as well as between measurements obtained by different examiners (ICC=0.890 95% CI 989–0.945).

Conclusion: 2-dimensional ultrasonographic measurements of cerebellar vermis throughout gestation in the mid-sagittal view seem to be feasible and reproducible enough to be potentially used in clinical practice. Such measurements may supply a tool for accurate identification of posterior fossa anomalies, providing the basis for proper counseling and management and of these conditions.

Key words

prenatal diagnosis - ultrasound 2D - cerebellar vermis
 

  • References

  • 1 Barkovich AJ. Developmental disorders of the midbrain and hindbrain. Front Neuroanat 2012; 6: 1-10
    PubMedGoogle Scholar
  • 2 Rapoport M, van Reekum R, Mayberg H. The role of the cerebellum in cognition and behavior: A selective review. J Neuropsychiatry Clin Neurosci 2000; 12: 193-198
    CrossrefPubMedGoogle Scholar
  • 3 Shevell M, Majnemer A. Clinical features of developmental disability associated with cerebellar hypoplasia. Pediatr Neurol 1996; 15: 337-339
    CrossrefPubMedGoogle Scholar
  • 4 Courchesne E, Yeung-Courchesne R, Press GA, Hesselink JR, Jernigan TL. Hypoplasia of cerebellar vermis lobules VI and VII in autism. N Engl J Med 1988; 318: 1349-1354
    CrossrefPubMedGoogle Scholar
  • 5 American Institute of Ultrasound in Medicine . AIUM practice guidelines for the performance of an antepartum obstetric ultrasound examination. J Ultrasound Med 2010; 29: 157-166
    CrossrefPubMedGoogle Scholar
  • 6 Salomon LJ, Alfirevic Z, Berghella V, Bilardo C, Hernandez-Handrade E, Johnsen SL, Kalache K, Leung KY, Malinger G, Munoz H, Prefumo F, Toi A, Lee W. Practice guidelines for performance of the routine mid-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol 2010; 37: 116-120
    PubMedGoogle Scholar
  • 7 International Society of Ultrasound in Obstetrics & Gynecology Education Committee . Sonographic examination of the fetal central nervous system: Guidelines for performing the basic examination and the fetal neurosonogram. Ultrasound Obstet Gynecol 2007; 29: 109-116
    CrossrefPubMedGoogle Scholar
  • 8 Joubert MEJ, Eisenring JJ, Robb JP, Andermann F. Familial agenesis of the cerebellar vermis. A syndrome of episodic hyperpnea, abnormal eye movements, ataxia and retardation. Neurology 1969; 19: 813-825
    Google Scholar
  • 9 Bordarier C, Aicardi J. Dandy-Walker syndrome and agenesis of the cerebellar vermis: diagnostic problems and genetic counselling. Dev Med Child Neurol 1990; 32: 285-294
    PubMedGoogle Scholar
  • 10 Zalel Y, Seidman D.S, Brandt N. et al. The development of the fetal vermis: an in utero sonographic evaluation. Ultrasound Obstet Gynecol 2002; 19: 136-139
    CrossrefPubMedGoogle Scholar
  • 11 Rizzo G, Pietrolucci M.E, Mammarella S et al. Assessment of cerebellar vermis biometry at 18–32 weeks of gestation by three-dimensional ultrasound examination. The Journal of Maternal-Fetal and Neonatal Medicine 2012; 25: 519-522
    PubMedGoogle Scholar
  • 12 Viñals F, Muñoz M, Naveas R et al. The fetal cerebellar vermis: anatomy and biometric assessment using volume contrast imaging in the C-plane (VCI-C). Ultrasound Obstet Gynecol. 2005; 26: 622-627
    CrossrefPubMedGoogle Scholar
  • 13 Rizzo G, Pietrolucci M.E, Capponi A. Assessment of corpus callosum biometric measurements at 18–32 weeks gestation by 3-dimensional sonography. J Ultrasound Med 2011; 30: 47-53
    CrossrefPubMedGoogle Scholar
  • 14 Royston P, Wright EM. How to construct 'normal ranges' for fetal variables. Ultrasound Obstet Gynecol. 1998; 11: 30-38
    CrossrefPubMedGoogle Scholar
  • 15 Robinson AJ. Inferior vermianhypoplasia – preconception, misconception. Ultrasound Obstet Gynecol 2014; 43: 123-136
    CrossrefPubMedGoogle Scholar
  • 16 Sgaier SK, Millet S, Villaneuva MP et al. Morphogenetic and cellular movements that shape the mouse cerebellum; insight from genetic fate mapping. Neuron 2005; 45: 27-40
    PubMedGoogle Scholar
  • 17 Sherer DM, Sokolovski M, Dalloul M et al. Nomograms of the axial fetal cerebellar hemisphere circumference and area throughout gestation. Ultrasound Obstet Gynecol 2007; 29: 32-37
    CrossrefPubMedGoogle Scholar
  • 18 Kapur RP, Mahony BS, Finch L et al. Normal and abnormal anatomy of the cerebellar vermis in midgestational human fetuses. Birth Defects Res A Clin Mol Teratol 2009; 85: 700-709
    CrossrefPubMedGoogle Scholar
  • 19 Dekain LH, Kanel H, El-Bashir HO. Joubert syndrome labeled as hypotonic cerebral palsy. Neurosciences (Riyadh) 2014; 19: 233-235
    PubMedGoogle Scholar
  • 20 Poretti A, Boltshauser E, Doherty D. Cerebellar hypoplasia: differential diagnosis and diagnostic approach. Am J Med Genet Semin Med Genet 2014; 166C: 211-226
    PubMedGoogle Scholar
  • 21 Barzegar M, Malaki M, Sadegi-Hokmabadi E. Joubert syndrome with variable features: presentation of two cases. Iran J Child Neurol 2013; 7: 43-46
    PubMedGoogle Scholar
  • 22 Basson MA, Wingate RJ. Congenital hypoplasia of the cerebellum: developmental causes and behavioral consequences. Front Neuroanat 2013; 3: 1-16
    PubMedGoogle Scholar
  • 23 Ginath S, Lerman-Sagie T, Haratz Krajden K et al. The fetal vermis, pons and brainstem: normal longitudinal development as shown by dedicated neurosonography. J Matern Fetal Neonatal Med 2013; 26: 757-762
    CrossrefPubMedGoogle Scholar
  • 24 Tonni G, Grisolia G, Sepulveda W. Second trimester fetal neurosonography: reconstructing cerebral midline anatomy and anomalies using a novel three-dimensional ultrasound technique. Prenatal Diagnosis. 2014; 34: 75-83
    CrossrefPubMedGoogle Scholar
  • 25 Carroli SG, Porter H, Abdel-Fattah S et al. Correlation of prenatal ultrasound diagnosis and pathological findings in fetal brain anomalies. Ultrasound Obstet Gynecol. 2000; 16: 149-153
    CrossrefPubMedGoogle Scholar
  • 26 Pilu G, Visentin A, Valeri B. The Dandy-Walker complex and fetal sonography. Ultrasound Obstet. Gynecol. 2000; 16: 115-117
    CrossrefPubMedGoogle Scholar
  • 27 Malinger G, Ginath S, Sagie-Lerman T et al. the fetal cerebellar vermis: normal development as shown by transvaginal ultrasound. Prenatal Diagnosis 2001; 21: 687-692
    CrossrefPubMedGoogle Scholar
  • 28 Lei T, Xie HN, Zhu YX, Zheng J, Zhang F, Feng JL. Date-independent parameters: an innovative method to assess fetal cerebellar vermis. Cerebellum 2015; 14: 231-239
    CrossrefPubMedGoogle Scholar