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Three‐dimensional ultrasound imaging and measurement of nasal bone length, prenasal thickness and frontomaxillary facial angle in normal second‐ and third‐trimester fetuses
Author(s) -
Vos F. I.,
De JongPleij E. A. P.,
Ribbert L. S. M.,
Tromp E.,
Bilardo C. M.
Publication year - 2012
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.10058
Subject(s) - medicine , nasal bone , ultrasound , gestational age , sagittal plane , 3d ultrasound , nuclear medicine , reference range , fetus , third trimester , reference values , gestation , first trimester , pregnancy , radiology , anatomy , biology , genetics
Objectives To assess the feasibility of nasal bone length (NBL), prenasal thickness (PT) and frontomaxillary facial (FMF) angle measurements performed on the same three‐dimensional (3D) multiplanar‐corrected profile view in healthy second‐ and third‐trimester fetuses, to create reference ranges and to review published measurement techniques. Methods 3D volumes of 219 healthy second‐ and third‐trimester fetuses were retrospectively analyzed. The quality of images and measurability of the markers were assessed with 5‐point and 3‐point scoring systems, respectively. Measurements of NBL (with care to exclude the frontal bone), PT and FMF were obtained in the exact mid‐sagittal plane. Reference ranges were constructed based on measurements from images with high‐quality (4 or 5 points) and high measurability (2 or 3 points) scores and compared with those in the most relevant published literature. Results A high‐quality score was assigned to 111 images. Among these, a high measurability score was significantly more often achieved for NBL (98.2%) and PT (97.3%) than for the FMF angle (26.1%) ( P < 0.001). Both NBL (NBL = − 6.927 + (0.83 × GA) − (0.01 × GA 2 )) and PT (PT = (0.212 × GA) − 0.873) (where GA = gestational age) showed growth with gestation, with less pronounced growth for NBL after 28 weeks. Our reference range for the NBL showed a systematically smaller length than those in other two‐dimensional (2D) ultrasound‐based publications. The FMF angle measurements that we obtained did not show a significant change with GA. Conclusions NBL and PT are easily measured using 3D ultrasound whereas FMF angle measurement is more challenging. When it is measured in the exact mid‐sagittal plane and care is taken to exclude the frontal bone, measurements of the NBL are systematically smaller than those in previous 2D ultrasound‐based publications. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.