Re: Vertical Cranial Diameter and Craniosynostoses

From: Terry J DuBose (DuBose@io.com)
Thu May 15 14:12:51 2003


Art, yes, this is one of the main uses that I stressed in FETAL SONOGRAPHY... See the discussion below, from FETAL SONOGRAPHY, p. 166-167, unfortunately the reference numbers did not translate from Framework, which was the original wordprocessor. There is a table of 17 parameters for age on page 97-100... the same table is in Berman & Cohen's OB/GYN Sonography, 2nd ed. p. 362-363.

You can also read more on the 3D fetal head on my web pages at: http://www.io.com/~dubose/3d.html you will find a graph there of the three diameters to age, and a graph of the residuals of the 3 diameters. Note that the average of the 3 diameters will be equal to a normal BPD.

I can fax the table from FETAL SONOGRAPHY, if you wish, it is not available on the Web. Or better yet, I will attach three files to this message... let me know if you have trouble with them....

Also, there was some discussion of fetal head volume measurements in the J Ultrasound in Medicine: "Three-dimensional Fetal Brain volumes" JUM 21:709-711, 2002.

Thanks, for asking... Please let me know how it turns out.

Peace, Terry

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CORONAL FETAL HEAD --------------------------

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--------------------------
INTRODUCTION:

The coronal view of the fetal skull has not been used as often for measurements.,,,,,,, However, we and others have found this view to be valuable for six different reasons:

1) The coronal view facilitates the measurement of the vertical cranial diameter (VCD), which allows an estimation of the cranial volume and the 3D BPD Correction. Goldberg and Kurtz stated that, "It is this measurement that makes the calculated head volumes theoretically more accurate.",

2) The coronal circumference of the fetal cranium is smaller than the transverse head circumference; and therefore the coronal measurements can be obtained at term when the FOD often exceeds the field of view of many transducers.

3) The vertical cranial diameter is most sensitive to head molding. The use of the VCD in three dimensional cranial ages provides more accurate dates for the pregnancy.

4) The coronal view provides anatomical images which include both the bodies and temporal horns of the lateral ventricles. This allows evaluation for hydrocephalus. Other cranial anatomy is also observable in this view, see chapter 9.

5) The curve of the sagittal cranial calvaria gives the coronal measurements a fairly large of tolerance of variation of the planes in which acceptable measurements can be obtained. See Figures 8-11 and 8-12.

6) The routine use of three dimensional measurements insures the fetal cranium is studied more closely. Anomalies are less likely to be missed with this additional view.

This section will discuss the geometry of the coronal view and how the measurements are taken. It will also provide some statistical analysis of these measurements. The anatomy of the brain will be discussed in Chapter 9, and the use of the coronal measurements used in combination with other measurements for cranial volume estimates will be discussed later in this chapter.

Figure 8-2B shows a coronal view of the fetal skull with the measurements which will be discussed here. The BPD in this view was discussed above. This discussion will take up with the coronal triangle and it's various measurements.

--
Peace, Terry J DuBose, M.S., RDMS
University of Arkansas for Medical Science
Little Rock, Arkansas, USA



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