Evaluation Of 2D Versus 4D Ultrasonography On Midline Structures Of The Fetal Brain In The Second

Background: Midline brain structures are critical for normal morphogenesis and function of the fetal brain. However, it is a diagnosis of congenital anomaly of midline brain structures. Job Objectives: This study aims to evaluate the role of 2D versus 4D ultrasound in the diagnosis of midline structures of the fetal brain in the second trimester of pregnancy. Patients and methods: 200 pregnant women in the second trimester [18–22 weeks] were selected. They are evaluated clinically to check the well-being of the woman and fetus. Then an examination of the midline stricture of the fetal brain is carried out using two- and four-dimensional ultrasound, which aims to find any abnormalities in the midline structure of the fetal brain. Both scans were compared with postnatal transcranial ultrasound. Results: 2D ultrasound did not detect abnormalities in 194 of 200 fetuses [97.0%], and 4 cases [2.0%] had megacisterna magna, and 2 cases [1.0%] had encephalomylocele, which was detected by 4D and confirmed by postnatal transcranial ultrasound. 4D ultrasound found 2 cases [1.0%] of Dandywalker malformation, which were confirmed by postnatal transcranial ultrasound. There was complete agreement between prenatal 4D ultrasound and postnatal transcranial ultrasound. Prenatal 2D ultrasound had a sensitivity of 75.0%, specificity of 100.0%, PPV of 100.0%, NPV of 98.7% and overall accuracy of 99.0%. Otherwise, prenatal 4D ultrasound is 100.0% sensitive and specific. Conclusion: 4D ultrasound shows superiority in the diagnosis and confirmation of fetal brain midline structural abnormalities. Additionally, prenatal 4D ultrasound was 100.0% sensitive compared to postnatal transcranial ultrasound.