Feasibility of brain volumetric analysis and reconstruction of images by transfontanel three-dimensional ultrasound

Based on the authors' experience with reconstruction of the heart using thr ee-dimensional echocardiography, the authors assessed the feasibility of th ree-dimensional reconstruction of brain images using transfontanelle ultras ound in selected cases of infants with abnormal intracranial findings. A co nventional 5-MHz ultrasound transducer inside a transducer holder was rotat ed 180 degrees around its vertical axis using a computer-controlled stepper motor to acquire multiple sequential cross-sections of the brain. The raw digital data of this three-dimensionally recorded dataset were transferred to a PC-based workstation for further analyis. The reconstruction of the th ree-dimensional brain images and volumetric analysis were undertaken using a new dedicated software capable of three-dimensional reconstruction and vo lumetric analysis (Echo-PAC-3D, version 1.2 Beta, GE Vingmed, Horton, Norwa y). The reconstruction of sequential slices from the stored three-dimension al data allowed the visualization of the epicortical extension and volumetr ic measurements of the focal ischemic infarction in the superior tempoparie tal lobe in a ii-week-old newborn with a focal ischemic brain lesion. In ot her 2-week-old newborns, the extension and volume of a periventricular hemo rrhage was visualized by three-dimensional reconstruction of coronal cross- sectional images from the acquired three-dimensional dataset. The three-dim ensional reconstruction of the lateral ventricles allowed the three-dimensi onal visualization and estimation of ventricular dilatation in milliliters in an 8-week-old infant with hydrocephalus. Three-dimensional reconstructio n of brain images and volume estimation of brain lesions and cavities by ul trasound may provide new insights into the morphology and extension of ultr asonographically visible brain lesions.