title: Ultrasonographic nomograms of the fetal fourth ventricle: additional tool for detecting abnormalities of the posterior fossa.
abstract: OBJECTIVE
  To characterize normal growth of the fetal fourth ventricle on ultrasonography throughout pregnancy.
  
  
  METHODS
  Consecutive biometric measurements and fetal organ scans were obtained from 299 patients undergoing fetal anatomic surveys between 13 and 40 weeks' gestation. Using 7- and 3.5-MHz transducers for early (13- to 17-week) and late (>17-week) examinations, respectively, we scanned the fetal head in the axial plane with special focus on the posterior fossa of the brain. The fourth ventricle was identified, and its anteroposterior diameter and width were measured. A "triangle" formula was used for calculating its circumference and area.
  
  
  RESULTS
  The fourth ventricle was shown as a hypoechoic triangle below the level of the cerebellum. A linear regression line of the fourth ventricle was observed across gestational age, and a first-degree correlation was found between gestational age and anteroposterior diameter of the fourth ventricle (r = 0.894; P < .0001; y = -0.84 + 0.23 x gestational age), its width (r = 0.657; P < .0001; y = 3.82 + 0.14 x gestational age), its circumference (r = 0.843; P < .0001; y = 5.11 + 0.58 x gestational age), and its area (r = 0.844; P < .0001; y = -10.11 + 1.17 x gestational age). Twelve enlarged fourth ventricles were found between 14 and 16 weeks, but results of follow-up scans at 20 weeks were normal.
  
  
  CONCLUSIONS
  An isolated enlarged fourth ventricle in the early second trimester might represent a normal variant; it should be followed, but decisions about the fate of the pregnancy should not be based solely on this finding.
authors.affiliation: Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel.
authors.forename: Israel
authors.initials: I
authors.lastname: Goldstein
authors.forename: Imad R
authors.initials: IR
authors.lastname: Makhoul
authors.forename: Ada
authors.initials: A
authors.lastname: Tamir
authors.forename: Bat-Sheva
authors.initials: BS
authors.lastname: Rajamim
authors.forename: Daniel
authors.initials: D
authors.lastname: Nisman
mesh_terms: D002552:Cerebral Ventricles / Q000000981:diagnostic imaging / Q000196:embryology*; D003388:Cranial Fossa, Posterior / Q000002:abnormalities / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005314:Embryonic and Fetal Development; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal