title: Three-dimensional ultrasonography of the fetal vermis at 18 to 26 weeks' gestation: time of appearance of the primary fissure.
abstract: OBJECTIVE
  The purpose of this study was to establish the normality of the fetal vermis, ie, the time of appearance of the primary fissure, as well as its measurements between 18 and 26 weeks' gestation, using 3-dimensional (3D) ultrasonography.
  
  
  METHODS
  A prospective cross-sectional study of normal singleton pregnancies was conducted. Examinations were performed with high-resolution transabdominal ultrasonography using the axial plane in 173 fetuses between 18 and 26 weeks' gestation. Postprocessing measurements of the fetal vermis were done with 4-dimensional software using static volume contrast imaging and tomographic ultrasound imaging in the C-plane. Detection of the primary fissure was evaluated in all cases, and the time of appearance was documented.
  
  
  RESULTS
  Adequate vermis measurements were obtained in 173 fetuses. Vermian length as a function of gestational age was expressed by regression equations, and the correlation coefficients were found to be highly statistically significant (P < .001). The normal mean +/- 2 SD for each gestational week was defined. The primary fissure was observed at 24 weeks' gestation in all cases, at 22 weeks in 94% of cases, and as early as 18 weeks in 40%.
  
  
  CONCLUSIONS
  This 3D study documents the appearance of the primary fissure and presents the normal range of vermian measurements, confirming normal development of the fetal vermis starting as early as 18 weeks' gestation. It also shows an easy method for visualizing the vermis with 3D ultrasonography at every gestational week regardless of fetal presentation.
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, 52621 Ramat Gan, Israel. zalel_y@netvision.net.il
authors.forename: Yaron
authors.initials: Y
authors.lastname: Zalel
authors.forename: Simcha
authors.initials: S
authors.lastname: Yagel
authors.forename: Reuven
authors.initials: R
authors.lastname: Achiron
authors.forename: Zvi
authors.initials: Z
authors.lastname: Kivilevich
authors.forename: Liat
authors.initials: L
authors.lastname: Gindes
mesh_terms: D000465:Algorithms; D002531:Cerebellum / Q000000981:diagnostic imaging* / Q000196:embryology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods*