title: First trimester brain ventricle fluid and embryonic volumes measured by three-dimensional ultrasound with the use of I-Space virtual reality.
abstract: OBJECTIVE
  Is it possible to evaluate first trimester brain ventricle development in human pregnancies using an innovative virtual reality (VR) application and to analyze the relation of the embryonic volume (EV) and brain ventricle fluid volume (BVFV) with gestational age (GA), crown-rump length (CRL) and the Carnegie stage?
  
  
  CONCLUSIONS
  Volumetry and staging of the human embryo using a VR application make it possible to obtain unique information about in-vivo embryonic normal and abnormal development and about the sizes of the ventricles and body.
  
  
  BACKGROUND
  Human brain development is complex and has a rapidly changing anatomy during the first trimester of pregnancy. New insights will enable early detection of cerebral pathology.
  
  
  METHODS
  In a prospective cohort study, we weekly performed three-dimensional (3D) ultrasound examinations in 112 uncomplicated pregnancies between 6 + 0 and 12 + 6 weeks GA.
  
  
  METHODS
  The examinations resulted in 696 3D ultrasound scans that were transferred to the I-Space VR system and analyzed using V-Scope volume rendering software. V-Scope is used to create a 'hologram' of the ultrasound image and allows depth perception and interaction with the rendered objects. The CRL measurements were performed with a tracing tool, and the volume measurements were automatically performed with a segmentation algorithm. The embryos were staged according to the internal and external characteristics of the Carnegie staging system. All longitudinal outcomes were analyzed using repeated measures ANOVA.
  
  
  RESULTS
  CRL could be measured in 91% of the datasets and ranged from 2.5 to 79.0 mm. EV could be measured in 66% of the datasets and ranged from 2.4 to 23 812.0 mm&sup3;, whereas the BVFV could be measured in 38% of the datasets and ranged from 10.4 to 226.3 mm&sup3;. Finally, in 74% of the datasets, the embryos were staged according to the Carnegie criteria, starting as early as stage 12. Reference charts of volumes versus GA, CRL and stage were constructed. There was no significant relationship between the CRL or EV and the birthweight.
  
  
  CONCLUSIONS
  The low success rate is a limitation of this study that can be explained mainly by non-targeted scanning of the embryonic head.
  
  
  CONCLUSIONS
  The I-Space VR system and the V-Scope software enable automatic EV and BVFV measurements and 3D observations of embryonic development in the first trimester. This allows in-vivo staging of human embryos based on both internal and external morphological characteristics.
  
  
  BACKGROUND
  None.
authors: Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center Rotterdam, The Netherlands. m.rousian@erasmusmc.nl
authors: M
authors: M
authors: Rousian
authors: W C
authors: WC
authors: Hop
authors: A H J
authors: AH
authors: Koning
authors: P J
authors: PJ
authors: van der Spek
authors: N
authors: N
authors: Exalto
authors: E A P
authors: EA
authors: Steegers
mesh_terms: D000328:Adult; D000465:Algorithms; D001921:Brain / Q000196:embryology*; D002552:Cerebral Ventricles / Q000196:embryology* / Q000473:pathology; D018568:Crown-Rump Length; D005260:Female; D005865:Gestational Age; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007231:Infant, Newborn; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D012984:Software; D013997:Time Factors; D016216:Ultrasonography, Prenatal; D014584:User-Computer Interface; D055815:Young Adult