Early prenatal assessment of the development of cerebral vascularization represents a real challenge in the field of fetal medicine. A detailed identification of those vessels and their formation carries great importance, especially in the late-first/early-second trimester of pregnancy, because an early identification of defects can be largely beneficial for treatment planning. By using transvaginal ultrasonography in the second and third trimesters, Monteagudo
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Recently, Dall’Asta
MV-flow allows a detailed view of blood flow at low speeds with high sensitivity and resolution in relation to the surrounding tissues. In this manner, it is possible to detect the micro-blood flow (microfluidic channel) in the tissues and organs. LumiFlow is an advanced post-processing and shading technique in which the images can be processed by placing a light source in the right position to create shadows and produce a three-dimensional (3D) effect. LumiFlow allows the 3D visualization of the vascular image in real time. The flow limits appear relatively darker and create a clear distinction between the blood vessels. In addition, the technique removes background noise in a highly effective manner.
By using the Hera W10 apparatus (Samsung Co., Seoul, South Korea), the study employed both the MV-Flow and LumiFlow to enable a clear assessment of the vascular anatomy of the fetal brain in the late-first/early-second trimester of pregnancy. These new Doppler technologies clearly visualized the development of midline cerebral vascularization in a fetus at 16 weeks of gestation (Fig. 1), as well as the development of the circle of Willis vascularization in a fetus at 12 + 4 weeks of gestation (Fig. 2).
Sagittal view of the fetal brain at 16 weeks of gestation showing detailed midline vascular neuroanatomy using both MV-Flow and LumiFlow: frontal polar artery, anterior cerebral artery, callosal marginal artery, pericallosal artery, and pre-cuneal artery
Axial view of the fetal brain at 12 + 4 weeks of gestation showing detailed vascular neuroanatomy of the circle of Willis using both MV-Flow and LumiFlow: anterior and posterior communicating arteries; anterior, middle, and posterior cerebral arteries
To the best of our knowledge, there are no previous reports that used both MV-Flow and LumiFlow to assess the fetal brain vascularization in the late-first/early-second trimester of pregnancy. In summary, both MV-Flow and LumiFlow can improve the evaluation of the development of fetal brain vessels, especially in detailed screening for vascular congenital anomalies.