3D Physical and Virtual Models in Fetal Medicine by Heron Werner & Gabriele Tonni & Jorge Lopes

Author:Heron Werner & Gabriele Tonni & Jorge Lopes
Language: eng
Format: epub
ISBN: 9783031148552
Publisher: Springer International Publishing

8.1.3.4 Microcephaly

Microcephaly is defined as a significant reduction in head circumference below the fifth percentile or two standard deviations below average (Fig. 8.12). It is usually detected after 24 weeks, being easier to diagnose with advancing gestation due to the contrast between the size of the head and the fetal body [6]. The main causes are autosomal recessive/dominant disorders, infections (cytomegalovirus, toxoplasmosis, rubella, and zika), radiation, drugs, alcohol, and hypoxia [7]. Gyration anomalies such as polymicrogyria, lissencephaly, or simplified gyral patterns may be associated with microcephaly. In such cases, US analysis of the brain is often limited due to the poor acoustic windows resulting from the ossified calvaria and the poor definition of the brain parenchyma, especially when the extra-axial fluid space is also small. MRI may be helpful in this situation, enabling more detailed examination of brain development and the parenchyma. 3D virtual and physical models from MRI, US, and computed tomography (CT) of the cranium of both fetuses and newborns have been described, showing in detail the degree of microcephaly, allowing the parents and medical team to better understand the anomaly [8–10].

Fig. 8.12Zika virus. Three-dimensional sagittal reconstruction from computed tomography scan and corresponding three-dimensional (3D) printing. The skull has collapsed appearance (arrow) (a). Postnatal image obtained from computed tomography and magnetic resonance imaging with 3D reconstruction and printing of a newborn with Zika virus (b). Microcephaly with occipital encephalocele (28 weeks). 3D reconstruction from magnetic resonance imaging with 3D printing in powder-based system (c)

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