(Ultrasound Review) In order to determine the benefit of 3-D ultrasonography in diagnosing vertebral defects, nine fetuses with known spina bifida were examined with 2-2-D and 3-D ultrasound. This research from William Beaumont Hospital in Royal Oak, MI was published in the Journal of Ultrasound in Medicine.
"Prenatal diagnosis of spina bifida has steadily improved as a result of maternal serum fetoprotein screening and widespread use of ultrasonography," they reported.
Other research has demonstrated that ultrasound successfully demonstrated spina bifida in 80-85% of cases and determined the defect level within one vertebral segment in 79% of cases. Parental counseling is facilitated through accurate data predicting clinical severity, and should include the level and extent of the vertebral defect. According to the authors, "the main ossification centers (two posterior and one anterior) can be shown by 16 menstrual weeks, although the distal spine may not be fully formed before 22 weeks."
Using Voluson technology, nine fetuses were evaluated using 2-D and 3-D at a mean gestational age of 22 weeks. The following information was obtained: standardized multiplanar views of the fetal spine, and surface rendered coronal views of the spine and ribs. The most superior vertebra with a visible rib was defined as the twelfth thoracic vertebra. Postnatal radiography or MRI was used to determine the true extent and level of the vertebral defect.
The authors reported that for 2-D ultrasound the spinal level agreed to within one vertebral segment in six of nine infants, while 3-D ultrasound agreed to within one vertebral segment in eight of nine fetuses. They concluded that "multiplanar views are generally more informative than rendered views for localizing bony defects of the fetal spine." Also, they reported that 3-D ultrasound improves the characterization of spina bifida by adding further information.
A diagnostic approach for the evaluation of spina bifida by three-dimensional ultrasonographyW Kee et al
Division of fetal imaging, department of obstetrics and gynecology, William Beaumont Hospital, Royal Oak, MI
J Ultrasound Med 2002 June, 21:619-626
By Ultrasound Review
July 19, 2002
Copyright © 2002 AuntMinnie.com
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
