POOH Ritsuko

Ritsuko POOH

クリフム夫律子マタニティクリニック臨床胎児医学研究所

Obstetrics and Gynecology, CRIFM Clinical Research Institute of Fetal Medicine PMC

キーワード :

Recent advanced ultrasound technology has led immense acceleration in understanding of early human development. The role of ultrasound in the first trimester includes genetic screening, morphological screening/diagnostic imaging. Owing to high-resolution three dimensional （3D） ultrasound, small embryos and fetuses can be clearly visualized and “3D sonoembryology”, embryology in vivo, has been established, allowing the definition of in vivo anatomy including visualization of the embryonic circulation and dynamic features which could not be described in the conventional embryology by examining fixed specimens. The further evolution of 3D ultrasound technology was silhouette ultrasound which can be appropriately named as ‘see-through fashion’. Silhouette ultrasound enables us to demonstrate early development of brain vesicles, abnormal intracerebral structure, and even early development of the eye ball including the lens and vitreous body. Additionally, it can depict hyperechoic structures such as bone and as an additional usage of silhouette ultrasound, ‘thick-slice silhouette’ was introduced showing detailed inner structure and anatomy. Furthermore, HDlive flow demonstrates early intrauterine vasculature, early embryonal intracorporeal circulation, embryo-villous/feto-placental circulation, intracerebral vasculature, and pulmonary vessels from early gestation.
3D ultrasound including silhouette technology has definitely extended more and more accurate and objective prenatal diagnoses of various abnormalities in the 1st trimester and may allow further detection of pathologic development in an earlier gestational age. It is beyond description that non-invasive direct viewing of the embryo/fetus by all-inclusive ultrasound technology, in short, NIP ‘D’ is definitely the first modality in a field of prenatal diagnosis and help our goal of proper perinatal care and management, even in the era of molecular genetics and advanced sequencing of fetal DNA in the maternal blood.