Role of 4D Ultrasound in Evaluation of Fetal Congenital Anomalies in the Central Nervous System

Abstract Background Congenital anomalies of the central nervous system (CNS) are a very important group of defects found in a fetal, often characterized by different severity and complexity. They develop within the fetus and might even develop within the brain, spinal cord, or other components of the nervous system. Neural tube defects (NTDs), such as spina bifida and anencephaly, make up one of the most common forms of congenital anomalies of the CNS. Aim of the Work This study aimed to evaluate the effectiveness of 4D ultrasound in detecting and assessing fetal congenital anomalies of the central nervous system (CNS) during the first and second trimesters of pregnancy, compared to traditional 2D ultrasound. Patients and Methods The study was conducted on 30 pregnant women with suspected CNS anomalies at Ain Shams University Hospitals, Sohag Teaching Hospital, and private centers. Both 2D and 3D/4D ultrasound examinations were performed, and the data collected were analyzed using SPSS v26. Results The 2D ultrasound had a detection rate of 80% with a sensitivity of 83.33%, specificity of 50%, and overall accuracy of 76.67%. The 3D/4D ultrasound also had a detection rate of 80% but demonstrated higher sensitivity (91.67%), specificity (83.33%), and overall accuracy (90%). Confirmatory diagnoses during or after birth revealed anomalies in 76.67% of the cases, consistent with the prenatal ultrasound findings. Common anomalies detected included hydrocephalus, Arnold-Chiari malformation, spina bifida, and corpus callosum agenesis. These results indicate that 4D ultrasound significantly enhances the detection and assessment of fetal CNS anomalies compared to 2D ultrasound, offering more detailed and dynamic imaging capabilities. Conclusion The study concludes that 4D ultrasound is a superior diagnostic tool for prenatal detection of CNS anomalies compared to 2D ultrasound. The higher sensitivity, specificity, and overall accuracy of 4D ultrasound make it an invaluable technique in prenatal care. The ability of 4D ultrasound to provide real-time, dynamic images of fetal anatomy and movements offers significant advantages in diagnosing complex CNS conditions, thereby improving perinatal outcomes and aiding in better clinical management and parental counseling.