Neurosonology

Texas Children’s Fetal Center® offers the latest advancements in the diagnosis of fetal brain anomalies through our unique expertise in fetal neurosonology.

What is Neurosonology?

Neurosonology is an imaging technique used to obtain a detailed view and assessment of the fetal brain by ultrasound.

The specialized ultrasound exam is used to detect brain anomalies in cases where:

• the fetus is at risk of a brain abnormality, or
• there is a suspicion of abnormality, following a basic ultrasound exam.

It is not used in cases where there are clear signs of a brain malformation.

Fetal neurosonology, also referred to as advanced central nervous system ultrasound or neurosonography, requires a level of expertise not available in many centers.

What to Expect

Neurosonology is performed using the same ultrasound machine used for routine prenatal scans.

If the baby is positioned head down, known as cephalic presentation, neurosonology is performed using a transabdominal approach (through the mother’s abdomen) and a transvaginal approach (through the vaginal canal) for better imaging of the fetal brain.

During the exam, the specialist assesses your baby’s brain from multiple views or “planes,” known as the axial, coronal and sagittal views. This multi-plane approach provides a thorough assessment of all the structures of the baby’s brain and a greater level of detail, improving the detection of fetal brain anomalies compared to traditional ultrasound.

In addition, the specialist will take measurements of your baby’s brain structures for comparison with established normal ranges, to help identify any abnormalities.  

Does my baby need neurosonology?

Examples of when neurosonology may be recommended include:

• The mother has a history of children affected with brain anomalies.
• The baby is at high risk of brain anomalies or brain injury, such as hypoxia (lack of blood flow and oxygen to the brain) caused by conditions such as twin-to-twin transfusion syndrome (TTTS) or severe fetal anemia or severe fetal growth restriction.
• The mother has taken drugs that could have a detrimental effect on the baby’s brain development
• There is suspicion the baby has a congenital infection such as cytomegalovirus, Zika,  toxoplasmosis etc.
• There is suspicion of a brain anomaly based on subtle findings during a basic exam that are out of the ordinary, such as cavities in the brain that seem darker than normal or structures that seem slightly dilated.
• The mother has a body mass index (BMI) or composition that prevents proper assessment of the fetal brain structures through regular ultrasound.
• The mother is unable to undergo an MRI because of any of the known contraindications for MRI such as a pacemaker or metal implants but the baby has a brain malformation that requires further assessment.

When during pregnancy is neurosonology performed?

The timing of neurosonology will depend on the clinical situation.

For a fetus with a higher risk of brain injury caused by conditions such as twin-to-twin transfusion syndrome (TTTS) or fetal anemia, neurosonology will be performed in the third trimester between 28 and 32 weeks when the brain is completely developed, making any possible problems easier to detect.

For babies where fetal brain anatomy is not completely normal, it will be performed after a routine anatomical scan at 20 to 22 weeks. Neurosonology is performed during that same time period. 

In mothers where there is a history of fetal brain anomalies, the scan is generally performed at about 20 weeks of gestation.

For More Information

If you have any questions regarding neurosonology or other diagnostic testing, and which test is right for your family’s needs, our specialists are here to help. We welcome an opportunity to visit with you.