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This study presents the initial results of a pilot project using the Elucis Virtual Reality (VR) platform for fetal heart segmentation. Twelve fetal heart cases, ranging in gestational age from 24 to 30 weeks, including various cardiac conditions, were reconstructed using 3D models facilitated by the Elucis platform's integration of automated algorithms and manual adjustments. The models, which were evaluated by four experts in virtual and 3D printed formats, were of high quality and offered improved visuospatial visualization and detailed anatomical insights. This research highlights the potential of VR technology to improve prenatal diagnosis and planning for complex cardiac conditions, suggesting significant implications for continuing medical education and clinical practice in fetal cardiology.
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Closed gastroschisis (CG) and vanishing gastroschisis (VG) are the most severe forms of evolution of the malformation. In this case, a fetus presented with gastroschisis at 13 weeks, and the gastroschisis was not visualized at 22 weeks of gestation. Distal ileum, cecum, and ascending colon atresia were diagnosed at surgery, and the child is fully enteral-fed at 5 months of age. In a literature review of 43 cases of prenatal diagnosis of CS-VG, intrauterine death occurred in 4.5% of cases. 79.6% of the cases underwent surgical treatment. Of these cases, 20% of cases died due to complications of treatment, 26% were still under treatment and 54% are alive with enteral feeding. In 77% of the cases, the closure of the umbilical ring occurred after 26 weeks of gestation and the absence of prenatal diagnosis of CG-VG during pregnancy has a risk of 71% of death.
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Pallister - Hall syndrome is a rare malformation that involves the presence of a suprasellar hamartoma and associated malformations. Prenatal diagnosis is also rare, and few cases have been reported using magnetic resonance imaging (MRI). A 35-year-old G5P2A2 woman at the 35th week of gestation was referred to our service. Fetal MRI showed an isointense image in the suprasellar region, pushing the brainstem up and backward, and compressing the vermis and cerebellum on T2-weighted images. On T1-weighted images, the hypointense signal of the tumor was similar to that of the brain parenchyma. Ultrasound images showed a suprasellar mass, which was more echogenic than the normal cerebral parenchyma, posteriorly pushing the brain stem, with involvement of the vermis of the tumor and compression of the posterior fossa. Three-dimensional reconstruction using MRI scan data showed a space view of the tumor and its relationships with the other brain tissues allowing better understanding by parents and multidisciplinary team.
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Feto , Cuidado Pré-Natal , Gravidez , Feminino , Humanos , Imageamento por Ressonância MagnéticaAssuntos
Infecções por Coronavirus , Coronavirus , Feminino , Humanos , Laboratórios , Gravidez , Impressão TridimensionalRESUMO
Image from a fragment of the video of virtual reality model evaluating a case of placenta accreta spectrum and placental invasion. In this image, the placenta (purple) goes through the uterus and reaches the bladder muscle and mucosa (pink).
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Placenta Acreta , Realidade Virtual , Feminino , Humanos , Imageamento por Ressonância Magnética , Placenta/diagnóstico por imagem , Placenta Acreta/diagnóstico por imagem , Gravidez , Estudos Retrospectivos , Ultrassonografia Pré-NatalRESUMO
BACKGROUND: Physical fetal models developed from three-dimensional (3D) ultrasound or magnetic resonance imaging (MRI) scan data may be used for medical education purposes, for parental counseling/multidisciplinary team management and to improve the maternal-fetal attachment (MFA) in blind pregnant women. PURPOSE: We proposed a new technique to create a maternal-fetal physical model by using MRI scan data to improve the MFA. METHODS: For the construction of the maternal-fetal physical model, two different processes were used. For the internal part of the maternal-fetal physical model, we used the segmentation and the 3D reconstruction made from the MRI scan data, and for the outside, we performed 3D scanning by using a white light scanner. After obtaining the 3D models, we used a registration tool to position them in alignment. CONCLUSION: Maternal-fetal physical models improve the MFA by using both tactile and visual sensations of the pregnant woman and her fetus.
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Imageamento Tridimensional , Imageamento por Ressonância Magnética , Feminino , Feto , Humanos , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Exame Físico , GravidezRESUMO
Conjoined twins (CTs) are a rare complication from monochorionic and monoamniotic twin pregnancies. We describe the use of 3D technologies, including 3D virtual and 3D physical models on prenatal evaluation of one parapagus CT. A 16-year-old G1P0 woman was referred for fetal magnetic resonance imaging (MRI) anatomical evaluation of a CT at 28 weeks of gestation. 3D images of the fetal surface were generated by the software during the examination for spatial comprehension of the relationship between the fetal parts. The pair of CTs died at the 32nd week of gestation, a few hours after cesarean section. 3D technologies are an important tool for parental counseling and preparation of the multidisciplinary care team for delivery and neonatal assistance and possible surgical planning for postnatal separation in CTs cases.
Gêmeos unidos (GUs) são uma complicação rara de gestações gemelares monocoriônicas e monoamnióticas. Descrevemos o uso de tecnologias 3D, incluindo modelos 3D virtuais e físicos, na avaliação pré-natal de GU parapagus. Mulher de 16 anos, G1P0, foi encaminhada para avaliação anatômica por ressonância magnética (RM) fetal de GU com 28 semanas de gestação. Imagens 3D da superfície fetal foram geradas pelo software durante o exame para compreensão espacial da relação entre as partes fetais. O par de GUs morreu na 32ª semana de gestação, poucas horas após a cesariana. As tecnologias 3D são uma importante ferramenta de aconselhamento dos pais e de preparação da equipe multiprofissional para o parto e a assistência neonatal, além de possível planejamento cirúrgico para separação pós-natal em casos de GUs.
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Gêmeos Unidos , Adolescente , Cesárea , Feminino , Humanos , Recém-Nascido , Gravidez , Gravidez de Gêmeos , Diagnóstico Pré-Natal , Ultrassonografia Pré-NatalRESUMO
Abstract Conjoined twins (CTs) are a rare complication from monochorionic and monoamniotic twin pregnancies. We describe the use of 3D technologies, including 3D virtual and 3D physical models on prenatal evaluation of one parapagus CT. A 16-year-old G1P0 woman was referred for fetal magnetic resonance imaging (MRI) anatomical evaluation of a CT at 28 weeks of gestation. 3D images of the fetal surface were generated by the software during the examination for spatial comprehension of the relationship between the fetal parts. The pair of CTs died at the 32nd week of gestation, a few hours after cesarean section. 3D technologies are an important tool for parental counseling and preparation of the multidisciplinary care team for delivery and neonatal assistance and possible surgical planning for postnatal separation in CTs cases.
Resumo Gêmeos unidos (GUs) são uma complicação rara de gestações gemelares monocoriônicas e monoamnióticas. Descrevemos o uso de tecnologias 3D, incluindo modelos 3D virtuais e físicos, na avaliação pré-natal de GU parapagus. Mulher de 16 anos, G1P0, foi encaminhada para avaliação anatômica por ressonância magnética (RM) fetal de GU com 28 semanas de gestação. Imagens 3D da superfície fetal foram geradas pelo software durante o exame para compreensão espacial da relação entre as partes fetais. O par de GUs morreu na 32ª semana de gestação, poucas horas após a cesariana. As tecnologias 3D são uma importante ferramenta de aconselhamento dos pais e de preparação da equipe multiprofissional para o parto e a assistência neonatal, além de possível planejamento cirúrgico para separação pós-natal em casos de GUs.
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Humanos , Feminino , Gravidez , Adolescente , Adulto , Gêmeos Unidos , Diagnóstico Pré-Natal , Cesárea , Ultrassonografia Pré-Natal , Gravidez de GêmeosRESUMO
BACKGROUND: Craniopagus twins represent a rare and complex congenital malformation characterized by conjoined twins fused at the cranium. Craniopagus is challenging for patients' families and surgeons, and accurate confirmation of the extent of cranial fusion is a complex process. Most information regarding the surgical anatomy of this rare condition is obtained through analysis of ultrasonographic, magnetic resonance, or computed tomographic images. A multidisciplinary team plays a key role in obtaining such information and in parental counseling and coordination of various complex processes for optimal postnatal care of these twins. The extent of fusion is usually determined based on conventional clinical methods, such as imaging studies. METHODS: Imaging software is being used in recent times to create three-dimensional reconstruction images and for virtual navigation to investigate the skulls and brains of craniopagus twins. However, the acquisition and maintenance costs of such sophisticated medical software may be unaffordable for medical centers in developing countries. To overcome this limitation, we investigated the role of open or free source software for accurate determination of complex malformations of the skull and brain of craniopagus twins.
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Crânio , Gêmeos Unidos , Encéfalo/diagnóstico por imagem , Encéfalo/cirurgia , Humanos , Imageamento Tridimensional , Crânio/diagnóstico por imagem , Crânio/cirurgia , Software , Gêmeos Unidos/cirurgiaRESUMO
BACKGROUND: Congenital high airway obstruction syndrome (CHAOS) involves the partial or complete obstruction of the fetal upper airways, usually caused by atresia or stenosis of the larynx or trachea. The obstruction of bronchial tree leads to lung distension, diaphragmatic eversion, and cardiac dysfunction, which can result in fetal death. CASE: A primigravid 19-year-old was diagnosed with CHAOS at 193 weeks gestation. Virtual navigation using magnetic resonance imaging (MRI) data was used to visualize the fetal airways after intrauterine endoscopic laser decompression. A perforation in the fetal larynx/trachea was identified and the diagnosis was modified to tracheal stenosis. Cesarean delivery occurred at 315 weeks using an ex utero intrapartum treatment (EXIT) procedure. The neonatology team were unable to perform intubation, suggesting a final diagnosis of tracheal atresia. The male newborn weighed 1920 g and died 1 hour later. CONCLUSION: 3D virtual bronchoscopy is a non-invasive approach to visualizing the fetal upper airways and can be used to diagnose and manage CHAOS.
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Obstrução das Vias Respiratórias , Doenças Fetais , Laringe , Adulto , Obstrução das Vias Respiratórias/diagnóstico por imagem , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/cirurgia , Feminino , Humanos , Recém-Nascido , Laringe/diagnóstico por imagem , Laringe/cirurgia , Masculino , Gravidez , Traqueia/diagnóstico por imagem , Traqueia/cirurgia , Ultrassonografia Pré-Natal , Adulto JovemRESUMO
BACKGROUND: Myelomeningocele (MMC) is the most severe form of spina bifida with intrauterine repairs becoming more prevalent. The development of three-dimensional ultrasound (3DUS) and magnetic resonance imaging (MRI) has drastically improved the visualization of fetal anatomy. METHODS: Virtual Navigation (VN) results from a technology that uses software generated realistic images to replicate the immersive feeling of a real environment. CONCLUSION: This report aims to demonstrate VN in a Chiari II malformation case, obtained from 3DUS and MRI files, comparing this with the fetal endoscopic surgery for MMC.