Background: Reconstruction of the heart by three-dimensional(3D)echocardiography provided new information on anatomy of complex congenital heart defects. We assessed the utility of 3D ultrasound in detecting morphological changes in cerebral anatomy following cardiac surgery by means of hypothermic cardiopulmonary bypass (CPB) in newborns.

Methods: Transfontanel cross-sectional ultrasound scans were obtained in standardized coronal and median sagittal planes. Subsequently, rotational or fan-like scanning was used to acquire the multiple sequential cross-sections of the brain.For rotational scanning, a conventional 5 MHz transducer was rotated 180 degrees, for fan-like scanning it was moved 30 degrees in each lateral direction.Scanning took less than one minute and no additional sedation was required. Data were stored in the image processing computer which allowed for off-line three dimensional reconstruction of different brain regions.Eight infants aged 5 days to 4 months (median 2.5 months) were assessed before, immediately after, and 3 days after cardiac surgery by means of CPB.

Results: Cavity of lateral ventricle, choroid plexus and the periventricular brain parenchyma could be reconstructed in all. Accurate estimation of size and volume of lateral ventricle, aqueduct, and other ultrasonographic visible pathological brain lesions could be performed. Reconstruction of various brain areas was accomplished in 3-10 minutes.However, the assessment of changes in the echodensity of the brain parenchyma is not improved by 3D reconstruction because gray-scale treshholding can be subjective and interobserver dependent.

Conclusion: 3D reconstruction of different areas of the brain may provide additional quantitative information on size and volume of the internal ventricle and choroid plexus, and better understanding of the topographical aspects and the extension of intra- and periventricular hemorrhage than conventional cross-sectional ultrasound.