Evalutation of fetal cerebral blood flow perfusion using three dimensional power doppler ultrasound angiography in fetuses affected by intrauterine growth retardation

The aim of the present study is to explore the possible use of 3D Power Doppler Angiography (3D-PDA) using VOCAL software (General Electric Healthcare, USA) in the assessment of different cerebral regions in normal and growth restricted fetuses (IUGR). This is a pilot study, that means a small experiment designed to test the method and gather information prior to a larger study.In Late Onset IUGR fetuses, presenting normal Bidimensional Doppler flow indices of umbilical and middle cerebral arteries, Vascularity Index (VI) and Vascular Flow Index (VFI) of the frontal zone of the fetal brain resulted increased demonstrating the “frontal brain sparing effect” . On the other hand, these vascular parameters were decreased in the temporal zone suggesting a vascular redistribution during brain sparing effect according to a regional increase in bloody supply to the frontal region sprinkled mainly by the anterior cerebral artery. This shift may indicate that general cognitive functions, such as impulse control, language, memory, problem solving and socialization may be preferentially preserved suggesting a hierarchical order in the protection of the brain functions