EP01.04: V‐mode and B‐mode in differential diagnosis among hydrocephalic persistent Blake's pouch, non‐ HDC persistent Blake's pouch and Dandy‐Walker complex

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To compare transabdominal (TA) Volume-Mode (V-Mode) and B-Mode in identification of ultrasonographic (US) markers useful in differential diagnosis between hydrocephalic persistent Blake's pouch (HDC-PB'sP), non-hydrocephalic persistent Blake's pouch (PB'sP), Dandy-Walker complex. 33 patients (g.a. 18w1d–27w6d) were examined by TA B-Mode and TA V-Mode: DW malformation (DWm–7 cases), DW variant (DWv–15 cases), megacisterna magna (MCM–3 cases), HDC-PBP (1 case), PBP (6 case) and CVHi (1 case). In DWm and DWv groups were included cases with vermis anomaly and high tentorium. Following US structures were assessed: cerebellar vermis(VH) and lobes(LH) hypoplasia, enlarged 4th ventricle (e4V), enlarged aqueduct of Silvius (eAS), vermis primary and secondary fissures (PF and SF), high tentorium (HT) respect of the inion (C. Raybaud method – tentorium and inion reciprocal position), enlarged posterior cranial fossa (ePCF), brainstem distortion against clivus (BDC). DWm (7 cases). Visualisation of VH (6/6 cases): 6/6 cases in V-Mode vs 6/6 in B-Mode. LH (6/6): 6/6 vs 6/6. PF and SF: (both absent). e4V (6/6): 6/6 vs 6/6. HT (6/6): 6/6 vs 3/4. ePCF (5/6): 5/5 vs 2/5. BDC (4/6): 4/4 vs 0/4. DWv (15 cases). Visualisation of VH (14/14): 14/14 vs11/14 + 3/14 (easy). PF (14/14): 13/14 vs 5/14. SF: no. e4V (14/14): 14/14 (easy) vs 11/14+ 3/14 (easy). HT (14/14): 12/14 vs 5/14 (difficult). ePCF (6/14): 5/6 vs 4/6. MCM (3 cases). Visualisation of PF (3/3): 3/3 vs 0/3. SF: (3/3): 2/3 vs 0/3. HDC-PB'sP (1 case). Visualisation of PF and SF(1/1): 0/1 vs 0/1. e4V (1/1): 1/1 vs 1/1. ePCF (1/1): 1/1 vs 0/1. eAS (1/1): 1/1 vs 0/1. BDC (1/1): 1/1 vs 0/1. PB'sP (6 case). Visualisation of PS: 5/5vs 3/5. SF: 5/5vs 3/5. e4V: 5/5 vs 3/5. Pouch was better visualised on B-Mode sagittal scan respect of V-Mode. V-Mode facilitates US midsagittal scan achievement respect to B-Mode and is further enhanced by multiplanar examination using stereotaxic voxel in cases of pathologic/anomalous posterior cranial fossa.

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