Role of TUI in First Trimester Evaluation of Palate

Abstract The purpose of the study is to report on the application of tomographic ultrasound imaging (TUI) in prenatal sonographic study of fetal palate in 11–14 week scan. TUI is a technology that allows the examiner to obtain a volume data set that allows the display of numerous 2D slices from a given volume on any of the three orthogonal planes. It allows automatic slicing of the volume datasets displaying multiple parallel images. The fetal palate was examined with TUI in thirteen abnormal volumes and in ninety-four normal volumes. The appearance of maxillary line in sagittal sections and the base of the retronasal triangle in coronal sections serve as key landmarks in evaluating palatine clefts. The intact palatal line in sagittal sections was observed in all the ninety-four normal volumes. The midline anatomy of the palate has been described in the study emphasising that the vomer can mimic palate in midsagittal section in secondary palatine clefts. The parasagittal sections truly reflects the presence or absence of the palate without the confounding factor of the vomer bone which was demonstrated in the abnormal volumes with TUI. The potential advantage of TUI in evaluating palate is that it allows the display of both midsagittal and parasagittal sections simultaneously. The different types of cleft have a constant reproducible pattern in TUI imaging which can be used to diagnose palatine clefts including isolated cleft of palate. Prospective studies are needed to confirm these promising results.