Preface to the Third Edition

It is hard to believe, but the first edition of this book saw the light 15 years ago. At the time, it became a useful reference for those who wanted to understand the development, the anatomy, and the pathophysiology of the fetal central nervous system from the viewpoint of ultrasonography.

After a relatively short 5 years—in 2001—the second edition of the book was published. We received encouraging feedback from the ultrasound and the feto-maternal specialists to add the necessary incremental knowledge and include relevant information to publish an updated second edition.

During the time from 2001 to recent days, several things happened that led us to consider the publication of the third edition of the book.

The first compelling reason to update the book was the “outburst” of new clinical research regarding imaging of the fetal brain. The use of high frequency and deep penetrating ultrasound transducer probes yielded increasing resolution, hence more accurate pictures of the fetal brain and spine. These high-resolution pictures found their way into the traditional “printed journals,” but even more so into the electronic media. Lectures at courses and webinars, and teaching on CDs and the Internet, spread the understanding and knowledge, requiring an organized way to compile it and reach out to those interested in the subject.

The second impetus to practically rewrite the previous edition was the tremendous improvement and dissemination of three-dimensional ultrasound techniques and magnetic resonance imaging. By resonating to these, we decided to incorporate those two imaging modalities into the individual chapters wherever necessary to enhance understanding, rather than leaving them as stand-alone chapters. In the previous editions, we had placed these two subjects in their separate chapters. Our intention was to emphasize, teach, and incorporate these two important imaging technologies. Now that they are used daily to complement traditional ultrasound imaging of the fetal brain, we incorporated this use as an integral part of the many “older” as well as the new chapters.

The third and not less important reason to redo and rejuvenate the book was the increasing interest in imaging the fetal nervous system as it pertains to imaging the fetal brain. The surging clinical research in Europe, North America, South America, and Israel, to name only a few locations, gave birth to a new generation of young and enthusiastic imagers, maternal–fetal medicine specialists, radiologists, and basic scientists, who literally inundated the field with new observations. As a result of this data surge, conference goers and others kept asking when a new edition of the book would be released.

To answer all three issues and explain the horizons of the new edition, Gustavo Malinger of Israel and Gianluigi Pilu of Italy graciously agreed to serve as co-editors. It was the widening of our perception of teaching that led us to change the format of the chapters completely, making them easier to read and easier to find points of interest. There is no doubt that adding new chapter authors, as well as scores of new 2D and 3D ultrasound images and updated literature were the necessary ingredients to consider this textbook of fetal neuroimaging a relevant reference source.

As to the newly added chapters, we would like to mention them briefly. Ventriculomegaly was given its own importance. It is the most common presenting sonographic sign of brain pathology; therefore, the possible underlying clinico-pathologic reasons for it were “carved out” from the many different sites that were mentioned, creating a dedicated chapter for easy reference.

The different anomalies were reclassified, such as those of the ventral and dorsal induction, and that of cortical development. We tried to pour light upon a diagnostically problematic area of the fetal brain, namely the posterior fossa, focusing on a small but nevertheless important structure, the vermis. Three new chapters dealing with intrauterine insults, intrauterine infections, and metabolic disorders were also added to cover the progress made in those areas that became pertinent to fetal neuroscans.

In short, the newly incorporated chapters, along with those updated and carried over from our last edition, may render this new edition useful for those engaging in the clinical evaluation of the fetal brain.