Background: Three-dimensional cranial ultrasonography [3DCUS] is a new developing technology that provides fast scanning time and image post processing ability. However, its image quality and diagnostic value are still questionable for clinical usage.

Objective: To evaluate the diagnostic effectiveness and image quality of 3DCUS compared to the two-dimensional cranial ultrasonography [2DCUS].

Materials and Methods: The present study was done prospectively in 175 cranial ultrasound examinations. Each examination consists of 2DCUS and 3DCUS images taken at the same session. Each set of data was reviewed by two pediatric radiologists for diagnosing of intracranial abnormalities and evaluating image quality in several intracranial regions. By using 2DCUS as a gold standard, the effectiveness and image quality of 3DCUS were assessed. The study protocol was approved by the Ethics Committee of Faculty of Medicine Siriraj Hospital, Mahidol University (Si577/2009).

Results: The 2DCUS demonstrated significant higher image quality in most of intracranial regions except occipital lobe (p = 0.07), midbrain (p = 0.13) and pons (p = 0.16). The 2DCUS also showed better demonstration of the intracranial lesions such as intraventricular hemorrhage, hydrocephalus, cerebral white matter lesions, cerebellar abnormalities and extracranial lesions. However, there was no significant difference in diagnostic capability between these two modalities.

Conclusion: Although Image quality of 3DCUS examination is inferior to that of 2DCUS, it is sufficient to diagnose intracranial abnormalities in clinical practice.

Keywords: Two-dimensional ultrasound, Three-dimensional ultrasound, Cranial ultrasound, 2D, 3D