Prenatal 2D/3D Ultrasound in Fetal Dural Sinus Malformations: Case Series and Prognostic Insights

Ke-xiong Niu; Jing-jing Ye; Bin Ma; Zhi-cheng Yue; Tian-gang Li

doi:10.5826/tuj.2026.18126

Authors

Ke-xiong Niu (Gansu Provincial Maternity and Child-care Hospital (Gansu Provincial Central Hospital）Ultrasound Medicine Center
Jing-jing Ye Department of Ultrasound Diagnosis, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu Province, P. R. China
Bin Ma Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital(Gansu Provincial Central Hospital）,Lanzhou, Gansu Province, P. R. China
Zhi-cheng Yue Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital(Gansu Provincial Central Hospital）,Lanzhou, Gansu Province, P. R. China
Tian-gang Li Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital(Gansu Provincial Central Hospital）,Lanzhou, Gansu Province, P. R. China

Keywords:

Keywords Fetal; Dural Sinus Malformation; Prenatal Diagnosis; 2D Ultrasound; 3D Ultrasound; Prognosis

Abstract

Objective: To evaluate the benefit of three-dimensional (3D) ultrasound over two-dimensional (2D) imaging in diagnosing fetal dural sinus malformations (DSM) and to explore the correlation between sonographic features, such as thrombosis and sinus involvement, with perinatal and postnatal outcomes.

Methods: This retrospective case series included 8 fetuses diagnosed with DSM at our center from 2020 to 2025. All cases underwent 2D and 3D ultrasound, with findings correlated to perinatal and postnatal outcomes. A literature review was conducted using PubMed, Embase, and Web of Science, with keywords: “fetal dural sinus malformation,” “prenatal ultrasound,” and “3D ultrasound.”

Results: The median gestational age at diagnosis was 27 weeks (range 20–35). Lesions involved the torcular Herophili (4/8), torcular and superior sagittal sinus (2/8), superior sagittal sinus (1/8), and posterior fossa venous region (1/8). Associated anomalies included hydrocephalus, mild ventriculomegaly, fetal growth restriction (FGR), and pleural and peritoneal effusions. 2D ultrasound identified cystic or anechoic lesions (18 × 19 mm to 90 × 110 mm), with 62.5% showing thrombosis. 3D ultrasound enhanced lesion delineation, venous continuity, thrombus morphology, and confirmed the absence of arterialization. Genetic testing (cfDNA and/or CMA) was normal in all cases. Among the 8 pregnancies, two were terminated, one resulted in fetal demise, and five were liveborn. Four (50%) had favorable neurodevelopmental outcomes at 29–60 months.

Conclusions: Combined 2D/3D ultrasound improves prenatal DSM assessment, with key features, particularly thrombosis, correlating with adverse outcomes. 3D ultrasound should be integrated into routine diagnostic protocols.

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