The MERIDIAN trial: caution is needed

Paladini, D.; Malinger, G.; Pilu, Gianluigi; Timor-Trisch, Ilan; Volpe, P.

doi:10.1016/s0140-6736(17)31337-5

Cited by 18 publications

(18 citation statements)

References 4 publications

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“…Although we acknowledge that there is debate whether MRI or ultrasound is the most sensitive to detect brain abnormalities [33-35], we deliberately chose to perform our study with ultrasound, because ultrasound is cheap and widely available. Therewith, it allows sequentially repeated measurements in a growing fetus [36-38].…”

Section: Discussionmentioning

confidence: 99%

Fetuses with Isolated Congenital Heart Defects Show Normal Cerebral and Extracerebral Fluid Volume Growth: A 3D Sonographic Study in the Second and Third Trimester

et al. 2019

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Objective: The aim of our study is to explore whether the cerebral growth is delayed in fetuses with congenital heart defects (CHD) in the second and early third trimester. Methods: A prospective cohort study was conducted in 77 CHD cases, with 75 healthy controls. 3D cerebral volume acquisition was performed sequentially. The volumes of the fetal hemicerebrum and extracerebral fluid were compared by linear regression analysis, and the Sylvian fissure was measured. Results: Between 19 and 32 weeks of gestation, 158 measurements in cases and 183 measurements in controls were performed (mean 2.2/subject). The volume growth of the hemicerebrum (R² = 0.95 vs. 0.95; p = 0.9) and the extracerebral fluid (R² = 0.84 vs. 0.82, p = 0.9) were similar. Fetuses with abnormal oxygen delivery to the brain have a slightly smaller brain at 20 weeks of gestation (p = 0.02), but this difference disappeared with advancing gestation. CHD cases demonstrated a slightly shallower Sylvian fissure (mean ratio 0.146 vs. 0.153; p = 0.004). Conclusions: Our study shows no differences in cerebral growth, studied in an unselected cohort, with successive cases of isolated CHD. Even in the severest CHD cases, cerebral size is similar in the early third trimester. The cause and meaning of a shallower Sylvian fissure is unclear; possibly, it is a marker for delayed cerebral maturation or it might be an expression of decreasing amount of extracerebral fluid.

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Section: Discussionmentioning

confidence: 99%

Fetuses with Isolated Congenital Heart Defects Show Normal Cerebral and Extracerebral Fluid Volume Growth: A 3D Sonographic Study in the Second and Third Trimester

et al. 2019

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“…As reported from Paladini et al, the MERIDIAN trial does not describe the ultrasound approach whose diagnostic accuracy was compared to fetal MRI. It is underlined that MRI should represent a second-line resource to be employed in selected cases, and only after expert neurosonography 57 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Fetal midline anomalies: Diagnosis and counselling Part 1: Corpus callosum anomalies

Leombroni

Khalil

Liberati

et al. 2018

European Journal of Paediatric Neurology

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Prosencephalic development is characterized by three sequential events: prosencephalic formation (at the rostral end of the neural tube), cleavage and midline development 1-2. In particular, during prosencephalic cleavage, three main splitting events occurs: horizontal, to form the paired optic vescicles, olfactory bulbs and tracts, transverse, in which telencephalon separates from diecephalon and sagittal, to form the cerebral hemispheres, lateral ventricles and basal ganglia. Prosencephalic development is characterized by appearance of three plates of tissue: the commissural, the chiasmatic and the hypothalamic plates. These structures are fundamental in the development of the corpus callosum (CC), cavum septum pellucidi (CSP), optic nerve chiasm and hypothalamic

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“…Most studies published over the last two decades seem to demonstrate that, when MRI is performed in cases of apparent IMV, it uncovers additional, clinically relevant, central nervous system (CNS) abnormalities in about 10% (range, 0–40%) of them. However, the diagnostic yield of fetal brain MRI has been challenged by several fetal neurology experts.…”

Section: Introductionmentioning

confidence: 99%

Indications for MRI in fetal isolated mild ventriculomegaly… ‘And then, there were none’

Paladini

Donarini

Rossi

2019

Ultrasound in Obstet & Gyne

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The MERIDIAN trial: caution is needed

Cited by 18 publications

References 4 publications

Fetuses with Isolated Congenital Heart Defects Show Normal Cerebral and Extracerebral Fluid Volume Growth: A 3D Sonographic Study in the Second and Third Trimester

Fetuses with Isolated Congenital Heart Defects Show Normal Cerebral and Extracerebral Fluid Volume Growth: A 3D Sonographic Study in the Second and Third Trimester

Fetal midline anomalies: Diagnosis and counselling Part 1: Corpus callosum anomalies

Indications for MRI in fetal isolated mild ventriculomegaly… ‘And then, there were none’

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