Three-dimensional neurosonography — a novel field in fetal medicine

Lipa, Michał; Pooh, Ritsuko K.; Wielgoś, Mirosław

doi:10.5603/gp.a2017.0041

Cited by 12 publications

(9 citation statements)

References 24 publications

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“…Since Pooh and colleagues described that delayed sulcation of the Sylvian fissure can be assessed by imaging the fetal brain in the anterior coronal view by transvaginal 3D ultrasound, this is the first prospective study utilizing the same approach for evaluating the normal development of the right and left Sylvian fissures objectively in the second and third trimesters of pregnancy. In this study, we developed reference ranges of the Sylvian fissure angles at 18 to 30 + 6 weeks with the aim of early detection of cortical maldevelopment.…”

Section: Discussionmentioning

confidence: 99%

Transvaginal three‐dimensional ultrasound assessment of Sylvian fissures at 18–30 weeks' gestation

Poon

Sahota

Chaemsaithong

et al. 2019

Ultrasound in Obstet & Gyne

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Objective To (1) evaluate the normal development of the Sylvian fissures in the anterior coronal view of the fetal brain at 18-30 weeks' gestation by transvaginal threedimensional (3D) ultrasound, (2) develop reference ranges of measurements of the right and left Sylvian fissure angles during normal pregnancy at 18-30 weeks' gestation, and (3) examine intra-and interobserver repeatability of measurements of the right and left Sylvian fissure angles.Methods This was a prospective cross-sectional study of 422 women with a singleton pregnancy attending an ultrasound-based research clinic between March and December 2017. The entry criteria for the study were appropriately grown live fetus with no suspected structural and/or chromosomal defects between 18 + 0 and 30 + 6 weeks' gestation. Normal development of the Sylvian fissures was assessed in the anterior coronal plane of the fetal brain using transvaginal 3D volume multiplanar imaging. The coronal view was visualized as a single image from the three orthogonal views. Subsequently, the right and left Sylvian fissure angles were measured between a horizontal reference line (0 • ) and a line drawn along the upper side of the respective Sylvian fissure. Intra-and interobserver repeatability of the Sylvian fissure angle measurements was assessed by Bland-Altman plots. Reference equations were constructed for right and left Sylvian fissure angles for gestational age (GA) and head circumference (HC) using the Generalized Additive Models for Location Scale and Shape package. ResultsIn the anterior coronal view of the fetal brain, an inward rotation of the upper portion of the Sylvian fissures was observed during the second and third trimesters of pregnancy. There was a significant negative polynomial association between the Sylvian fissure angles and GA and HC. Both Sylvian fissure angles crossed the reference line (zero), going from positive to negative, at around 25 weeks' gestation or at HC of 22 cm. Z-score difference between the smoothed percentiles of the right and left Sylvian fissure angles indicated that median, 10 th and 90 th smoothed percentiles were closest and almost the same for the GA-based references between 18 and 28 weeks and for the HC-based references between 14 and 24 cm. The intraclass correlation coefficient of the right and left Sylvian fissure angle measurements between the two sonographers was excellent at 0.993 (95% CI,, respectively. On Bland-Altman analysis, the mean difference between the two sonographers in right Sylvian fissure angle measurement was 0.4 • (95% CI, −10.2 to 10.1 • ) and in left Sylvian fissure angle it was 1.0 • (95% CI, −9.6 to 11.6 • ).Conclusions Assessment of the Sylvian fissure angles is highly reproducible. Sylvian fissure angle reference charts can serve as a screening tool for malformations of cortical development, guiding subsequent follow-up and referral for fetal brain magnetic resonance imaging and/or assessment by an expert neurosonologist.

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Section: Discussionmentioning

confidence: 99%

Transvaginal three‐dimensional ultrasound assessment of Sylvian fissures at 18–30 weeks' gestation

Poon

Sahota

Chaemsaithong

et al. 2019

Ultrasound in Obstet & Gyne

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“…Prenatal detection of corpus callosal malformations present a challenge as the US signs may be very subtle or appear late after the second-trimester scans [15]. Direct visualization of the corpus callosum and its abnormalities by US is difficult; thus, we mainly depend on the indirect signs of callosal development (such as the absence of the cavum septum pellucidum, colpocephaly, and the inferior orientation of the medial hemispheric sulci).…”

Section: Discussionmentioning

confidence: 99%

The prevalence and the adding value of fetal MRI imaging in midline cerebral anomalies

Raafat

Abdelrahman

Hafez

2020

Egypt J Radiol Nucl Med

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Background: Foetal MR imaging is widely accepted as an adjunct to foetal ultrasonography; however, there are many controversies regarding its importance and indications. Therefore, this study aimed to evaluate foetuses with different midline cerebral abnormalities, to determine the prevalence of these anomalies, to define the role of foetal MRI, and to compare MRI and ultrasound (US) result with postnatal MRI findings. Seventy-eight pregnant women who had foetuses with CNS abnormalities detected by sonogram were included. Foetuses with midline anomalies were selected and evaluated by anomaly scan foetal US, pre-and postnatal MRI. Results: Midline brain anomalies were found in 47.4% of foetuses with brain anomalies. Holoprosencephaly was found in 24.3% of midline anomaly foetuses, corpus callosum abnormalities (ACC) were detected in 40.5%, midline intracranial mass lesions in 2.7%, and midline posterior fossa anomalies in 32.

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“…Three‐dimensional US has been reported by multiple investigators to offer advantages in visualizing the normal corpus callosum and the anterior complex 12,26–35 . The midline sagittal plane of the CSP is best shown on multiplanar displays that can be oriented optimally by rotating the coronal and axial planes into symmetric orientations (Figure 8B).…”

Section: Discussionmentioning

confidence: 99%

“…Three-dimensional US has been reported by multiple investigators to offer advantages in visualizing the normal corpus callosum and the anterior complex. 12,[26][27][28][29][30][31][32][33][34][35] The midline sagittal plane of the CSP is best shown on multiplanar displays that can be oriented optimally by rotating the coronal and axial planes into symmetric orientations ( Figure 8B). The addition of thick-slice displays (eg, Volume Contrast Imaging; GE Healthcare) also optimizes visualization of the corpus callosum as well as the CSP and FHs ( Figure 8B).…”

Section: Timing and Type Of Imagingmentioning

confidence: 99%

Ultrasound and Magnetic Resonance Imaging of Agenesis of the Corpus Callosum in Fetuses

Ghassemi

Rupe

Perez

et al. 2020

J of Ultrasound Medicine

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Objectives-We hypothesized that: (1) fetal frontal horn (FH) morphology and their proximity to the cavum septi pellucidi (CSP) can assist in suspecting complete agenesis of the corpus callosum (cACC) and partial agenesis of the corpus callosum (pACC) earlier than known indirect ultrasound (US) findings; (2) FHs assist in differentiating a true CSP from a pseudocavum; and (3) magnetic resonance imaging (MRI) is useful in learning FH morphology and pseudocavum etiology. Methods-Thirty-two patients with cACC and 9 with pACC were identified on an Institutional Review Board-approved retrospective review. Of the 41 cases, 40 had prenatal US, and 21 had prenatal MRI; 17 had follow-up neonatal US, and 14 had follow-up neonatal MRI. Variables evaluated retrospectively were the presence of a CSP or a pseudocavum, ventricle size and shape, and FH shape (comma, trident, parallel, golf club, enlarged, or fused). Displacement between the inferior edge of the FH and the midline or cavum/pseudocavum was measured. Results-Fetal FHs had an abnormal shape in 77% ≤20 weeks' gestation, 86% ≤24 weeks, and 90% >24 weeks. Frontal horns were laterally displaced greater than 2 mm in 85% ≤20 weeks, 91% ≤24 weeks, and 95% >24 weeks. The CSP was absent in 100% of cACC cases and 78% of pACC cases, and a pseudocavum was present in 88% of cACC cases and 78% of pACC cases across gestation. Magnetic resonance imaging confirmed US pseudocavums to be focal interhemispheric fluid or an elevated/dilated third ventricle. Conclusions-Frontal horns assist in assessing ACC ≤24 weeks and throughout gestation. Pseudocavums, often simulating CSPs, are common in ACC. Frontal horn lateral displacement and abnormal morphology, recognized by MRI correlations, are helpful in differentiating a pseudocavum from a true CSP. A normal CSP should not be cleared on screening US unless normally shaped FHs are seen directly adjacent to it. Key Words-agenesis of the corpus callosum; cavum septi pellucidi; fetus; frontal horns; ventriculomegaly A genesis of the corpus callosum (ACC) is defined as complete or partial absence of the large commissure that connects the two cerebral hemispheres. Development

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Three-dimensional neurosonography — a novel field in fetal medicine

Cited by 12 publications

References 24 publications

Transvaginal three‐dimensional ultrasound assessment of Sylvian fissures at 18–30 weeks' gestation

Transvaginal three‐dimensional ultrasound assessment of Sylvian fissures at 18–30 weeks' gestation

The prevalence and the adding value of fetal MRI imaging in midline cerebral anomalies

Ultrasound and Magnetic Resonance Imaging of Agenesis of the Corpus Callosum in Fetuses

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