Utility of fetal anteroposterior to transverse cerebellar diameter ratio to exclude cerebellar hypoplasia in trisomy 18

Takano, Mayumi; Nakata, Masahiko; Oji, Ayako; Nagasaki, Sumito; Umemura, Nahomi; Maemura, T.; Morita, Mineto

doi:10.1111/jog.13632

Cited by 2 publications

(3 citation statements)

References 15 publications

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“…Excluded studies and reasons for exclusion are reported in Table S3 . Finally, 42 studies, reported between January 1970 and 2021, met the inclusion criteria, and these provided data for 45,626 fetuses, included in the final analysis ( Table 1 ) [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. The median sample size of participating fetuses was 372.5 (range: 50 to 8313; 25th percentile: 175.8; 75th percentile: 709.3).…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies reported more than one fetal brain structure [ 9 , 10 , 17 , 32 , 34 , 36 , 41 , 42 , 43 ]. In addition, 4 studies reported charts for POF [ 9 , 10 , 17 , 36 ], 6 for SF [ 9 , 10 , 17 , 35 , 36 , 44 ], 3 for AV [ 22 , 36 , 43 ], 14 for PV [ 7 , 8 , 14 , 19 , 23 , 26 , 27 , 30 , 32 , 34 , 36 , 38 , 40 , 43 ], 20 for TCD [ 12 , 15 , 16 , 18 , 20 , 21 , 24 , 25 , 28 , 31 , 32 , 34 , 39 , 41 , 42 , 43 , 45 ,…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of Methodology Used in Studies Aimed at Creating Charts of Fetal Brain Structures

et al. 2021

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Ultrasound-based assessment of the fetal nervous system is routinely recommended at the time of the mid-trimester anatomy scan or at different gestations based on clinical indications. This review evaluates the methodological quality of studies aimed at creating charts for fetal brain structures obtained by ultrasound, as poor methodology could explain substantial variability in percentiles reported. Electronic databases (MEDLINE, EMBASE, Cochrane Library, and Web of Science) were searched from January 1970 to January 2021 to select studies on singleton fetuses, where the main aim was to construct charts on one or more clinically relevant structures obtained in the axial plane: parieto-occipital fissure, Sylvian fissure, anterior ventricle, posterior ventricle, transcerebellar diameter, and cisterna magna. Studies were scored against 29 predefined methodological quality criteria to identify the risk of bias. In total, 42 studies met the inclusion criteria, providing data for 45,626 fetuses. Substantial heterogeneity was identified in the methodological quality of included studies, and this may explain the high variability in centiles reported. In 80% of the studies, a high risk of bias was found in more than 50% of the domains scored. In conclusion, charts to be used in clinical practice and research should have an optimal study design in order to minimise the risk of bias and to allow comparison between different studies. We propose to use charts from studies with the highest methodological quality.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Methodology Used in Studies Aimed at Creating Charts of Fetal Brain Structures

et al. 2021

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“…Lin et al showed that the most common brain lesion was CH (32%), followed by brain edema (29%), enlarged cisterna magna (26%) and choroid plexus cysts (19%). Takano et al launched series studies in TCD, APCD, APCD/TCD ratio for the detection of CH for trisomy 18. They showed that TCD was not useful for identifying trisomy 18, and a reduced APCD/TCD ratio was more remarkable and effective with a cutoff value 0.44.…”

Section: Discussionmentioning

confidence: 99%

The ratio of cavum septi pellucidi width to anteroposterior cerebellar diameter: A novel index as a diagnostic adjunct for prenatal diagnosis of trisomy 18

Xie

et al. 2019

J of Obstet and Gynaecol

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Aim To explore the effectiveness of cavum septi pellucidi (CSP) width to anteroposterior cerebellar diameter (APCD) ratio as a diagnostic adjunct for prenatal diagnosis of trisomy 18. Methods Images of normal fetal brain within 15 and 35 weeks were stored in our center from 2016 to 2017. Images of aneuploid fetuses were retrospectively collected from 2004 to 2017. The transverse cerebellar diameter, APCD and CSP width were measured. CSP/APCD and APCD/transverse cerebellar diameter ratios were calculated and compared between euploid and aneuploid fetuses. Results One thousand and forty one fetuses were analyzed, including 817 euploid fetuses and 224 aneuploid fetuses (trisomy 21 117 cases, trisomy 18 82 cases, trisomy 13 9 cases, sex‐linked 16 cases). No correlation had been found between both ratios and gestational weeks (P > 0.05). In aneuploid groups, means of ratios were both significantly different just between trisomy 18 group and euploid group (P < 0.05). The best area under the curve was shown by the CSP/APCD ratio. The cutoff value of CSP/APCD was 0.46 (sensitivity 87.0%, specificity 85.0%). Conclusion A wide CSP or cerebellar hypoplasia warrants a more detailed ultrasound screening and genetic counseling. A larger CSP/APCD ratio alerts us to trisomy 18 syndrome, especially in cases with subtle anomalies.

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Utility of fetal anteroposterior to transverse cerebellar diameter ratio to exclude cerebellar hypoplasia in trisomy 18

Abstract: This study shows that TCD and APCD are correlated with GA, while the APCD/TCD ratio is a fixed value throughout gestation. Using the APCD/TCD ratio to assess cerebellar hypoplasia in trisomy 18 is useful because it does not require the individual evaluation of the TCD and APCD.

Cited by 2 publications

References 15 publications

A Systematic Review of Methodology Used in Studies Aimed at Creating Charts of Fetal Brain Structures

A Systematic Review of Methodology Used in Studies Aimed at Creating Charts of Fetal Brain Structures

The ratio of cavum septi pellucidi width to anteroposterior cerebellar diameter: A novel index as a diagnostic adjunct for prenatal diagnosis of trisomy 18

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