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Kaewnin J, Dulyaphat W, Tongsong T, Lertrat W, Tangshewinsirikul C. Neurosonographic Measurements of the Fetal Anterior Complex in Singleton Pregnancies. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:2725-2737. [PMID: 37490581 DOI: 10.1002/jum.16307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVE To construct reference ranges of the fetal cerebral anterior complex, including ventricular index (VI), anterior horn of lateral ventricle width (AW), and cavum septi pellucidi (CSP) width, as a function of gestational age (GA), in Thai fetuses. METHODS Low-risk pregnancies were recruited to measure fetal anterior complex on axial transventricular and coronal transcaudate planes using transabdominal ultrasound. The downside and upside hemisphere were defined as cerebral hemisphere located distal and proximal to the transducer, respectively. The five variables, downside/upside VI, downside/upside AW and CSP width, were measured from each fetus. Best-fit models in predicting mean and standard deviation for each value as a function of GA were constructed, using regression analysis. Distributions of Z-scores of all values based on GA were created to evaluate the fitness of models. Intraclass correlation coefficients were used to assess inter-/intraobserver variability. RESULTS A total of 395 fetuses were measured for anterior complex. All parameters changed with GA with quadratic function. The models for predicting means and standard deviation of the five parameters as well as percentile charts were created. All models were proven well-fitted. The intra-/interobserver reliability coefficients of all values showed excellent agreement. CONCLUSION The reference ranges of the fetal anterior complex, including VI, AW, and CSP, in axial transventricular and coronal transcaudate planes have been established and available for clinical use.
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Affiliation(s)
- Jetsadaporn Kaewnin
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wirada Dulyaphat
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Theera Tongsong
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Waranyu Lertrat
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chayada Tangshewinsirikul
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Patelli C, Berti G, Marra MC, Lu JLA, Resta S, Mappa I, Rizzo G. Modeling fetal cavum septum pellucidi width by quantile regression at 18-34 weeks of gestation: A prospective cross-sectional study. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1466-1471. [PMID: 37548058 DOI: 10.1002/jcu.23533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE Develop charts for cavum septum pellucidi (CSP) following a standardized methodology and using quantile regression. The secondary objective was to assess the influence of fetal gender on the generated reference curves. METHODS In a cross-sectional prospective study 453 low-risk singleton pregnancies were evaluated at a gestational age interval between 18 and 34 weeks. The width of CSP were measured on ultrasound images using a standardized technique and their changes were evaluated by quantile regression as a function of gestational age (GA) interval or head circumference (HC). Differences between sex were evaluated. RESULTS The measurement of CSP significantly increased with gestation and HC. Linear models better described the changes of CSP with GA and HC. The fits of CSP width with GA and HC were not significantly different. Male fetuses showed significantly higher CSP width when compared to female fetuses (u = 2.973; p = 0.005). CONCLUSIONS We generated prospective nomograms of fetal CSP development using quantile regression and following a strict standardized methodology. These new charts may be useful to better identify abnormal cases at higher risk of associated anomalies. Further our findings underline the potential effect of gender in developing fetal brain.
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Affiliation(s)
- Chiara Patelli
- Department of Obstetrics and Gynecology, Università diVerona, Verona, Italy
| | - Giorgia Berti
- Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy
| | - Maria Chiara Marra
- Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy
| | - Jia Li Angela Lu
- Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy
| | - Serena Resta
- Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy
| | - Ilenia Mappa
- Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy
| | - Giuseppe Rizzo
- Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy
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Goergen S, Furruqh F, Evans R, Cicilet S, Mankad K. Algorithmic approach to neuroradiological diagnosis with pre-natal MRI: non-visualization of the fetal cavum septi pellucidi on mid-trimester screening ultrasound. Br J Radiol 2023:20221042. [PMID: 36930694 DOI: 10.1259/bjr.20221042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
ADVANCES IN KNOWLEDGE A systematic approach by the radiologist to analysis of imaging and other clinical data in the fetus with absent septal leaflets suspected on ultrasound will improve diagnostic efficiency, accuracy, and pre-natal counselling.
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Affiliation(s)
- Stacy Goergen
- Department of Imaging, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.,Monash Health Imaging, Monash Health, Clayton, Victoria, Australia
| | - Farha Furruqh
- Monash Health Imaging, Monash Health, Clayton, Victoria, Australia
| | - Rachel Evans
- Monash Health Imaging, Monash Health, Clayton, Victoria, Australia
| | - Soumya Cicilet
- Monash Health Imaging, Monash Health, Clayton, Victoria, Australia
| | - Kshitij Mankad
- Department of Radiology, Great Ormond Street Hospital, London, United Kingdom.,University College London, Institute of Child Health, London, United Kingdom
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BAYRAKTAR B, TANER CE. Fetal cavum septum pellucidum nomogram and its relationship with fetal Doppler: a prospective study of a Turkish population. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2023. [DOI: 10.32322/jhsm.1200856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim: Septum pellucidum is a thin membrane with right and left leaves, and cavum septum pellucidum (CSP) is formed in the intermembrane region. This study investigates CSP nomogram dimensions for all trimesters in the Turkish population. In addition, the relationship between fetal Doppler flow and CSP size was investigated in this study.
Methods: This study was designed as a prospective cohort between 2019-2020. Pregnant women between 19-42 weeks who were followed up at XXX, Department of Obstetrics and Gynecology were included in the study. (blind review)
Results: A total of 517 fetuses meeting our criteria were included in this prospective study. In the second trimester (19-28 weeks) CSP width (4.12±0.88 vs. 4.91±1.42, p < 0.001) and length (7.95±1.04 vs. 9.48±2.19, p < 0.001) were significantly higher than in the third trimester (28-42 weeks). While the mean CSP width increased up to 32th weeks, there was no clear increase-decrease pattern between 32th-38th weeks, and it was observed to decrease after 38th weeks. The mean CSP length increased up to 29th weeks, while there was no clear increase-decrease pattern between 29th-38th weeks, but decreased after 38th weeks. While a significant correlation was observed between gestational week and CSP width (r = 0.118, p = 0.010), there was no significant correlation between CSP length (r = 0.086, p =0.062). A significant correlation was observed between biparietal diameter (BPD) and CSP width (r = 0.180, p < 0.001) and length (r = 0.202, p < 0.001), but not with head circumference (HC). There was a significant correlation between middle cerebral artery (MCA) systolic/diastolic ratio (S/D) (r = 0.185, p < 0.001), pulsatility index (PI) (r = 0.210, p < 0.001) and resistive index (RI) (r = 0.233, p < 0.001) and CSP length, but not with CSP width.
Conclusion: Turkish population fetal CSP nomogram is presented in this study. Fetal middle cerebral artery Doppler measurements (S/D, PI, and RI) showing cerebral blood flow correlate with CSP length, but not with CSP width. There was no correlation between fetal umbilical artery Doppler measurements and CSP sizes. The results pave the way for population-based studies with much larger samples.
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Affiliation(s)
- Burak BAYRAKTAR
- UNIVERSITY OF HEALTH SCIENCES, İZMİR TEPECİK HEALTH RESEARCH CENTER
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Rosenbloom JI, Yaeger LH, Porat S. Reference Ranges for Corpus Callosum and Cavum Septi Pellucidi Biometry on Prenatal Ultrasound: Systematic Review and Meta-Analysis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:2135-2148. [PMID: 34877699 DOI: 10.1002/jum.15905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/17/2021] [Accepted: 11/20/2021] [Indexed: 06/13/2023]
Abstract
We conducted a systematic review and meta-analysis of published nomograms for fetal corpus callosum and cavum septi pellucid biometry. A structured literature search was conducted to identify studies that reported normal measurements of the fetal corpus callosum and cavum septi pellucidi. Random effects metaanalysis was used to calculate normal ranges, and reference curves are provided. The quality assessment demonstrated that there was generally poor reporting regarding maternal characteristics and neonatal outcomes. Our findings emphasize that standardization of research protocols and publishing criteria for normal biometric ranges is needed.
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Affiliation(s)
- Joshua I Rosenbloom
- Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
- Department of Obstetrics and Gynecology Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Lauren H Yaeger
- Bernard Becker Medical Library, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Shay Porat
- Department of Obstetrics and Gynecology Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Green S, Pretorius DH, Crouch A, Anton T, Jacobs M, Ho Y, Hevner R, Lamale-Smith L. What Are the Double Lines of the Fetal Cavum Septi Pellucidi on Ultrasound? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1907-1914. [PMID: 34751464 DOI: 10.1002/jum.15867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To demonstrate the significance of the double line appearance of the septi pellucidi laminae (SPL) on fetal ultrasound. METHOD A total of 522 uncomplicated singleton pregnancies (15 to 39 weeks' gestational age) with fetal ultrasounds were enrolled. The presence of a single versus double line SP as well as measurement of the cavum septi pellucidi (CSP) was determined retrospectively. Ultrasound settings from the CSP images were recorded. Thickness of the SPL was measured in 20 ultrasound and 14 MRI cases; histology was reviewed from one neonate. Maternal BMI and gestational age were also recorded. RESULTS The presence of double line SPL is a normal sonographic finding, seen in 47% (188/403) of normal fetuses. Thickness of the SPL in 10 cases with double line averaged 1.4 mm and in 10 cases with single line averaged 0.8 mm; MRI measurements were within 0.1 mm of the corresponding ultrasound measurements. Double line cavum was more often seen with mid-dynamic contrast range settings (5, 6) rather than high range settings (7-10) (P value <.05). The double line was only visualized on ultrasound when the angle of insonation was at or near perpendicular to the laminae; it was never visualized on coronal ultrasound imaging or MRI imaging. CONCLUSION A double line septum pellucidum lamina is a normal finding seen in almost 50% of uncomplicated singleton pregnancies. It may be attributed to borders of cell layers within each lamina that form separate specular reflections on both sides; this can be accentuated by ultrasound settings and beam angulation.
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Affiliation(s)
- Shannon Green
- Department of Radiology, University of California, San Diego, San Diego, California, USA
| | - Dolores H Pretorius
- Department of Radiology, University of California, San Diego, San Diego, California, USA
- Maternal-Fetal Care and Genetics, University of California, San Diego, La Jolla, California, USA
| | - Amanda Crouch
- Maternal-Fetal Care and Genetics, University of California, San Diego, La Jolla, California, USA
- Department of Reproductive Medicine, University of California, San Diego, La Jolla, California, USA
| | - Tracy Anton
- Maternal-Fetal Care and Genetics, University of California, San Diego, La Jolla, California, USA
- Department of Reproductive Medicine, University of California, San Diego, La Jolla, California, USA
| | - Marni Jacobs
- Maternal-Fetal Care and Genetics, University of California, San Diego, La Jolla, California, USA
| | - Yoona Ho
- Department of Radiology, Scripps Health, La Jolla, California, USA
| | - Robert Hevner
- Department of Pathology, University of California, San Diego, San Diego, California, USA
| | - Leah Lamale-Smith
- Maternal-Fetal Care and Genetics, University of California, San Diego, La Jolla, California, USA
- Department of Reproductive Medicine, University of California, San Diego, La Jolla, California, USA
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Di Mascio D, Buca D, Rizzo G, Khalil A, Timor-Tritsch IE, Odibo A, Mappa I, Flacco ME, Giancotti A, Liberati M, D'Antonio F. Methodological quality of fetal brain structure charts for screening examination and targeted neurosonography: a systematic review. Fetal Diagn Ther 2022; 49:145-158. [DOI: 10.1159/000521421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 12/06/2021] [Indexed: 11/19/2022]
Abstract
Introduction: The methodological quality of fetal brain charts has not been critically appraised yet.
Material and methods: MEDLINE, EMBASE, CINAHL and the Web of Science databases were searched electronically up to December 31, 2020. The primary outcome was to evaluate the methodology of the studies assessing the growth of fetal brain structures throughout gestation. A list of 28 methodological quality criteria divided into three domains according to “study design”, “statistical and reporting methods”, and “specific relevant neurosonography aspects” was developed in order to assess the methodological appropriateness of the included studies. The overall quality score was defined as the sum of low risk of bias marks, with the range of possible scores being 0–28. This quality assessment was applied to each individual study reporting reference ranges for fetal brain structures.
Results: Sixty studies were included in the systematic review. The overall mean quality score of the studies included in this review was 51.3%. When focusing on each of the assessed domains, the mean quality score was 53.7% for “study design”, 54.2% for “statistical and reporting methods” and 38.6% for “specific relevant neurosonography aspects”. The sample size calculation, the correlation with a postnatal imaging evaluation and the whole fetal brain assessment were the items at the highest risk of bias for each domain assessed, respectively. The subgroup analysis according to different anatomical location showed the lowest quality score for ventricular and periventricular structures and the highest for cortical structures.
Conclusions: Most previously published studies reporting fetal brain charts suffers from poor methodology and are at high risk of biases, mostly when focusing on neurosonography issues. Further prospective longitudinal studies aiming at constructing specific growth charts for fetal brain structures should follow rigorous methodology to minimize the risk of biases, guarantee higher levels of reproducibility and improve the standard of care.
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Cinar A, Sezik M, Yalcin SE, Yavuz A. Reference intervals and reliability of cavum septi pellucidi volume measurements by three-dimensional ultrasound between 19 and 24 weeks' gestation. J Perinat Med 2021; 49:333-339. [PMID: 33095755 DOI: 10.1515/jpm-2020-0327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/22/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES A small or a large cavum septi pellucidi (CSP) during routine second trimester sonography may suggest abnormal cerebral development. Therefore, determination of CSP volume with three-dimensional (3D) ultrasound can be valuable. For this purpose, we sought to evaluate the reference ranges and measurement reliability of CSP volume by Virtual Organ Computer-aided AnaLysis (VOCAL). METHODS VOCAL software was used to calculate the CSP volume from transabdominal multiplanar datasets of 99 structurally normal fetal ultrasound examinations between 19 and 24 weeks of gestation. Linear regression was utilized to determine reference intervals for CSP volumes as a function of gestational week (GW). Agreement among three evaluators with different proficiency levels (obstetrics and gynecology resident, perinatology fellow, and perinatologist) was assessed, using intraclass correlation coefficients (ICC) and 95% confidence intervals (CI). RESULTS CSP volume and gestational age was positively correlated (r2=0.383, p=0.0001), represented by the following equation: 0.058-(1.016 x GW). Interobserver agreement between perinatologist and fellow was relatively high (ICC, 0.78; 95% CI, 0.70-0.85), whereas limited ultrasound experience (resident) was associated with fair agreement with non-novice observers (ICC for resident and perinatologist, 0.50; 95% CI, 0.29-0.65 and ICC for resident and fellow, 0.57; 95% CI, 0.38-0.71). CONCLUSIONS Reference ranges of CSP volumes using VOCAL from 19 0/6 through 24 6/7 weeks of gestation were established. A first-degree model to estimate CSP volume as a function of gestational age was also constructed. CSP volumetry seems reliable when evaluated by an examiner with particular 3D sonography experience.
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Affiliation(s)
- Aslim Cinar
- Department of Obstetrics and Gynecology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Mekin Sezik
- Department of Obstetrics and Gynecology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Serenat Eris Yalcin
- Department of Obstetrics and Gynecology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - And Yavuz
- Department of Obstetrics and Gynecology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
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Ghassemi N, Rupe E, Perez M, Lamale-Smith L, Fratto VM, Farid N, Hahn M, Ramos GA, Ho Y, Rakow-Penner R, Horton K, Khan S, Jones M, Pretorius DH. Ultrasound and Magnetic Resonance Imaging of Agenesis of the Corpus Callosum in Fetuses: Frontal Horns and Cavum Septi Pellucidi Are Clues to Earlier Diagnosis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:2389-2403. [PMID: 32597533 DOI: 10.1002/jum.15348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 06/11/2023]
Abstract
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.
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Affiliation(s)
- Neda Ghassemi
- University of California, San Diego, School of Medicine (N.G.)
| | - Eric Rupe
- University of California, San Diego, Maternal-Fetal Care and Genetics (M.P., L.L.-S., V.M.F., M.H., G.A.R., M.J., D.H.P.), USA
| | - Mishella Perez
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
- Obstetrics, Gynecology and Reproductive Sciences (M.P., L.L.-S., V.M.F., G.A.R.), USA
| | - Leah Lamale-Smith
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
- Obstetrics, Gynecology and Reproductive Sciences (M.P., L.L.-S., V.M.F., G.A.R.), USA
| | - Victoria M Fratto
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
- Obstetrics, Gynecology and Reproductive Sciences (M.P., L.L.-S., V.M.F., G.A.R.), USA
| | - Nikdokht Farid
- University of California, San Diego, Maternal-Fetal Care and Genetics (M.P., L.L.-S., V.M.F., M.H., G.A.R., M.J., D.H.P.), USA
| | - Michael Hahn
- University of California, San Diego, Maternal-Fetal Care and Genetics (M.P., L.L.-S., V.M.F., M.H., G.A.R., M.J., D.H.P.), USA
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
| | - Gladys A Ramos
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
- Obstetrics, Gynecology and Reproductive Sciences (M.P., L.L.-S., V.M.F., G.A.R.), USA
| | - Yoona Ho
- University of California, San Diego, Maternal-Fetal Care and Genetics (M.P., L.L.-S., V.M.F., M.H., G.A.R., M.J., D.H.P.), USA
| | - Rebecca Rakow-Penner
- University of California, San Diego, Maternal-Fetal Care and Genetics (M.P., L.L.-S., V.M.F., M.H., G.A.R., M.J., D.H.P.), USA
| | - Katelyn Horton
- University of California, Berkeley, California, USA (K.H.), USA
| | - Sohini Khan
- University of California, Berkeley, California, USA (K.H.), USA
| | - Marilyn Jones
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
- General Surgery (S.K.) and Pediatrics (M.J.), University of California, USA
| | - Dolores H Pretorius
- University of California, San Diego, Maternal-Fetal Care and Genetics (M.P., L.L.-S., V.M.F., M.H., G.A.R., M.J., D.H.P.), USA
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
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Maduram A, Farid N, Rakow-Penner R, Ghassemi N, Khanna PC, Robbins SL, Hull A, Gold J, Pretorius DH. Fetal Ultrasound and Magnetic Resonance Imaging Findings in Suspected Septo-Optic Dysplasia: A Diagnostic Dilemma. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1601-1614. [PMID: 32118312 DOI: 10.1002/jum.15252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/23/2020] [Accepted: 02/09/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To investigate prenatal imaging findings supporting a diagnosis of suspected septo-optic dysplasia (SOD) by fetal ultrasound (US), magnetic resonance imaging (MRI), or both. METHODS A retrospective review identified 11 patients with SOD: 9 had a clinical diagnosis of SOD postnatally, and 2 were terminated on the basis of suspicious prenatal imaging. Prenatal and neonatal imaging of the cavum septi pellucidi (CSP), frontal horns (FHs), and lateral ventricles was evaluated. RESULTS The appearance of the CSP varied on US and MRI. Complete ("fused") FHs or partial absence of the CSP was reported in 6 of 11 patients by fetal US and 7 of 8 patients by fetal MRI. The diagnosis of SOD was prospectively suspected prenatally in 6 of 11 and in an additional 5 of 11 cases retrospectively. Fetal MRI incorrectly initially reported normal morphologic abnormalities for 2 cases with partial absence of the CSP, whereas US accurately identified the morphologic abnormalities in 1 of these cases before MRI. Imaging features were first suggested at anatomic US (4 patients) and follow-up prenatal US (2 patients). Neonatal imaging was concordant in all 9 live births: 5 completely absent CSP, 3 partially absent CSP, and 1 completely present CSP. Clinical manifestations included optic nerve hypoplasia (9 of 9), panhypopituitarism (5 of 9), and neurodevelopmental delays. CONCLUSIONS Primary imaging features of SOD are "continuous" FHs with complete or partial absence of the CSP. Septo-optic dysplasia can be suspected in utero and can appear isolated but has substantial associated central nervous system anomalies identified on fetal MRI or after birth. Partial absence of the CSP can be a prenatal sign of suspected SOD, although fetal MRI lacked the spatial resolution to identify it accurately in all cases.
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Affiliation(s)
| | | | | | | | - Paritosh C Khanna
- Rady's Children's Hospital and Sharp Healthcare, Department of Radiology
| | - Shira L Robbins
- Viterbi Family Department of Ophthalmology, Ratner Children's Eye Center
| | - Andrew Hull
- Reproductive Medicine
- University of California San Diego Maternal Fetal Care and Genetics, University of California, San Diego, La Jolla, California, USA
| | | | - Dolores H Pretorius
- Departments of Radiology
- University of California San Diego Maternal Fetal Care and Genetics, University of California, San Diego, La Jolla, California, USA
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