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Calixto C, Taymourtash A, Karimi D, Snoussi H, Velasco-Annis C, Jaimes C, Gholipour A. Advances in Fetal Brain Imaging. Magn Reson Imaging Clin N Am 2024; 32:459-478. [PMID: 38944434 PMCID: PMC11216711 DOI: 10.1016/j.mric.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Over the last 20 years, there have been remarkable developments in fetal brain MR imaging analysis methods. This article delves into the specifics of structural imaging, diffusion imaging, functional MR imaging, and spectroscopy, highlighting the latest advancements in motion correction, fetal brain development atlases, and the challenges and innovations. Furthermore, this article explores the clinical applications of these advanced imaging techniques in comprehending and diagnosing fetal brain development and abnormalities.
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Affiliation(s)
- Camilo Calixto
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, 401 Park Dr, 7th Floor West, Boston, MA 02215, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| | - Athena Taymourtash
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Spitalgasse 23, Wien 1090, Austria
| | - Davood Karimi
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, 401 Park Dr, 7th Floor West, Boston, MA 02215, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Haykel Snoussi
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, 401 Park Dr, 7th Floor West, Boston, MA 02215, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Clemente Velasco-Annis
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, 401 Park Dr, 7th Floor West, Boston, MA 02215, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Camilo Jaimes
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02215, USA
| | - Ali Gholipour
- Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, 401 Park Dr, 7th Floor West, Boston, MA 02215, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
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2
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Dhakal P, Aryal AB, Dev A, Dhakal S, Kandel D. Asymmetric ventriculomegaly, interhemispheric cyst, and dysgenesis of corpus callosum (AVID) - case report. Radiol Case Rep 2023; 18:3936-3940. [PMID: 37663572 PMCID: PMC10472145 DOI: 10.1016/j.radcr.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 08/03/2023] [Indexed: 09/05/2023] Open
Abstract
AVID (Asymmetric ventriculomegaly, interhemispheric cyst, and dysgenesis of corpus callosum) spectrum is a rare phenomenon as such in its whole and the defects are not exclusive to the condition. Each may occur in isolation or together and have characteristic clinical and imaging findings. The vast array of mimics coexisting with the condition makes it a harder diagnosis to make and requires a great length of experience and observation which may explain the limited recordings of AVID. Sonography and fetal magnetic resonance imaging goes a long way and provide accurate diagnosis ruling out the mimics and aiding in prenatal visualization of the defects. Accurate diagnosis aids in effective management and counseling regarding outcomes and the potential timeline of the severity of the symptoms. In its rarity, this case report of AVID is one of the first report of its kind reported from Nepal.
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Affiliation(s)
- Prakash Dhakal
- Department of Radiology, Bir, Hospital, Kathmandu, Nepal
| | | | - Abinash Dev
- B.P. Koirala Institute Of Health Sciences, Dharan, Nepal
| | | | - Devraj Kandel
- Department of Radiology, Bir, Hospital, Kathmandu, Nepal
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3
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Payette K, Li HB, de Dumast P, Licandro R, Ji H, Siddiquee MMR, Xu D, Myronenko A, Liu H, Pei Y, Wang L, Peng Y, Xie J, Zhang H, Dong G, Fu H, Wang G, Rieu Z, Kim D, Kim HG, Karimi D, Gholipour A, Torres HR, Oliveira B, Vilaça JL, Lin Y, Avisdris N, Ben-Zvi O, Bashat DB, Fidon L, Aertsen M, Vercauteren T, Sobotka D, Langs G, Alenyà M, Villanueva MI, Camara O, Fadida BS, Joskowicz L, Weibin L, Yi L, Xuesong L, Mazher M, Qayyum A, Puig D, Kebiri H, Zhang Z, Xu X, Wu D, Liao K, Wu Y, Chen J, Xu Y, Zhao L, Vasung L, Menze B, Cuadra MB, Jakab A. Fetal brain tissue annotation and segmentation challenge results. Med Image Anal 2023; 88:102833. [PMID: 37267773 DOI: 10.1016/j.media.2023.102833] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 03/16/2023] [Accepted: 04/20/2023] [Indexed: 06/04/2023]
Abstract
In-utero fetal MRI is emerging as an important tool in the diagnosis and analysis of the developing human brain. Automatic segmentation of the developing fetal brain is a vital step in the quantitative analysis of prenatal neurodevelopment both in the research and clinical context. However, manual segmentation of cerebral structures is time-consuming and prone to error and inter-observer variability. Therefore, we organized the Fetal Tissue Annotation (FeTA) Challenge in 2021 in order to encourage the development of automatic segmentation algorithms on an international level. The challenge utilized FeTA Dataset, an open dataset of fetal brain MRI reconstructions segmented into seven different tissues (external cerebrospinal fluid, gray matter, white matter, ventricles, cerebellum, brainstem, deep gray matter). 20 international teams participated in this challenge, submitting a total of 21 algorithms for evaluation. In this paper, we provide a detailed analysis of the results from both a technical and clinical perspective. All participants relied on deep learning methods, mainly U-Nets, with some variability present in the network architecture, optimization, and image pre- and post-processing. The majority of teams used existing medical imaging deep learning frameworks. The main differences between the submissions were the fine tuning done during training, and the specific pre- and post-processing steps performed. The challenge results showed that almost all submissions performed similarly. Four of the top five teams used ensemble learning methods. However, one team's algorithm performed significantly superior to the other submissions, and consisted of an asymmetrical U-Net network architecture. This paper provides a first of its kind benchmark for future automatic multi-tissue segmentation algorithms for the developing human brain in utero.
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Affiliation(s)
- Kelly Payette
- Center for MR Research, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland.
| | - Hongwei Bran Li
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland; Department of Informatics, Technical University of Munich, Munich, Germany
| | - Priscille de Dumast
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; CIBM, Center for Biomedical Imaging, Lausanne, Switzerland
| | - Roxane Licandro
- Laboratory for Computational Neuroimaging, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, United States; Department of Biomedical Imaging and Image-guided Therapy, Computational Imaging Research Lab (CIR), Medical University of Vienna, Vienna, Austria
| | - Hui Ji
- Center for MR Research, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland
| | | | | | | | - Hao Liu
- Shanghai Jiaotong University, China
| | | | | | - Ying Peng
- School of Computer Science, Shaanxi Normal University, Xi'an 710119, China
| | - Juanying Xie
- School of Computer Science, Shaanxi Normal University, Xi'an 710119, China
| | - Huiquan Zhang
- School of Computer Science, Shaanxi Normal University, Xi'an 710119, China
| | - Guiming Dong
- School of Mechanical and Electrical Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Hao Fu
- School of Mechanical and Electrical Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Guotai Wang
- School of Mechanical and Electrical Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - ZunHyan Rieu
- Research Institute, NEUROPHET Inc., Seoul 06247, South Korea
| | - Donghyeon Kim
- Research Institute, NEUROPHET Inc., Seoul 06247, South Korea
| | - Hyun Gi Kim
- Department of Radiology, The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Seoul 06247, South Korea
| | - Davood Karimi
- Boston Children's Hospital and Harvard Medical School, Boston, MA, United States
| | - Ali Gholipour
- Boston Children's Hospital and Harvard Medical School, Boston, MA, United States
| | - Helena R Torres
- Algoritmi Center, School of Engineering, University of Minho, Guimarães, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga Guimarães, Portugal
| | - Bruno Oliveira
- Algoritmi Center, School of Engineering, University of Minho, Guimarães, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga Guimarães, Portugal
| | - João L Vilaça
- 2Ai - School of Technology, IPCA, Barcelos, Portugal
| | - Yang Lin
- Department of Computer Science, Hong Kong University of Science and Technology, China
| | - Netanell Avisdris
- School of Computer Science and Engineering, The Hebrew University of Jerusalem, Israel; Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Ori Ben-Zvi
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Dafna Ben Bashat
- Sagol School of Neuroscience, Tel Aviv University, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Lucas Fidon
- School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EU, United Kingdom
| | - Michael Aertsen
- Department of Radiology, University Hospitals Leuven, Leuven 3000, Belgium
| | - Tom Vercauteren
- School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EU, United Kingdom
| | - Daniel Sobotka
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Georg Langs
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Mireia Alenyà
- BCN-MedTech, Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Maria Inmaculada Villanueva
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Oscar Camara
- BCN-MedTech, Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Bella Specktor Fadida
- School of Computer Science and Engineering, The Hebrew University of Jerusalem, Israel
| | - Leo Joskowicz
- School of Computer Science and Engineering, The Hebrew University of Jerusalem, Israel
| | - Liao Weibin
- School of Computer Science, Beijing Institute of Technology, China
| | - Lv Yi
- School of Computer Science, Beijing Institute of Technology, China
| | - Li Xuesong
- School of Computer Science, Beijing Institute of Technology, China
| | - Moona Mazher
- Department of Computer Engineering and Mathematics, University Rovira i Virgili,Spain
| | | | - Domenec Puig
- Department of Computer Engineering and Mathematics, University Rovira i Virgili,Spain
| | - Hamza Kebiri
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; CIBM, Center for Biomedical Imaging, Lausanne, Switzerland
| | - Zelin Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Yuquan Campus, Hangzhou, China
| | - Xinyi Xu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Yuquan Campus, Hangzhou, China
| | - Dan Wu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Yuquan Campus, Hangzhou, China
| | | | - Yixuan Wu
- Zhejiang University, Hangzhou, China
| | | | - Yunzhi Xu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Yuquan Campus, Hangzhou, China
| | - Li Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Yuquan Campus, Hangzhou, China
| | - Lana Vasung
- Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, United States; Department of Pediatrics, Harvard Medical School, United States
| | - Bjoern Menze
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Meritxell Bach Cuadra
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; CIBM, Center for Biomedical Imaging, Lausanne, Switzerland
| | - Andras Jakab
- Center for MR Research, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland; University Research Priority Project Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zürich, Zurich, Switzerland
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4
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Karimi D, Rollins CK, Velasco-Annis C, Ouaalam A, Gholipour A. Learning to segment fetal brain tissue from noisy annotations. Med Image Anal 2023; 85:102731. [PMID: 36608414 PMCID: PMC9974964 DOI: 10.1016/j.media.2022.102731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/17/2022] [Accepted: 12/23/2022] [Indexed: 01/03/2023]
Abstract
Automatic fetal brain tissue segmentation can enhance the quantitative assessment of brain development at this critical stage. Deep learning methods represent the state of the art in medical image segmentation and have also achieved impressive results in brain segmentation. However, effective training of a deep learning model to perform this task requires a large number of training images to represent the rapid development of the transient fetal brain structures. On the other hand, manual multi-label segmentation of a large number of 3D images is prohibitive. To address this challenge, we segmented 272 training images, covering 19-39 gestational weeks, using an automatic multi-atlas segmentation strategy based on deformable registration and probabilistic atlas fusion, and manually corrected large errors in those segmentations. Since this process generated a large training dataset with noisy segmentations, we developed a novel label smoothing procedure and a loss function to train a deep learning model with smoothed noisy segmentations. Our proposed methods properly account for the uncertainty in tissue boundaries. We evaluated our method on 23 manually-segmented test images of a separate set of fetuses. Results show that our method achieves an average Dice similarity coefficient of 0.893 and 0.916 for the transient structures of younger and older fetuses, respectively. Our method generated results that were significantly more accurate than several state-of-the-art methods including nnU-Net that achieved the closest results to our method. Our trained model can serve as a valuable tool to enhance the accuracy and reproducibility of fetal brain analysis in MRI.
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Affiliation(s)
- Davood Karimi
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Caitlin K Rollins
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Clemente Velasco-Annis
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Abdelhakim Ouaalam
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ali Gholipour
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Eshiba SM, Zahran MH, Elnekeidy AM, Abdeldayem TM, Hassan HHM. Added value of fetal MRI as a complementary method to antenatal ultrasound in the assessment of non-CNS fetal congenital anomalies. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00708-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Birth defects and congenital anomalies are different words used to describe developmental abnormalities that occur at birth. Congenital anomalies diagnosis during pregnancy is a difficult topic to which ultrasonography has made significant contributions. The availability of a generally safe, independent technique in the evaluation of prenatal anomalies would be a welcomed clinical and scientific alternative. Ultrasound (US) is the predominant modality for evaluating disorders related to fetus and pregnancy. In most situations, this examination by a professional operator offers sufficient information about fetal morphology, surroundings, and well-being. The abnormalities revealed by ultrasound can be subtle or inconclusive at times. MRI has been demonstrated to be useful in such circumstances in various studies. So the effective use of fetal MRI in the evaluation of non-CNS abnormalities of the body is a reason for adopting fetal MRI as an adjunct to US in obstetric imaging. This study aimed to examine the role of fetal MRI as a complementary method to the antenatal US in assessing non-CNS anomalies and how it changed or modified the diagnosis of anomalies.
Results
By analyzing the data of 30 pregnant females with fetal non-CNS congenital anomalies, the diagnostic accuracy of prenatal ultrasound alone in the detection of congenital anomalies was 76%, with a sensitivity of about 76%. And diagnostic accuracy of MRI alone was 96.6%, with a sensitivity of approximately 96.6%. Moreover, the diagnostic accuracy of combined prenatal US and prenatal MRI in the detection of congenital anomalies was 100%, with sensitivity about 100% and PPV about 100%.
Conclusion
Fetal MRI raises confidence in non-CNS malformation assessment. Compared to US, MRI overcomes many of the obstacles faced by the antenatal US. MRI is superior to the US in refining, changing, or adding more diagnostic information about the disease.
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Peng SW, Peng KP, Tian GX, Cao XY, Liu MH, Dong QY. Ultrasonic Diagnosis of Lissencephaly: Literature Review and A Case Report. JOURNAL OF FETAL MEDICINE 2021. [DOI: 10.1007/s40556-021-00313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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7
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Payette K, de Dumast P, Kebiri H, Ezhov I, Paetzold JC, Shit S, Iqbal A, Khan R, Kottke R, Grehten P, Ji H, Lanczi L, Nagy M, Beresova M, Nguyen TD, Natalucci G, Karayannis T, Menze B, Bach Cuadra M, Jakab A. An automatic multi-tissue human fetal brain segmentation benchmark using the Fetal Tissue Annotation Dataset. Sci Data 2021; 8:167. [PMID: 34230489 PMCID: PMC8260784 DOI: 10.1038/s41597-021-00946-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 05/13/2021] [Indexed: 11/09/2022] Open
Abstract
It is critical to quantitatively analyse the developing human fetal brain in order to fully understand neurodevelopment in both normal fetuses and those with congenital disorders. To facilitate this analysis, automatic multi-tissue fetal brain segmentation algorithms are needed, which in turn requires open datasets of segmented fetal brains. Here we introduce a publicly available dataset of 50 manually segmented pathological and non-pathological fetal magnetic resonance brain volume reconstructions across a range of gestational ages (20 to 33 weeks) into 7 different tissue categories (external cerebrospinal fluid, grey matter, white matter, ventricles, cerebellum, deep grey matter, brainstem/spinal cord). In addition, we quantitatively evaluate the accuracy of several automatic multi-tissue segmentation algorithms of the developing human fetal brain. Four research groups participated, submitting a total of 10 algorithms, demonstrating the benefits the dataset for the development of automatic algorithms.
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Affiliation(s)
- Kelly Payette
- Center for MR Research, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Neuroscience Center Zurich, University of Zurich/ETH Zurich, Zurich, Switzerland.
| | - Priscille de Dumast
- CIBM, Center for Biomedical Imaging, Lausanne, Switzerland
- Medical Image Analysis Laboratory, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Hamza Kebiri
- CIBM, Center for Biomedical Imaging, Lausanne, Switzerland
- Medical Image Analysis Laboratory, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ivan Ezhov
- Image-Based Biomedical Imaging Group, Technical University of Munich, München, Germany
| | - Johannes C Paetzold
- Image-Based Biomedical Imaging Group, Technical University of Munich, München, Germany
| | - Suprosanna Shit
- Image-Based Biomedical Imaging Group, Technical University of Munich, München, Germany
| | - Asim Iqbal
- Neuroscience Center Zurich, University of Zurich/ETH Zurich, Zurich, Switzerland
- Brain Research Institute, University of Zurich, Zurich, Switzerland
- Center for Intelligent Systems & Brain Mind Institute, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
| | - Romesa Khan
- Neuroscience Center Zurich, University of Zurich/ETH Zurich, Zurich, Switzerland
- Institute for Biomedical Engineering, UZH/ETH Zurich, Zurich, Switzerland
| | - Raimund Kottke
- Department of Diagnostic Imaging, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Patrice Grehten
- Department of Diagnostic Imaging, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hui Ji
- Center for MR Research, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Levente Lanczi
- Faculty of Medicine, Department of Medical Imaging, University of Debrecen, Debrecen, Hajdú-Bihar, Hungary
| | - Marianna Nagy
- Faculty of Medicine, Department of Medical Imaging, University of Debrecen, Debrecen, Hajdú-Bihar, Hungary
| | - Monika Beresova
- Faculty of Medicine, Department of Medical Imaging, University of Debrecen, Debrecen, Hajdú-Bihar, Hungary
| | - Thi Dao Nguyen
- Newborn Research, Department of Neonatology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Giancarlo Natalucci
- Newborn Research, Department of Neonatology, University Hospital and University of Zurich, Zurich, Switzerland
- Larsson-Rosenquist Center for Neurodevelopment, Growth and Nutrition of the Newborn, Department of Neonatology, University Hospital and University of Zurich, Zurich, Switzerland
| | | | - Bjoern Menze
- Image-Based Biomedical Imaging Group, Technical University of Munich, München, Germany
| | - Meritxell Bach Cuadra
- CIBM, Center for Biomedical Imaging, Lausanne, Switzerland
- Medical Image Analysis Laboratory, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Andras Jakab
- Center for MR Research, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich/ETH Zurich, Zurich, Switzerland
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Caceres A, Segura-Masis JL, Caceres-Alan A, Gutierrez-Duran F, Zamora-Chaves J, Segura-Valverde JL. Craniopagus parasiticus: successful separation of a 28-week preterm newborn from parasite sibling twin bearing lethal congenital anomalies associated to Cantrell's pentad and sirenomelia-case-based review of the literature. Childs Nerv Syst 2021; 37:2139-2146. [PMID: 33934204 DOI: 10.1007/s00381-021-05179-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/19/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This paper reviews the plausible etiological mechanisms, clinical features, preoperative analysis, and documented modern-day craniopagus parasiticus surgical separation attempts as well as an historical review of the few cases documented in the literature. METHODS We describe the successful separation of a 28-week preterm newborn from its parasite sibling twin bearing lethal congenital anomalies associated to Cantrell's pentad and sirenomelia. Description of the case, plausible explanations on the mechanisms of conjointment along with the associated congenital abnormalities of the deceased twin are examined along with an historical revision of craniopagus parasiticus and their separation attempts with special attention to the previously undocumented attempt of the Dominican CP separation surgery by Lazareff et al. RESULTS: The use of the deceased twin cranial vault tissues (skin, bone, and duramater) as an autologous implant due to the identical genetical profile served to remodel and close the skull of the surviving twin with good esthetic results and no tissue rejection. To our knowledge, this is the youngest preterm set of craniopagus parasiticus separated in an emergency fashion with good functional and esthetic outcome. CONCLUSIONS Craniopagus parasiticus is an infrequent subvariant of this rare form of twin conjointment which may require urgent separation due to the associated malformations of the parasitic twin; therefore, the fact that both siblings are genetically identical may prove as an advantage to use duramater, bone, and soft tissues from the parasitic twin as ideal grafts for covering the resultant defect after the separation has been performed.
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Affiliation(s)
- Adrian Caceres
- Neurosurgery Department, National Children's Hospital of Costa Rica "Dr. Carlos Sáenz Herrera", Paseo Colón y calle 20 sur, San Jose, Costa Rica, 10103.
| | - Juan Luis Segura-Masis
- Neurosurgery Department, National Children's Hospital of Costa Rica "Dr. Carlos Sáenz Herrera", Paseo Colón y calle 20 sur, San Jose, Costa Rica, 10103
| | - Ariadnna Caceres-Alan
- Neurosurgery Department, National Children's Hospital of Costa Rica "Dr. Carlos Sáenz Herrera", Paseo Colón y calle 20 sur, San Jose, Costa Rica, 10103
| | | | - Justiniano Zamora-Chaves
- Neurosurgery Department, National Children's Hospital of Costa Rica "Dr. Carlos Sáenz Herrera", Paseo Colón y calle 20 sur, San Jose, Costa Rica, 10103
| | - Juan Luis Segura-Valverde
- Neurosurgery Department, National Children's Hospital of Costa Rica "Dr. Carlos Sáenz Herrera", Paseo Colón y calle 20 sur, San Jose, Costa Rica, 10103
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9
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Chen L, Huang FX. Apert syndrome diagnosed by prenatal ultrasound combined with magnetic resonance imaging and whole exome sequencing: A case report. World J Clin Cases 2021; 9:912-918. [PMID: 33585639 PMCID: PMC7852645 DOI: 10.12998/wjcc.v9.i4.912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/06/2020] [Accepted: 12/16/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Most cases of Apert syndrome (AS) are found after birth. Cases of AS diagnosed by ultrasound combined with magnetic resonance imaging (MRI) and whole exome sequencing (WES) during pregnancy are rare.
CASE SUMMARY We present the case of a 34-year old female patient (gravida 2, para 1) whose fetus was diagnosed with AS during pregnancy. Fetal ultrasound performed at 30, 2/7 wk of pregnancy showed abnormalities. MRI and three-dimensional ultrasound performed at 31, 1/7 wk of pregnancy showed the possibility of AS. Chromosome examination and core family WES were conducted at 31, 5/7 wk of pregnancy. The results showed that FGFR2 in the fetus had a c.755C>G missense mutation in its nucleotide, and AS was confirmed.
CONCLUSION This case highlights the importance of imaging examinations. Prenatal ultrasound combined with MRI can identify fetal morphological abnormalities accurately, which can be confirmed by WES.
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Affiliation(s)
- Lei Chen
- Ultrasonography Department, Hangzhou Women’s Hospital, Hangzhou 310008, Zhejiang Province, China
| | - Fei-Xiang Huang
- Department of Traditional Chinese Medicine, Hangzhou Women’s Hospital, Hangzhou 310008, Zhejiang Province, China
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10
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Douglas Wilson R, Van Mieghem T, Langlois S, Church P. Guideline No. 410: Prevention, Screening, Diagnosis, and Pregnancy Management for Fetal Neural Tube Defects. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 43:124-139.e8. [PMID: 33212246 DOI: 10.1016/j.jogc.2020.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This revised guideline is intended to provide an update on the genetic aspects, prevention, screening, diagnosis, and management of fetal neural tube defects. TARGET POPULATION Women who are pregnant or may become pregnant. Neural tube defect screening should be offered to all pregnant women. OPTIONS For prevention: a folate-rich diet, and folic acid and vitamin B12 supplementation, with dosage depending on risk level. For screening: second-trimester anatomical sonography; first-trimester sonographic screening; maternal serum alpha fetoprotein; prenatal magnetic resonance imaging. For genetic testing: diagnostic amniocentesis with chromosomal microarray and amniotic fluid alpha fetoprotein and acetylcholinesterase; fetal exome sequencing. For pregnancy management: prenatal surgical repair; postnatal surgical repair; pregnancy termination with autopsy. For subsequent pregnancies: prevention and screening options and counselling. OUTCOMES The research on and implementation of fetal surgery for prenatally diagnosed myelomeningocele has added a significant treatment option to the previous options (postnatal repair or pregnancy termination), but this new option carries an increased risk of maternal morbidity. Significant improvements in health and quality of life, both for the mother and the infant, have been shown to result from the prevention, screening, diagnosis, and treatment of fetal neural tube defects. BENEFITS, HARMS, AND COSTS The benefits for patient autonomy and decision-making are provided in the guideline. Harms include an unexpected fetal diagnosis and the subsequent management decisions. Harm can also result if the patient declines routine sonographic scans or if counselling and access to care for neural tube defects are delayed. Cost analysis (personal, family, health care) is not within the scope of this clinical practice guideline. EVIDENCE A directed and focused literature review was conducted using the search terms spina bifida, neural tube defect, myelomeningocele, prenatal diagnosis, fetal surgery, neural tube defect prevention, neural tube defect screening, neural tube defect diagnosis, and neural tube defect management in order to update and revise this guideline. A peer review process was used for content validation and clarity, with appropriate ethical considerations. VALIDATION METHODS The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations). INTENDED AUDIENCE Maternity care professionals who provide any part of pre-conception, antenatal, delivery, and neonatal care. This guideline is also appropriate for patient education. RECOMMENDATIONS (GRADE RATINGS IN PARENTHESES).
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Douglas Wilson R, Van Mieghem T, Langlois S, Church P. Directive clinique n o 410 : Anomalies du tube neural : Prévention, dépistage, diagnostic et prise en charge de la grossesse. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 43:140-157.e8. [PMID: 33212245 DOI: 10.1016/j.jogc.2020.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIF La présente directive clinique révisée vise à fournir une mise à jour sur les aspects génétiques, la prévention, le dépistage, le diagnostic et la prise en charge des anomalies du tube neural. POPULATION CIBLE Les femmes enceintes ou qui pourraient le devenir. Il convient d'offrir le dépistage des anomalies du tube neural à toutes les femmes enceintes. OPTIONS Pour la prévention : un régime alimentaire riche en acide folique et des suppléments d'acide folique et de vitamine B12 selon une posologie d'après le niveau de risque. Pour le dépistage : l'échographie obstétricale du deuxième trimestre, le dépistage échographique du premier trimestre, le dosage de l'alphafœtoprotéine sérique maternelle et l'imagerie par résonance magnétique prénatale. Pour les tests génétiques : l'amniocentèse diagnostique avec analyse chromosomique sur micropuce et le dosage de l'alphafœtoprotéine et de l'acétylcholinestérase dans le liquide amniotique et le séquençage de l'exome fœtal. Pour la prise en charge de la grossesse : la réparation chirurgicale prénatale, la réparation chirurgicale postnatale et l'interruption de grossesse avec autopsie. Pour les grossesses subséquentes : les options de prévention et de dépistage et les conseils. RéSULTATS: La recherche et la mise en œuvre du traitement chirurgical fœtal en cas de diagnostic prénatal de myéloméningocèle ont ajouté une option thérapeutique fœtale importante aux options précédentes (réparation postnatale ou interruption de grossesse), mais cette nouvelle option comporte un risque accru de morbidité maternelle. La prévention, le dépistage, le diagnostic et le traitement des anomalies du tube neural se révèlent entraîner des améliorations importantes à la mère et au nourrisson en matière de santé et de qualité de vie. BéNéFICES, RISQUES ET COûTS: Le type et l'ampleur des bénéfices, risques et coûts attendus pour les patientes grâce à la mise en œuvre de la présente directive clinique par un établissement de soins de santé intègrent un canal maternel préconception et prénatal adéquat comprenant l'accès des patientes aux soins, les conseils, les analyses et examens, l'imagerie, le diagnostic et l'interprétation. Les bénéfices relatifs à l'autonomie de la patiente et au processus décisionnel sont énoncés dans la présente directive clinique. Les risques comprennent un diagnostic fœtal inattendu et les décisions de prise en charge subséquentes. Le fait que la patiente refuse les échographies habituelles et le retard du conseil ou d'accès aux soins en cas d'anomalie du tube neural comportent également des risques. L'analyse des coûts (personnels, familiaux, santé publique) ne fait pas partie de la portée de la présente directive clinique. DONNéES PROBANTES: Afin de mettre à jour et réviser la présente directive, une revue de la littérature ciblée et dirigée a été effectuée à l'aide des termes de recherche suivants : spina bifida, neural tube defect, myelomeningocele, prenatal diagnosis, fetal surgery, neural tube defect prevention, neural tube defect screening, neural tube defect diagnosis et neural tube defect management. Un processus d'examen par les pairs a été utilisé pour la validation et la clarté du contenu, avec des considérations appropriées d'ordre éthique. MéTHODES DE VALIDATION: Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant l'approche d'évaluation, de développement et d'évaluation (GRADE). Consulter l'annexe A en ligne (le tableau A1 pour les définitions et le tableau A2 pour les interprétations des recommandations fortes et faibles). PROFESSIONNELS CONCERNéS: Professionnels des soins de maternité qui offrent des soins préconception, prénataux, obstétricaux ou néonataux. La présente directive clinique convient également aux fins d'éducation des patientes. RECOMMANDATIONS (CLASSEMENT GRADE ENTRE PARENTHèSES).
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Griffiths PD, Bradburn M, Campbell MJ, Cooper CL, Embleton N, Graham R, Hart AR, Jarvis D, Kilby MD, Lie M, Mason G, Mandefield L, Mooney C, Pennington R, Robson SC, Wailoo A. MRI in the diagnosis of fetal developmental brain abnormalities: the MERIDIAN diagnostic accuracy study. Health Technol Assess 2020; 23:1-144. [PMID: 31538569 DOI: 10.3310/hta23490] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Ultrasonography has been the mainstay of antenatal screening programmes in the UK for many years. Technical factors and physical limitations may result in suboptimal images that can lead to incorrect diagnoses and inaccurate counselling and prognostic information being given to parents. Previous studies suggest that the addition of in utero magnetic resonance imaging (iuMRI) may improve diagnostic accuracy for fetal brain abnormalities. These studies have limitations, including a lack of an outcome reference diagnosis (ORD), which means that improvements could not be assessed accurately. OBJECTIVES To assess the diagnostic impact, acceptability and cost consequence of iuMRI among fetuses with a suspected fetal brain abnormality. DESIGN A pragmatic, prospective, multicentre, cohort study with a health economics analysis and a sociological substudy. SETTING Sixteen UK fetal medicine centres. PARTICIPANTS Pregnant women aged ≥ 16 years carrying a fetus (at least 18 weeks' gestation) with a suspected brain abnormality detected on ultrasonography. INTERVENTIONS Participants underwent iuMRI and the findings were reported to their referring fetal medicine clinician. MAIN OUTCOME MEASURES Pregnancy outcome was followed up and an ORD from postnatal imaging or postmortem autopsy/imaging collected when available. Developmental data from the Bayley Scales of Infant Development and questionnaires were collected from the surviving infants aged 2-3 years. Data on the management of the pregnancy before and after the iuMRI were collected to inform the economic evaluation. Two surveys collected data on patient acceptability of iuMRI and qualitative interviews with participants and health professionals were undertaken. RESULTS The primary analysis consisted of 570 fetuses. The absolute diagnostic accuracies of ultrasonography and iuMRI were 68% and 93%, respectively [a difference of 25%, 95% confidence interval (CI) 21% to 29%]. The difference between ultrasonography and iuMRI increased with gestational age. In the 18-23 weeks group, the figures were 70% for ultrasonography and 92% for iuMRI (difference of 23%, 95% CI 18% to 27%); in the ≥ 24 weeks group, the figures were 65% for ultrasonography and 94% for iuMRI (difference of 29%, 95% CI 23% to 36%). Patient acceptability was high, with at least 95% of respondents stating that they would have iuMRI again in a similar situation. Health professional interviews suggested that iuMRI was acceptable to clinicians and that iuMRI was useful as an adjunct to ultrasonography, but not as a replacement. Across a range of scenarios, iuMRI resulted in additional costs compared with ultrasonography alone. The additional cost was consistently < £600 per patient and the cost per management decision appropriately changed was always < £3000. There is potential for reporting bias from the referring clinicians on the diagnostic and prognostic outcomes. Lower than anticipated follow-up rates at 3 years of age were observed. CONCLUSIONS iuMRI as an adjunct to ultrasonography significantly improves the diagnostic accuracy and confidence for the detection of fetal brain abnormalities. An evaluation of the use of iuMRI for cases of isolated microcephaly and the diagnosis of fetal spine abnormalities is recommended. Longer-term follow-up studies of children diagnosed with fetal brain abnormalities are required to fully assess the functional significance of the diagnoses. TRIAL REGISTRATION Current Controlled Trials ISRCTN27626961. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 49. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Paul D Griffiths
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Michael Bradburn
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Michael J Campbell
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Cindy L Cooper
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Nicholas Embleton
- Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Ruth Graham
- School of Geography, Politics and Sociology, Newcastle University, Newcastle upon Tyne, UK
| | - Anthony R Hart
- Department of Perinatal and Paediatric Neurology, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| | - Deborah Jarvis
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Mark D Kilby
- Centre for Women's and Newborn Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.,Fetal Medicine Centre, Birmingham Women's and Children's NHS Foundation Trust (Birmingham Health Partners), Birmingham, UK
| | - Mabel Lie
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | | | - Laura Mandefield
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Cara Mooney
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Rebekah Pennington
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Stephen C Robson
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Allan Wailoo
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK
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Tanacan A, Ozgen B, Fadiloglu E, Unal C, Oguz KK, Beksac MS. Prenatal diagnosis of central nervous system abnormalities: Neurosonography versus fetal magnetic resonance imaging. Eur J Obstet Gynecol Reprod Biol 2020; 250:195-202. [PMID: 32460228 DOI: 10.1016/j.ejogrb.2020.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/30/2020] [Accepted: 05/07/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To share our experience in diagnosis of congenital central nervous system (CNS) abnormalities by fetal magnetic resonance imaging (MRI). STUDY DESIGN This study consisted of 110 pregnancies. Neurosonography (NS) findings were compared with MRI results. Anomalies were categorized into 10 groups: 1) Corpus callosum (CC) and cavum septum pellucidum (CSP) anomalies, 2) Neural tube defects (NTD), 3) Posterior fossa anomalies (PFA), 4) Primary ventriculomegaly (PVM), 5) Microcephaly, 6) Macrocephaly, 7) Periventricular leukomalacia (PVL), 8) Craniosynostosis, 9) Intracranial hemorrhage (ICH) and 10) Lumbosacral teratoma. Demographic features, clinical characteristics and perinatal outcomes of the study subjects were evaluated. RESULTS Gestational weeks for NS and for MRI were 25.5 and 26.5 weeks, respectively. Fourteen (12.7%) pregnancies were terminated. PVM (n = 36, 32.7%), CC and CSP anomalies (n = 29, 26.3%), PFA (n = 11, 10%) and NTD (n = 11, 10%) were the most common fetal MRI indications. There were no statistically significant differences between the accuracy of fetal NS and fetal MRI for CC and CSP anomalies, NTDs, PFA and PVM (p = 0.09, 0.43, 0.45 and 0.23, respectively). However, fetal MRI was more accurate for the detection of normal anatomic findings in cases with suspected microcephaly, macrocephaly and craniosynostosis in NS when pooled together (p = 0.007). Furthermore, MRI also seemed to be advantageous in CC & CSP anomalies though it was not validated by statistical measures. No statistically significant difference was found for diagnostic performance of NS and MRI according to gestational week (p = 0.27). CONCLUSION Fetal MRI in addition to NS may improve diagnostic accuracy in pregnancies with congenital CNS abnormalities.
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Affiliation(s)
- Atakan Tanacan
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey.
| | - Burce Ozgen
- Department of Radiology, Hacettepe University, Ankara, Turkey
| | - Erdem Fadiloglu
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Canan Unal
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | | | - Mehmet Sinan Beksac
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
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Beresford C, Hall S, Smedley A, Mathad N, Waters R, Chakraborty A, Sparrow OC, Tsitouras V. Prenatal diagnosis of arachnoid cysts: a case series and systematic review. Childs Nerv Syst 2020; 36:729-741. [PMID: 31897633 DOI: 10.1007/s00381-019-04477-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 12/17/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Primary cysts are believed to arise from the splitting of the arachnoid membrane during prenatal development and can be diagnosed in utero. Prenatal diagnosis is uncommon; therefore, the evidence base for counselling expectant mothers is limited. The purpose of this article is to present a case series and review the current literature on prenatally diagnosed arachnoid cysts. METHOD A keyword search of hospital electronic records was performed for all patients with a prenatally diagnosed arachnoid cyst at a tertiary neurosurgical centre. Case notes were reviewed for all patients diagnosed between 2005 and 2017. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to structure a systematic review of all English language articles published up to May 2018. RESULTS A total of eight eligible patients were identified from our own records and 123 from the literature. Sixty-eight per cent of patients had a normal outcome. Sixty-three per cent of patients underwent surgical intervention which was not associated with abnormal outcome. The diagnosis of syndromic/genetic diagnosis (p < 0.001) and the presence of other intra-cranial anatomical abnormalities (p = 0.05) were significant predictors of abnormal outcome. CONCLUSION The pathogenesis and prognosis of a prenatal arachnoid cyst diagnosis remain unclear. These results suggest favourable outcomes from simple cysts without associated abnormalities and expectant mothers should be counselled accordingly. A wider prospective review is required to better established evidence-based practice.
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Affiliation(s)
- Charles Beresford
- Faculty of Medicine, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Samuel Hall
- Department of Neurosurgery, Wessex Neurological Centre, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
| | - Alexander Smedley
- Department of Neurosurgery, Wessex Neurological Centre, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Nijaguna Mathad
- Department of Neurosurgery, Wessex Neurological Centre, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Ryan Waters
- Department of Neurosurgery, Wessex Neurological Centre, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Aabir Chakraborty
- Department of Neurosurgery, Wessex Neurological Centre, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Owen C Sparrow
- Department of Neurosurgery, Wessex Neurological Centre, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Vassilios Tsitouras
- Department of Neurosurgery, Wessex Neurological Centre, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
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Ziaulhaq P, Khan N, Banday S. The comparative study of antenatal magnetic resonance imaging and ultrasound in the evaluation of fetal central nervous system abnormalities. CHRISMED JOURNAL OF HEALTH AND RESEARCH 2020. [DOI: 10.4103/cjhr.cjhr_52_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mata RP, Alves T, Figueiredo A, Santos A. Prenatal diagnosis of congenital mesoblastic nephroma: a case with poor prognosis. BMJ Case Rep 2019; 12:12/8/e230297. [PMID: 31466985 DOI: 10.1136/bcr-2019-230297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Congenital mesoblastic nephromais a rare tumour found in neonates, with a very small number of cases diagnosed prenatally. We report a case of a fetal renal tumour suspected at 28 weeks' gestation on routine ultrasound. Prenatal follow-up revealed a severe polyhydramnios at 32 weeks' gestation subsequent amniodrainage was undertaken. She delivered at 34+5 weeks' gestation, after spontaneous premature rupture of membranes.
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Affiliation(s)
- Rodrigo Pereira Mata
- Gynecology-Obstetrics, Centro Hospitalar Universitário do Algarve, Portimão, Portugal
| | - Teresa Alves
- Radiology, Hospital Garcia de Orta EPE, Almada, Portugal
| | | | - Antónia Santos
- Gynecology-Obstetrics, Hospital Garcia de Orta EPE, Almada, Portugal
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Oh KY, Gibson TJ, Pinter JD, Pettersson D, Shaffer BL, Selden NR, Sohaey R. Clinical outcomes following prenatal diagnosis of asymmetric ventriculomegaly, interhemispheric cyst, and callosal dysgenesis (AVID). Prenat Diagn 2018; 39:26-32. [PMID: 30511781 DOI: 10.1002/pd.5393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 11/17/2018] [Accepted: 11/21/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVES When identified prenatally, the imaging triad of asymmetric ventriculomegaly, interhemispheric cyst, and dysgenesis of the corpus callosum (AVID) can indicate a more serious congenital brain anomaly. In this follow-up series of 15 fetuses, we present the neurodevelopmental outcomes of a single institution cohort of children diagnosed prenatally with AVID. METHODS Our fetal ultrasound database was queried for cases of AVID between 2000 and 2016. All available fetal MR imaging studies were reviewed for the presence of (a) interhemispheric cysts or ventricular diverticula and (b) dysgenesis or agenesis of the corpus callosum. Clinical records were reviewed for perinatal management, postnatal surgical management, and neurodevelopmental outcomes. RESULTS Fifteen prenatal cases of AVID were identified. Twelve were live-born and three pregnancies were terminated. Of the 12 patients, 11 underwent neurosurgical intervention. Of the eight patients surviving past infancy, seven of eight have moderate to severe neurodevelopmental delays or disabilities, encompassing both motor and language skills, and all have variable visual abnormalities. CONCLUSION In our cohort of 15 prenatally diagnosed fetuses with AVID, eight survived past infancy and all have neurodevelopmental disabilities, including motor and language deficits, a wide range of visual defects, craniofacial abnormalities, and medical comorbidities.
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Affiliation(s)
- Karen Y Oh
- Department of Radiology, Oregon Health & Science University, Portland, Oregon
| | - Thomas J Gibson
- Department of Radiology, Oregon Health & Science University, Portland, Oregon
| | - Joseph D Pinter
- Department of Pediatrics (Institute on Development & Disability, and Pediatric Neurology), Oregon Health & Science University, Portland, Oregon
| | - David Pettersson
- Department of Radiology, Oregon Health & Science University, Portland, Oregon
| | - Brian L Shaffer
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Oregon Health & Science University, Portland, Oregon
| | - Nathan R Selden
- Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon
| | - Roya Sohaey
- Department of Radiology, Oregon Health & Science University, Portland, Oregon
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Yin L, Yang Z, Pan Q, Zhang J, Li X, Wang F, Ye Y, Deng X, Hu C. Sonographic diagnosis and prognosis of fetal arachnoid cysts. JOURNAL OF CLINICAL ULTRASOUND : JCU 2018; 46:96-102. [PMID: 28984371 DOI: 10.1002/jcu.22532] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 07/17/2017] [Accepted: 08/06/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE To explore the clinical significance of sonographic (US) diagnosis of fetal arachnoid cysts and to evaluate their prognosis. METHODS Sixty fetuses deemed to have arachnoid cysts by prenatal US were included in this study. Data from serial US, prenatal and/or postnatal MRI, or post-mortem examinations were retrospectively analyzed. For live births, the developmental quotient scores were determined using the Gesell Developmental Scale. RESULTS Thirty fetuses were diagnosed during the second trimester and another 30 fetuses were diagnosed in the third trimester. Fifty-one lesions were located in the supratentorial compartment, and 9 were located in the posterior fossa. Twenty-four lesions were isolated, and the remaining lesions were associated with intracranial and/or extra central nervous system malformations. The evolution of the cysts included progression, stability, or spontaneous resolution. The outcomes included induced abortion, intrauterine death, live birth with either normal neurodevelopment or mental retardation, and infant mortality. Two cases were lost to follow-up. The accuracy of prenatal US diagnosis was 86.2% (50/58). CONCLUSION Prenatal US is the modality of choice for the diagnosis of fetal arachnoid cysts. Serial US examinations are critical to monitor the lesions. Moreover, prenatal MRI is a valuable complementary tool. For live births, the prognosis appears to be good.
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Affiliation(s)
- Linliang Yin
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Center for Medical Ultrasound, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu, China
| | - Zhong Yang
- Center for Medical Ultrasound, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu, China
| | - Qi Pan
- Center for Medical Ultrasound, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu, China
| | - Jun Zhang
- Center for Medical Ultrasound, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu, China
| | - Xiaobing Li
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Nanqiao New City, Fengxian District, Shanghai, China
| | - Feng Wang
- Department of Pathology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu, China
| | - Yanlin Ye
- Department of Child Healthcare, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu, China
| | - Xuedong Deng
- Center for Medical Ultrasound, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu, China
| | - Chunhong Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Werner H, Gasparetto TD, Daltro P, Leandro Gasparetto E, Araujo Júnior E. Typical lesions in the fetal nervous system: correlations between fetal magnetic resonance imaging and obstetric ultrasonography findings. Ultrasonography 2017; 37:261-274. [PMID: 29325241 PMCID: PMC6044224 DOI: 10.14366/usg.17040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 10/21/2017] [Indexed: 11/23/2022] Open
Abstract
Central nervous system (CNS) malformations play a role in all fetal malformations. Ultrasonography (US) is the best screening method for identifying fetal CNS malformations. A good echographic study depends on several factors, such as positioning, fetal mobility and growth, the volume of amniotic fluid, the position of the placenta, the maternal wall, the quality of the apparatus, and the sonographer’s experience. Although US is the modality of choice for routine prenatal follow-up because of its low cost, wide availability, safety, good sensitivity, and real-time capability, magnetic resonance imaging (MRI) is promising for the morphological evaluation of fetuses that otherwise would not be appropriately evaluated using US. The aim of this article is to present correlations of fetal MRI findings with US findings for the major CNS malformations.
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Affiliation(s)
- Heron Werner
- Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI), Rio de Janeiro, Brazil
| | | | - Pedro Daltro
- Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI), Rio de Janeiro, Brazil
| | | | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
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Wilson RD. Anomalies fœtales affectant le tube neural : Dépistage / diagnostic prénatal et prise en charge de la grossesse. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2017; 38:S496-S511. [PMID: 28063560 DOI: 10.1016/j.jogc.2016.09.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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A systematic review and meta-analysis to determine the contribution of mr imaging to the diagnosis of foetal brain abnormalities In Utero. Eur Radiol 2016; 27:2367-2380. [PMID: 27655301 PMCID: PMC5408056 DOI: 10.1007/s00330-016-4563-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/14/2016] [Accepted: 08/11/2016] [Indexed: 12/19/2022]
Abstract
Objectives This systematic review was undertaken to define the diagnostic performance of in utero MR (iuMR) imaging when attempting to confirm, exclude or provide additional information compared with the information provided by prenatal ultrasound scans (USS) when there is a suspicion of foetal brain abnormality. Methods Electronic databases were searched as well as relevant journals and conference proceedings. Reference lists of applicable studies were also explored. Data extraction was conducted by two reviewers independently to identify relevant studies for inclusion in the review. Inclusion criteria were original research that reported the findings of prenatal USS and iuMR imaging and findings in terms of accuracy as judged by an outcome reference diagnosis for foetal brain abnormalities. Results 34 studies met the inclusion criteria which allowed diagnostic accuracy to be calculated in 959 cases, all of which had an outcome reference diagnosis determined by postnatal imaging, surgery or autopsy. iuMR imaging gave the correct diagnosis in 91 % which was an increase of 16 % above that achieved by USS alone. Conclusion iuMR imaging makes a significant contribution to the diagnosis of foetal brain abnormalities, increasing the diagnostic accuracy achievable by USS alone. Key points • Ultrasound is the primary modality for monitoring foetal brain development during pregnancy • iuMRI used together with ultrasound is more accurate for detecting foetal brain abnormalities • iuMR imaging is most helpful for detecting midline brain abnormalities • The moderate heterogeneity of reviewed studies may compromise findings
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Gómez Huertas M, Culiañez Casas M, Molina García F, Carrillo Badillo M, Pastor Pons E. Complementary role of magnetic resonance imaging in the study of the fetal urinary system. RADIOLOGIA 2016. [DOI: 10.1016/j.rxeng.2016.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gómez Huertas M, Culiañez Casas M, Molina García F, Carrillo Badillo M, Pastor Pons E. Papel complementario de la resonancia magnética en el estudio del sistema urinario fetal. RADIOLOGIA 2016; 58:101-10. [DOI: 10.1016/j.rx.2015.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 12/11/2015] [Accepted: 12/16/2015] [Indexed: 12/11/2022]
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van Doorn M, Oude Rengerink K, Newsum EA, Reneman L, Majoie CB, Pajkrt E. Added value of fetal MRI in fetuses with suspected brain abnormalities on neurosonography: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2015; 29:2949-61. [PMID: 26592136 DOI: 10.3109/14767058.2015.1109621] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To evaluate the additional diagnostic value of fetal Magnetic Resonance Imaging (MRI) in fetuses with suspected brain abnormalities identified with advanced neurosonography (NS). METHODS A systematic literature search was performed for studies reporting on a comparison between diagnosis with NS and MRI, in fetuses suspected for brain abnormalities. Abnormalities detected on NS were compared with those detected on MRI as well as with postnatal imaging findings to assess the added value of fetal MRI. RESULTS We included 27 articles, reporting on 1184 cases in which NS and MRI diagnosis were compared. In 65% of cases [773/1184] fetal NS and fetal MRI diagnosis agreed completely. In 23% [312/1184], MRI showed additional or different pathology. In 8% [99/1184], MRI rejected the NS diagnosis with normal brain as conclusion. For 454 cases a comparison with postnatal imaging could be made. Compared to the postnatal diagnosis, fetal MRI diagnosis agreed completely in 80% [364/454] and fetal NS in 54% [243/454] (difference 27%, 95% CI 21-33%). Additional abnormalities were found on postnatal imaging in 36% [164/454] after NS and in 14% [61/454] after fetal MRI. CONCLUSIONS This meta-analysis shows that fetal MRI in addition to NS improves diagnostic accuracy in detecting brain abnormalities.
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Affiliation(s)
| | - Katrien Oude Rengerink
- b Department of Obstetrics and Gynecology , Academic Medical Center , Amsterdam , The Netherlands , and
| | - Esther A Newsum
- c Department of Radiology , Maastricht University Medical Center , Maastricht , The Netherlands
| | | | | | - Eva Pajkrt
- b Department of Obstetrics and Gynecology , Academic Medical Center , Amsterdam , The Netherlands , and
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Kaufman MG, Cassady CI, Hyman CH, Lee W, Watcha MF, Hippard HK, Olutoye OA, Khechoyan DY, Monson LA, Buchanan EP. Prenatal Identification of Pierre Robin Sequence: A Review of the Literature and Look towards the Future. Fetal Diagn Ther 2015; 39:81-9. [PMID: 25967128 DOI: 10.1159/000380948] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 02/13/2015] [Indexed: 11/19/2022]
Abstract
Fetal ultrasonography is an important tool used to prenatally diagnose many craniofacial conditions. Pierre Robin sequence (PRS) is a rare congenital deformation characterized by micrognathia, glossoptosis, and airway obstruction. PRS can present as a perinatal emergency when the retropositioned tongue obstructs the airway leading to respiratory compromise. More predictable and reliable diagnostic studies could help the treating medical team as well as families prepare for these early airway emergencies. The medical literature was reviewed for different techniques used to prenatally diagnose PRS radiologically. We have reviewed these techniques and suggested a possible diagnostic pathway to consistently identify patients with PRS prenatally.
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Affiliation(s)
- Matthew G Kaufman
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex., USA
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Feldman N, Melcer Y, Levinsohn-Tavor O, Orenstein A, Svirsky R, Herman A, Maymon R. Prenatal ultrasound charts of orbital total axial length measurement (TAL): a valuable data for correct fetal eye malformation assessment. Prenat Diagn 2015; 35:558-63. [DOI: 10.1002/pd.4572] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 01/29/2015] [Accepted: 01/30/2015] [Indexed: 01/16/2023]
Affiliation(s)
- Noa Feldman
- Department of Obstetrics and Gynecology; Assaf Harofeh Medical Center; Zerifin Israel
| | - Yaakov Melcer
- Department of Obstetrics and Gynecology; Assaf Harofeh Medical Center; Zerifin Israel
| | - Orna Levinsohn-Tavor
- Department of Obstetrics and Gynecology; Assaf Harofeh Medical Center; Zerifin Israel
| | - Adi Orenstein
- Department of Obstetrics and Gynecology; Assaf Harofeh Medical Center; Zerifin Israel
| | - Ran Svirsky
- Institute of Medical Genetics; Sourasky Medical Center; Tel-Aviv Israel
- Sackler School of Medicine; Tel-Aviv University; Tel-Aviv Israel
| | - Arie Herman
- Department of Obstetrics and Gynecology; Assaf Harofeh Medical Center; Zerifin Israel
| | - Ron Maymon
- Department of Obstetrics and Gynecology; Assaf Harofeh Medical Center; Zerifin Israel
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Wilson RD, Wilson RD, Audibert F, Brock JA, Campagnolo C, Carroll J, Cartier L, Chitayat D, Gagnon A, Johnson JA, Langlois S, MacDonald WK, Murphy-Kaulbeck L, Okun N, Pastuck M, Popa V. Prenatal Screening, Diagnosis, and Pregnancy Management of Fetal Neural Tube Defects. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2014; 36:927-939. [DOI: 10.1016/s1701-2163(15)30444-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Wright R, Kyriakopoulou V, Ledig C, Rutherford M, Hajnal J, Rueckert D, Aljabar P. Automatic quantification of normal cortical folding patterns from fetal brain MRI. Neuroimage 2014; 91:21-32. [PMID: 24473102 DOI: 10.1016/j.neuroimage.2014.01.034] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 01/13/2014] [Accepted: 01/21/2014] [Indexed: 01/18/2023] Open
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Gindes L, Weissmann-Brenner A, Zajicek M, Weisz B, Shrim A, Geffen KT, Mendes D, Kuint J, Berkenstadt M, Achiron R. Three-dimensional ultrasound demonstration of the fetal palate in high-risk patients: the accuracy of prenatal visualization. Prenat Diagn 2013; 33:436-41. [DOI: 10.1002/pd.4083] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Liat Gindes
- Department of Obstetrics and Gynecology; The Chaim Sheba Medical Center; Ramat-Gan Israel
| | | | - Michal Zajicek
- Department of Obstetrics and Gynecology; The Chaim Sheba Medical Center; Ramat-Gan Israel
| | - Boaz Weisz
- Department of Obstetrics and Gynecology; The Chaim Sheba Medical Center; Ramat-Gan Israel
| | - Alon Shrim
- Department of Obstetrics and Gynecology; The Chaim Sheba Medical Center; Ramat-Gan Israel
| | | | - David Mendes
- Department of Plastic Surgery; The Chaim Sheba Medical Center; Ramat-Gan Israel
| | - Jaacov Kuint
- Department of Neonatology; The Chaim Sheba Medical Center; Ramat-Gan Israel
| | - Michal Berkenstadt
- Danek Gertner Institute of Human Genetics; The Chaim Sheba Medical Center; Ramat-Gan Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Reuven Achiron
- Department of Obstetrics and Gynecology; The Chaim Sheba Medical Center; Ramat-Gan Israel
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Abdelazim IA, Belal MM. The role of magnetic resonance imaging in refining the diagnosis of suspected fetal renal anomalies. J Turk Ger Gynecol Assoc 2013; 14:6-10. [PMID: 24592062 DOI: 10.5152/jtgga.2013.02] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 01/01/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This prospective study was designed to detect the role of magnetic resonance imaging (MRI) in refining the diagnosis of suspected fetal renal anomalies detected during screening sonography. MATERIAL AND METHODS 54 pregnant women, with suspected fetal renal anomalies detected during routine ultrasound screening, were rescanned by MRI to refine the diagnosis of the suspected renal anomalies. The pregnancy outcome was examined externally and by postnatal ultrasonography. RESULTS Fifty-four cases of suspected renal anomalies detected during screening sonography of 8400 pregnant women (0.6%), were res-canned by MRI in this study. The MRI gave a similar diagnosis to postnatal ultrasound in 46 cases (16 cases of hydronephrosis, 14 cases of Polycystic Kidney Disease (PCKD), 9 cases of Multicystic Kidney Disease (MCKD), 2 cases of Renal Agensis (RA), 3 cases of single renal cyst and 2 cases of megacystis+hydroureter), while it gave a different diagnosis (false positive) in 6 cases (4 cases of hydronephrosis diagnosed by MRI confirmed to be PCKD by postnatal ultrasound, also, 1 case of MCKD diagnosed by MRI confirmed to be hydronephrosis by postnatal ultrasound and 1 case of RA diagnosed by MRI confirmed to be normal by postnatal ultrasound). The prenatal ultrasound gave a similar diagnosis to postnatal ultrasound in 43 cases (14 cases of hydronephrosis, 13 case of PCKD, 9 cases of MCKD, 2 cases of RA, 3 cases of single renal cyst and 2 case of megacystis+hydroureter), while it gave a different diagnosis (false positive) in 9 cases; 4 cases of hydronephrosis diagnosed by prenatal sonography confirmed to be PCKD by postnatal ultrasound, one case of PCKD+one case of MCKD, and one case of megacystis+hydroureter confirmed to be hydronephrosis by postnatal ultrasound, while one case of MCKD diagnosed by prenatal sonography was confirmed to be PCKD by postnatal ultrasound and one case of RA diagnosed by prenatal ultrasound was confirmed to be normal by postnatal ultrasound. CONCLUSION The MRI can be used as a complementary adjunctive modality with excellent tissue contrast, especially in equivocal cases or inconclusive sonographic findings.
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Affiliation(s)
- Ibrahim Anwar Abdelazim
- Department of Obstetrics and Gynecology, Ain Shams University Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Eygpt ; Al-Rashid Maternity Hospital, Salmyia, Kuwait
| | - Maha Mohamed Belal
- Department of Diagnostic Radiology, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Cairo, Egypt ; Al-Rashid Maternity Hospital, Salmyia, Kuwait
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Oh KY, Kennedy AM, Selden NR, McLean L, Sohaey R. Asymmetric ventriculomegaly, interhemispheric cyst, and dysgenesis of the corpus callosum (AVID): an imaging triad. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:1811-1820. [PMID: 23091253 DOI: 10.7863/jum.2012.31.11.1811] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A series of 20 cases from 2 academic institutions is presented with a characteristic imaging triad of asymmetric ventriculomegaly, a large interhemispheric cyst, and partial or complete agenesis of the corpus callosum. Most cases were initially referred as aqueduct stenosis and hydrocephalus or focal porencephaly. We describe the imaging findings that identify an abnormal or absent corpus callosum associated with a type 1 interhemispheric cyst in fetuses initially thought to have hydrocephalus attributable to aqueductal stenosis. We suggest that the acronym AVID (asymmetric ventriculomegaly, interhemispheric cyst, and dysgenesis of the corpus callosum) may be useful in recognition of these cases. All cases presented with markedly asymmetric ventriculomegaly on initial sonography, with progressive hydrocephalus throughout gestation. Fetal magnetic resonance imaging was performed in 15 of 20 cases. Thirteen of 20 cases were identified in male fetuses. Associated fetal and postnatal abnormalities are also reported. Technological improvements in sonography and fetal magnetic resonance imaging allow improved characterization of associated intracranial anomalies in the setting of hydrocephalus. Accurate diagnosis can aid parental counseling, especially because isolated aqueductal stenosis suggests a better prognosis than hydrocephalus with anomalies. Markedly asymmetric ventriculomegaly in this series was the key to excluding isolated aqueductal stenosis and was associated with callosal malformation with a type 1a interhemispheric cyst.
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Affiliation(s)
- Karen Y Oh
- Department of Radiology, Oregon Health and Science University, Mail Code L340, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098, USA.
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The role of magnetic resonance imaging (MRI) in refining the diagnosis of suspected fetal renal anomalies. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2012. [DOI: 10.1016/s2305-0500(13)60076-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Sattar S, Gleeson JG. The ciliopathies in neuronal development: a clinical approach to investigation of Joubert syndrome and Joubert syndrome-related disorders. Dev Med Child Neurol 2011; 53:793-798. [PMID: 21679365 PMCID: PMC3984879 DOI: 10.1111/j.1469-8749.2011.04021.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A group of disorders with disparate symptomatology, including congenital cerebellar ataxia, retinal blindness, liver fibrosis, polycystic kidney disease, and polydactyly, have recently been united under a single disease mechanism called 'ciliopathies'. The ciliopathies are due to defects of the cellular antenna known as the primary cilium, a microtubule-based extension of cellular membranes found in nearly all cell types. Key among these ciliopathies is Joubert syndrome, displaying ataxia, oculomotor apraxia, and mental retardation* with a pathognomonic 'molar tooth sign' on brain magnetic resonance imaging. The importance of ciliary function in neuronal development has been appreciated only in the last decade with the classification of Joubert syndrome as a ciliopathy. This, together with the identification of many of the clinical features of ciliopathies in individuals with Joubert syndrome and the localization of Joubert syndrome's causative gene products at or near the primary cilium, have defined a new class of neurological disease. Cilia are involved in diverse cellular processes including protein trafficking, photoreception, embryonic axis patterning, and cell cycle regulation. Ciliary dysfunction can affect a single tissue or manifest as multi-organ involvement. Ciliary defects have been described in retinopathies such as retinitis pigmentosa and Leber congenital amaurosis (defects in photoreceptor ciliary protein complexes), renal syndromes with nephronophthisis and cystic dysplastic kidneys, and liver conditions such as fibrosis and biliary cirrhosis. Recognizing the diverse presentations of the ciliopathies and screening strategies following diagnosis is an important part of the treatment plan of children with cilia-related disorders.
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Affiliation(s)
- Shifteh Sattar
- Department of Neurosciences and Paediatrics, University of California, San Diego, La Jolla, CA, USA
| | - Joseph G Gleeson
- Department of Neurosciences and Paediatrics, University of California, San Diego, La Jolla, CA, USA
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Gucciardo L, Uyttebroek A, De Wever I, Renard M, Claus F, Devlieger R, Lewi L, De Catte L, Deprest J. Prenatal assessment and management of sacrococcygeal teratoma. Prenat Diagn 2011; 31:678-88. [DOI: 10.1002/pd.2781] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 04/14/2011] [Accepted: 04/20/2011] [Indexed: 11/08/2022]
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