Egaña-Ugrinovic Gabriela, Savchev Stefan, Bazán-Arcos Carolina, Puerto Bienvenido, Gratacós Eduard, Sanz-Cortés Magdalena
Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), and University of Barcelona, Barcelona, Spain.
Fetal Diagn Ther. 2015;37(4):281-8. doi: 10.1159/000366160. Epub 2015 Feb 6.
To explore corpus callosum (CC) developmental differences by ultrasound in late-onset small fetuses compared with adequate for gestational age (AGA) controls.
Ninety four small (estimated fetal weight <10th centile) and 71 AGA fetuses were included. Small fetuses were further subdivided into fetal growth restriction (IUGR, n = 64) and small for gestational age (SGA, n = 30) based on poor perinatal outcome factors, that is, birth weight <3rd centile and/or abnormal cerebroplacental ratio and/or uterine artery Doppler. The entire cohort was scanned to assess CC by transvaginal neurosonography obtaining axial, coronal and midsagittal images. CC length, thickness, total area and the areas after a subdivision in 7 portions were evaluated by semiautomatic software. Furthermore, the weekly average growth of the CC in each study group was calculated and compared.
Small fetuses showed significantly shorter (small fetuses: 0.49 vs. AGA: 0.52; p < 0.01) and smaller CC (1.83 vs. 2.03; p < 0.01) with smaller splenium (0.47 vs. 0.55; p < 0.01) compared to controls. The CC growth rate was also reduced when compared to controls. Changes were more prominent in small fetuses with abnormal cerebroplacental Doppler suggesting fetal growth restriction.
Neurosonographic assessment of CC showed significantly altered callosal development, suggesting in-utero brain reorganization in small fetuses. This data support the potential value of CC assessment by US to monitor brain development in fetuses at risk.
通过超声检查，探讨晚发性小胎儿与适于胎龄（AGA）对照组相比胼胝体（CC）的发育差异。
纳入94例小胎儿（估计胎儿体重<第10百分位数）和71例AGA胎儿。根据围产期不良结局因素，即出生体重<第3百分位数和/或脑胎盘比率异常和/或子宫动脉多普勒异常，将小胎儿进一步细分为胎儿生长受限（IUGR，n = 64）和小于胎龄儿（SGA，n = 30）。对整个队列进行经阴道神经超声扫描，获取轴位、冠状位和正中矢状位图像，以评估CC。使用半自动软件评估CC的长度、厚度、总面积以及分为7部分后的各部分面积。此外，计算并比较每个研究组中CC的每周平均生长情况。
与对照组相比，小胎儿的CC明显更短（小胎儿：0.49 vs. AGA：0.52；p < 0.01）且更小（1.83 vs. 2.03；p < 0.01），压部更小（0.47 vs. 0.55；p < 0.01）。与对照组相比，CC的生长速率也降低。在脑胎盘多普勒异常提示胎儿生长受限的小胎儿中，变化更为显著。
CC的神经超声评估显示胼胝体发育明显改变，提示小胎儿在子宫内发生脑重组。该数据支持超声评估CC对监测高危胎儿脑发育的潜在价值。
