From the Department of Obstetrics and Gynecology (I.V.K., J.A.R., I.A.L.G., S.P.W., R.P.M.S.-T.), Division of Obstetrics and Prenatal Medicine.
Department of Pediatrics (I.V.K., J.A.R., M.J.V., I.K.M.R., P.P.G., R.P.M.S.-T., J.D.), Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
AJNR Am J Neuroradiol. 2017 Sep;38(9):1807-1813. doi: 10.3174/ajnr.A5278. Epub 2017 Jun 29.
Most ultrasound markers for monitoring brain growth can only be used in either the prenatal or the postnatal period. We investigated whether corpus callosum length and corpus callosum-fastigium length could be used as markers for both prenatal and postnatal brain growth.
A 3D ultrasound study embedded in the prospective Rotterdam Periconception Cohort was performed at 22, 26 and 32 weeks' gestational age in fetuses with fetal growth restriction, congenital heart defects, and controls. Postnatally, cranial ultrasound was performed at 42 weeks' postmenstrual age. First, reliability was evaluated. Second, associations between prenatal and postnatal corpus callosum and corpus callosum-fastigium length were investigated. Third, we created reference curves and compared corpus callosum and corpus callosum-fastigium length growth trajectories of controls with growth trajectories of fetuses with fetal growth retardation and congenital heart defects.
We included 199 fetuses; 22 with fetal growth retardation, 20 with congenital heart defects, and 157 controls. Reliability of both measurements was excellent (intraclass correlation coefficient ≥ 0.97). Corpus callosum growth trajectories were significantly decreased in fetuses with fetal growth restriction and congenital heart defects (β = -2.295; 95% CI, -3.320-1.270; < .01; β = -1.267; 95% CI, -0.972-0.562; < .01, respectively) compared with growth trajectories of controls. Corpus callosum-fastigium growth trajectories were decreased in fetuses with fetal growth restriction (β = -1.295; 95% CI, -2.595-0.003; = .05).
Corpus callosum and corpus callosum-fastigium length may serve as reliable markers for monitoring brain growth from the prenatal into the postnatal period. The clinical applicability of these markers was established by the significantly different corpus callosum and corpus callosum-fastigium growth trajectories in fetuses at risk for abnormal brain growth compared with those of controls.
大多数监测脑生长的超声标志物只能用于产前或产后。我们研究了胼胝体长度和胼胝体-fastigium 长度是否可以作为产前和产后脑生长的标志物。
在胎儿生长受限、先天性心脏病和对照组胎儿中，进行了一项嵌入前瞻性鹿特丹围孕期队列的 3D 超声研究，分别在 22、26 和 32 孕周进行。产后，在末次月经后 42 周进行颅超声检查。首先，评估可靠性。其次，研究了产前和产后胼胝体和胼胝体-fastigium 长度之间的关联。第三，我们创建了参考曲线，并比较了对照组与胎儿生长受限和先天性心脏病胎儿的胼胝体和胼胝体-fastigium 长度生长轨迹。
我们纳入了 199 名胎儿；22 名胎儿生长受限，20 名先天性心脏病，157 名对照组。两种测量方法的可靠性均极佳（组内相关系数≥0.97）。与对照组相比，胎儿生长受限和先天性心脏病胎儿的胼胝体生长轨迹明显下降（β=-2.295；95%CI，-3.320-1.270；<0.01；β=-1.267；95%CI，-0.972-0.562；<0.01）。与对照组相比，胎儿生长受限胎儿的胼胝体-fastigium 生长轨迹下降（β=-1.295；95%CI，-2.595-0.003；=0.05）。
胼胝体和胼胝体-fastigium 长度可作为从产前到产后监测脑生长的可靠标志物。与对照组相比，风险脑生长异常的胎儿胼胝体和胼胝体-fastigium 生长轨迹明显不同，从而确立了这些标志物的临床适用性。
