Ultrasound Obstet Gynecol. 2021 Jul;58(1):26-33. doi: 10.1002/uog.23612.
To assess the performance of fetal magnetic resonance imaging (MRI) in detecting associated anomalies in fetuses diagnosed with isolated corpus callosal (CC) anomaly on multiplanar ultrasound evaluation of the fetal brain (neurosonography).
This was a multicenter, retrospective cohort study involving 14 fetal medicine centers in Italy, UK, Portugal, Canada, Austria and Spain. Inclusion criteria were fetuses with an apparently isolated CC anomaly, defined as an anomaly of the CC and no other additional central nervous system (CNS) or extra-CNS abnormality detected on expert ultrasound, including multiplanar neurosonography; normal karyotype; maternal age ≥ 18 years; and gestational age at diagnosis ≥ 18 weeks. The primary outcome was the rate of additional CNS abnormalities detected exclusively on fetal MRI within 2 weeks following neurosonography. The secondary outcomes were the rate of additional abnormalities according to the type of CC abnormality (complete (cACC) or partial (pACC) agenesis of the CC) and the rate of additional anomalies detected only on postnatal imaging or at postmortem examination.
A total of 269 fetuses with a sonographic prenatal diagnosis of apparently isolated CC anomalies (207 with cACC and 62 with pACC) were included in the analysis. Additional structural anomalies of the CNS were detected exclusively on prenatal MRI in 11.2% (30/269) of cases, with malformations of cortical development representing the most common type of anomaly. When stratifying the analysis according to the type of CC anomaly, the rate of associated anomalies detected exclusively on MRI was 11.6% (24/207) in cACC cases and 9.7% (6/62) in pACC cases. On multivariate logistic regression analysis, only maternal body mass index was associated independently with the likelihood of detecting associated anomalies on MRI (odds ratio, 1.07 (95% CI, 1.01-1.14); P = 0.03). Associated anomalies were detected exclusively after delivery and were missed on both types of prenatal imaging in 3.9% (8/205) of fetuses with prenatal diagnosis of isolated anomaly of the CC.
In fetuses with isolated anomaly of the CC diagnosed on antenatal neurosonography, MRI can identify a small proportion of additional anomalies, mainly malformations of cortical development, which are not detected on ultrasound. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
评估胎儿磁共振成像（MRI）在多平面超声评估胎儿脑（神经超声）时诊断孤立胼胝体（CC）异常胎儿中检测相关异常的性能。
这是一项多中心、回顾性队列研究，涉及意大利、英国、葡萄牙、加拿大、奥地利和西班牙的 14 个胎儿医学中心。纳入标准为胎儿存在明显孤立的 CC 异常，定义为 CC 异常且专家超声检查未发现其他中枢神经系统（CNS）或 CNS 外异常，包括多平面神经超声；正常核型；母亲年龄≥18 岁；诊断时的孕龄≥18 周。主要结局是神经超声后 2 周内仅通过胎儿 MRI 检测到的 CNS 异常的发生率。次要结局是根据 CC 异常的类型（完全（cACC）或部分（pACC）CC 发育不全）和仅在产后影像学或尸检中检测到的额外异常的发生率。
共纳入 269 例超声产前诊断为明显孤立 CC 异常的胎儿（207 例为 cACC，62 例为 pACC）。在 11.2%（30/269）的病例中，仅在产前 MRI 上检测到 CNS 结构异常，皮质发育畸形是最常见的异常类型。当根据 CC 异常的类型对分析进行分层时，cACC 病例中仅在 MRI 上检测到相关异常的发生率为 11.6%（24/207），pACC 病例中为 9.7%（6/62）。多元逻辑回归分析显示，仅母亲的体重指数与 MRI 检测相关异常的可能性独立相关（优势比，1.07（95%CI，1.01-1.14）；P=0.03）。在 205 例产前诊断为孤立 CC 异常的胎儿中，有 3.9%（8/205）的胎儿仅在产后发现相关异常，且两种产前影像学均漏诊。
在产前神经超声诊断为孤立性 CC 异常的胎儿中，MRI 可以识别一小部分超声未检测到的额外异常，主要是皮质发育畸形。© 2021 年国际妇产科超声学会。
