Obstetric Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital (Drs Montaguti, Rizzo, Livi, and Salsi and Pilu).
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA (Dr Bellussi).
Am J Obstet Gynecol MFM. 2021 Jul;3(4):100357. doi: 10.1016/j.ajogmf.2021.100357. Epub 2021 Mar 21.
Abnormal sulcation of the brain is frequently associated with severe malformations, but the prenatal diagnosis is challenging, especially in early pregnancy.
Our study aimed to investigate the value of Sylvian fossa sonographic biometry in the diagnosis of cerebral malformation in the second trimester of gestation.
We prospectively established the normal values of the Sylvian fossa depth in a cohort of nonconsecutive patients, with singleton pregnancies and normal fetuses between 18+0 and 23+0 weeks' gestation. For each patient, a coronal view of the fetal brain, with a clear visualization of the anterior complex and the Sylvian fissure, was acquired by 1 sonologist, who also measured the depth of the fossa. Reproducibility for each parameter was assessed by a second sonologist using stored images. We also retrospectively acquired the same measurements in second trimester fetuses with central nervous system anomalies.
In 103 fetuses with a normal sonogram, the mean depth of the Sylvian fossa was 3.9±0.8 mm Interobserver reproducibility analysis demonstrated good results. Notably, 11 of 31 fetuses with cerebral malformations had a Sylvian fossa depth of <-2 z-scores, and these were found to have malformations of cortical development, lissencephaly in particular, or microcephaly.
Sonographic measurement of the Sylvian fossa during second trimester is feasible and reproducible. A shallow Sylvian fossa is associated with malformations of cortical development, microcephaly, or both.
大脑的异常脑沟通常与严重畸形有关，但产前诊断具有挑战性，尤其是在孕早期。
本研究旨在探讨在妊娠中期，通过测量外侧裂池的超声生物测量值诊断脑畸形的价值。
我们前瞻性地建立了非连续队列中单胎妊娠和正常胎儿（妊娠 18+0 至 23+0 周）外侧裂池深度的正常值。由 1 位超声医生对每位患者进行冠状位胎儿脑扫查，要求清晰显示前复合体和外侧裂，测量外侧裂池的深度。由第 2 位超声医生使用存储的图像评估每个参数的可重复性。我们还回顾性地获取了有中枢神经系统异常的妊娠中期胎儿的相同测量值。
在 103 例正常超声胎儿中，外侧裂池的平均深度为 3.9±0.8mm。观察者间的可重复性分析结果良好。值得注意的是，31 例脑畸形胎儿中有 11 例外侧裂池深度<-2z 评分，这些胎儿存在皮质发育畸形，特别是无脑回畸形或小头畸形。
妊娠中期外侧裂池的超声测量是可行且可重复的。外侧裂池浅与皮质发育畸形、小头畸形或两者均有关。
