Vasciaveo Lorenzo, Rizzo Giuseppe, Khalil Asma, Alameddine Sara, Di Girolamo Raffaella, Candia Mariangela, De Lucia Graziana, Mappa Ilenia, Liberati Marco, Nappi Luigi, D'Antonio Francesco
Fetal Medicine Unit, Department of Obstetrics and Gynaecology, University of Foggia, Foggia, Italy.
Department of Obstetrics and Gynaecology, Fondazione Policlinico Tor Vergata Università Roma Tor Vergata Roma, Rome, Italy.
J Clin Ultrasound. 2022 Sep;50(7):984-988. doi: 10.1002/jcu.23191. Epub 2022 Mar 22.
To report the rate of visualization of the pericallosal artery (PCA) in the first trimester of pregnancy (11-14 weeks).
Prospective observational study of consecutive fetuses undergoing first trimester risk assessment for chromosomal anomalies. The presence of PCA was assessed in a midsagittal view of fetal brain using high-definition power Color Doppler. A normal course of the PCA was defined as the visualization of an artery emerging from the anterior cerebral artery running parallel the corpus callosum (CC). The reference standard was the visualization of CC and PCA between the 20 and 22 weeks of gestation. We also performed a systematic review and meta-analysis of the published literature. Multivariate logistic regression and random-effect meta-analyses of proportion were used to analyze the data.
Cohort study: Five-hundred women were included. PCA was identified trans-abdominally or transvaginally at 11-14 weeks of gestation in 98.8% (95% CI 97.4-99.6: 494/500); of the four cases of PCA not identified one had a diagnosis of complete agenesis of the corpus callosum during the anomaly scan which was confirmed at birth. Systematic review of the published literature: Six studies (1093 fetuses, including the present series) were included. The PCA was detected at the 11-14 weeks scan and confirmed to co-exist with a normal CC at time of the anomaly scan in 96.9% (95% CI 93.8-99.0); 20.6% (95% CI 5.7-41.7) of fetuses with no clear identification of the PCA at the 11-14 weeks scan had a normal appearance of the CC at the time of anomaly scan.
Prenatal ultrasonography has a high diagnostic accuracy in detecting PCA in the first trimester. Visualization of the PCA at the time of 11-14 scan is highly specific for the presence of a normal CC later in pregnancy.
报告妊娠早期（11 - 14周）胼周动脉（PCA）的显示率。
对连续进行染色体异常妊娠早期风险评估的胎儿进行前瞻性观察研究。使用高清能量彩色多普勒在胎儿脑的正中矢状面评估PCA的存在。PCA的正常走行定义为从大脑前动脉发出并与胼胝体（CC）平行的动脉的显示。参考标准是妊娠20至22周之间CC和PCA的显示。我们还对已发表的文献进行了系统评价和荟萃分析。使用多变量逻辑回归和比例的随机效应荟萃分析来分析数据。
队列研究：纳入500名女性。在妊娠11 - 14周时经腹或经阴道识别出PCA的比例为98.8%（95%CI 97.4 - 99.6：494/500）；在未识别出PCA的4例病例中，有1例在异常扫描时诊断为胼胝体完全发育不全，出生时得到证实。已发表文献的系统评价：纳入6项研究（1093例胎儿，包括本系列）。在11 - 14周扫描时检测到PCA并在异常扫描时证实与正常CC共存的比例为96.9%（95%CI 93.8 - 99.0）；在11 - 14周扫描时未明确识别出PCA的胎儿中，20.6%（95%CI 5.7 - 41.7）在异常扫描时CC外观正常。
产前超声在妊娠早期检测PCA具有较高的诊断准确性。在11 - 14周扫描时显示PCA对妊娠后期正常CC的存在具有高度特异性。
