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早期胎儿胼胝体:在早期妊娠中显示正常生长和检测病变。

Early Fetal Corpus Callosum: Demonstrating Normal Growth and Detecting Pathologies in Early Pregnancy.

机构信息

From The Institute of Obstetrical and Gynecological Imaging (T.W., A.M., E.H., E. Katorza, A.B.-W., R.A., B.W., E. Kassif)

Sackler School of Medicine (T.W., A.M., E.H., S.L., A.H., E. Katorza, A.B.-W., R.S., R.A., B.W., E. Kassif), Tel Aviv University, Tel Aviv, Israel.

出版信息

AJNR Am J Neuroradiol. 2023 Feb;44(2):199-204. doi: 10.3174/ajnr.A7757. Epub 2023 Jan 19.

Abstract

BACKGROUND AND PURPOSE

A malformed corpus callosum carries a risk for abnormal neurodevelopment. The advent of high-frequency transducers offers the opportunity to assess corpus callosum development in early pregnancy. The aim of the study was to construct a reference chart of the fetal corpus callosum length on ultrasound between 13 and 19 weeks of gestation and to prospectively examine growth patterns in pathologic cases.

MATERIALS AND METHODS

We performed a prospective cross-sectional study between 2020 and 2022 in well-dated, low-risk, singleton pregnancies between 13 and 19 weeks of gestation. A standardized image was obtained in the midsagittal plane. Imaging criteria were used as a confirmation of the early corpus callosum. Measurements were taken by 4 trained sonographers. Intra- and interobserver variability was assessed. Corpus callosum length in centiles were calculated for each gestational week.

RESULTS

One hundred eighty-seven fetuses were included in the study. All cases met inclusion criteria. At 13 weeks of gestation, the margins of the early corpus callosum were sufficiently clear to be measured in 80% (20/25) of fetuses. A cubic polynomial regression model best described the correlation between corpus length and gestational age. The correlation coefficient ( ) was 0.929 (< .001). Intra- and interobserver variability had high interclass correlation coefficients (>0.99). Presented is the earliest published case of agenesis of corpus callosum and a case of dysgenetic corpus callosum in Rubinstein-Taybi syndrome.

CONCLUSIONS

Provided is a nomogram of the early fetal corpus callosum. Applying imaging criteria helped to identify a case of complete agenesis of the corpus callosum as early as 14 weeks.

摘要

背景与目的

胼胝体畸形与神经发育异常的风险相关。高频超声探头的出现为评估妊娠早期胼胝体发育提供了机会。本研究旨在构建 13-19 孕周胎儿胼胝体长度的超声参考图谱,并前瞻性研究病变病例的生长模式。

材料与方法

我们在 2020 年至 2022 年期间进行了一项前瞻性的横断面研究,纳入了 13-19 孕周、有明确孕龄、低风险的单胎妊娠。在正中矢状面获取标准图像。使用成像标准来确认早期胼胝体。由 4 名经过培训的超声医师进行测量。评估了观察者内和观察者间的变异性。计算了每个孕周的胼胝体长度百分位数。

结果

本研究共纳入 187 例胎儿。所有病例均符合纳入标准。在 13 孕周时,80%(20/25)的胎儿早期胼胝体边缘清晰,可进行测量。立方多项式回归模型最能描述胼胝体长度与胎龄之间的相关性。相关系数(r)为 0.929(<0.001)。观察者内和观察者间的变异性具有较高的组内相关系数(>0.99)。本研究报道了最早发现的完全性胼胝体发育不全病例和 Rubinstein-Taybi 综合征中的发育不良性胼胝体病例。

结论

本研究提供了早期胎儿胼胝体的生长图表。应用成像标准有助于在 14 周时识别出完全性胼胝体发育不全的病例。

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