Stanislao Veronica, Rizzo Giuseppe, Grisolia Gianpaolo, Raffaelli Ricciarda, Arduini Maurizio, Pinto Alessia, Mappa Ilenia, Pisello Marlene, Patelli Chiara, Mazzucca Benedetto, Matarrelli Barbara, Khalil Asma, Pagani Giorgio, Lucidi Alessandro, Prefumo Federico, D'Antonio Francesco
Center for Fetal Care and High-Risk Pregnancy, University of Chieti, Chieti, Italy.
Department of Obstetrics and Gynecology, Università Tor Vergata, Rome, Italy.
J Ultrasound Med. 2025 Jul 2. doi: 10.1002/jum.16760.
Prenatal diagnosis of partial agenesis (pACC) or hypoplasia of the corpus callosum (CC) is hindered by the lack of objective and reproducible ultrasound signs. The aim of this study was to report the role of a new ultrasound sign, the distance between the choroid plexus (CP) of the third ventricle and the distal part of the CC, in identifying fetuses with partial agenesis (pACC) or hypoplasia of CC.
Retrospective multicenter case-control study including fetuses with pACC or hypoplasia of the CC confirmed at post-natal imaging or autopsy. The distance between the CP of the third ventricle and its ratio with the length of the CC were compared with unaffected cases on stored images assessed by 2 different examiners. Intraclass correlation, Bland-Altman, univariate, and multivariate logistic regression analyses were used to analyze the data.
One hundred and four (29 with pACC or hypoplasia of the CC and 75 controls) were included in the analysis. At univariate analysis, fetuses with pACC or hypoplasia had a larger transverse diameter (3.9 ± 0.7 versus 5.3 ± 1.6 mm; P < .001) and an increased area (31.6 ± 8.8 versus 41.6 ± 15.6 mm; P < .001) of the CSP compared to unaffected cases. Fetuses with pACC or hypoplasia of the CC had a shorter distance between the CP of the third ventricle and the distal part of the CC (1.6 ± 0.9 versus 8.4 ± 1.8; P < .001) and a higher ratio between the length of the CC and the distance between the CP of the third ventricle and the CC (13.5 ± 9.3 versus 2.6 ± 0.5; P < .001) compared to controls. At multivariate logistic regression analysis, the distance between the CP and the CC (OR: 0.67, 95% CI 0.5-0.7, per 1 mm increase; P < .001) and the ratio between the CC length and the distance between the CP and the CC (OR: 1.4, 95% CI 1.0-1.6; per 1 mm increase; P < .001) were independently associated with pACC or hypoplasia of the CC.
Fetuses with pACC or hypoplasia of the CC had a shorter distance between the distal part of the CC and the CP of the third ventricle and a higher ratio of this measurement with the length of the CC. Further prospective study aimed at longitudinally evaluate the relationship between the CC and the CP of the third ventricle are needed to confirm these findings and to elucidate whether these measurements can be integrated in the diagnostic algorithm applied to fetuses with suspected pACC or hypoplasia of the CC.
缺乏客观且可重复的超声征象阻碍了胼胝体部分发育不全（pACC）或胼胝体发育不良（CC）的产前诊断。本研究的目的是报告一种新的超声征象，即第三脑室脉络丛（CP）与胼胝体远端之间的距离，在识别患有胼胝体部分发育不全（pACC）或胼胝体发育不良的胎儿中的作用。
回顾性多中心病例对照研究，纳入产后影像学检查或尸检确诊为胼胝体部分发育不全或发育不良的胎儿。由2名不同的检查人员对存储图像进行评估，比较第三脑室脉络丛与胼胝体长度的比值以及未受影响病例之间的距离。采用组内相关分析、Bland-Altman分析、单因素和多因素逻辑回归分析来分析数据。
104例（29例胼胝体部分发育不全或发育不良，75例对照）纳入分析。单因素分析显示，与未受影响的病例相比，胼胝体部分发育不全或发育不良的胎儿透明隔腔横径更大（3.9±0.7对5.3±1.6mm；P<0.001），面积增加（31.6±8.8对41.6±15.6mm；P<0.001）。胼胝体部分发育不全或发育不良的胎儿第三脑室脉络丛与胼胝体远端之间的距离较短（1.6±0.9对8.4±1.8；P<0.001），胼胝体长度与第三脑室脉络丛与胼胝体之间距离的比值更高（13.5±9.3对2.6±0.5；P<0.001）。多因素逻辑回归分析显示，脉络丛与胼胝体之间的距离（比值比：0.67，95%可信区间0.5 - 0.7，每增加1mm；P<0.001）以及胼胝体长度与脉络丛与胼胝体之间距离的比值（比值比：1.4，95%可信区间1.0 - 1.6；每增加1mm；P<0.001）与胼胝体部分发育不全或发育不良独立相关。
胼胝体部分发育不全或发育不良的胎儿胼胝体远端与第三脑室脉络丛之间的距离较短，且该测量值与胼胝体长度的比值更高。需要进一步的前瞻性研究纵向评估第三脑室脉络丛与胼胝体之间的关系，以证实这些发现，并阐明这些测量值是否可纳入应用于疑似胼胝体部分发育不全或发育不良胎儿的诊断算法中。
