Non‐visualization of choroid plexus of fourth ventricle as first‐trimester predictor of posterior fossa anomalies and chromosomal defects

Martínez-Ten, Pilar; Illescas, Tamara; Adiego, Begoña; Estévez, M.; Bermejo, C.; Wong, Amy E.; Sepúlveda, Waldo

doi:10.1002/uog.17445

Cited by 30 publications

(44 citation statements)

References 29 publications

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“…Volpe et al [13] expressed that the pregnancy was terminated in 71% (12/17) of the cases who had abnormal image in the posterior fossa. In the study of Martinez-Ten et al, [23] the rate of ended or terminated case was 82% (23/28) after similar findings. In our series, the rate of ended-terminated cases we found after actual negatives were determined was 84% (21/25), and it was similar to other studies.…”

Section: Discussionmentioning

confidence: 56%

“…When we interpreted our findings together with further examinations, we determined that this was caused by chromosomal anomalies in particular. Martinez-Ten et al [23] reported in their study that there was an increase in NT in 50% of IT(-) cases and 71% of the entire group had major chromosomal anomalies. When we excluded false negative cases, the rate of major chromosomal anomaly was 48%.…”

Section: Discussionmentioning

confidence: 89%

“…[4,[19][20][21] When we reviewed the literature, we found out that many studies on IT issue were rather archive studies which investigated recorded images retrospectively. [13,22,23] When these examinations were reevaluated, it was found that any fluid image seen in posterior fossa of some fetuses could be measured as IT by accident. [8] We did not scrutinize false positivity as it may be difficult to carry out prospective investigation on archived images in the studies with wide series such as ours; however, we decreased the negative influence of this matter on our results by investigating the follow-ups and prognoses of IT(+) cases.…”

Section: Discussionmentioning

confidence: 99%

“…The frequency of occurrence for any of them increases approximately 9 times. In fact, Ferreira et al, [10] Bornstein et al, [12] Volpe et al, [13] Fong et al, [20] Martinez-Ten et al, [23] and Volpe et al [24] showed that posterior fossa examinations may help to diagnose chromosomopathy and CNS defects.…”

Section: Discussionmentioning

confidence: 99%

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Failure of getting intracranial translucency image in posterior fossa in the examination of singleton pregnancies at 11–13 weeks of gestation: reasons and outcomes

Aydın¹,

Yayla²

2019

Perinatal J

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Tekil gebeliklerin 11-13 hafta incelemesinde posterior fossada intrakraniyal saydaml›k görüntüsünün elde edilememesi: Nedenler ve sonuçlar Amaç: ‹ntrakraniyal saydaml›k (IT) görülememesinin neden ve sonuçlar›n› araflt›rmak, IT negatifli¤ini takip edebilen olumsuzluklardaki duyarl›l›¤›, özgünlü¤ü, pozitif ve negatif belirleyicilikleri ve tan›sal do¤ruluk oran›m›z› belirlemek. Yöntem: Bu çal›flma 2670 tekil gebeli¤in verilerinin retrospektif de¤erlendirilmesi olarak tasarland›. Serebral yap›lar ve posterior fossa incelemesi klasik ense kal›nl›¤› inceleme plan›nda gerçeklefltirildi ve IT'nin görülemedi¤i veya ölçülemedi¤i olgular çal›flma grubunu oluflturdu. Bu olgulardaki maternal özelliklerin yan› s›ra gebelik prognozuna etki edebilecek kromozom anomalileri, malformasyonlar ve fetüs kay›plar›n›n da¤›l›m› incelenerek normal olarak kabul edilen grup ile karfl›laflt›r›ld›. Bulgular: Posterior fossada IT ölçülemeyen olgu oran› %4.05 idi. IT ölçülebilmifl grup ile karfl›laflt›r›ld›¤›nda IT ölçülememifl olan grupta kötü gebelik prognozu, fetüs kayb› veya gebelik sonland›rma ifllemi, erken döneme ait kromozomopati belirteçleri ile kromozom anomali varl›¤›, merkezi sinir sistemi ve di¤er sistem mal-formasyonlar›n›n oran› istatistiksel olarak anlaml› flekilde daha yüksek saptand›. IT görülememesinin yukar›da say›lan kötü gebelik prognozunu tahmin etmedeki duyarl›l›¤› %26.9, özgünlü¤ü %95.9, pozitif belirleyicili¤i %21.9, negatif belirleyicili¤i %96.9, do¤ruluk oran› %93, olas›l›k oran› 8.7 olarak saptand›. Sonuç: Çal›flmam›zda elde etti¤imiz bulgular, intrakraniyal say-daml›¤›n merkezi sinir sistemi ve di¤er sistem malformasyonlar› ile baz› kromozom anomalilerinin erken tan›s›nda klasik yöntemlere yard›mc› bir parametre olarak yer alabilece¤ini ve rutin perinatal incelemenin içinde kullan›lmas›n›n faydal› olabilece¤ini düflündürmektedir.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Failure of getting intracranial translucency image in posterior fossa in the examination of singleton pregnancies at 11–13 weeks of gestation: reasons and outcomes

Aydın¹,

Yayla²

2019

Perinatal J

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“…Later studies found that there may be some fluid in the region of the IT, but the volume is reduced 9,23 . Furthermore, in OSB fetuses, the cisterna magna is typically not identifiable and the CP of the fourth ventricle is abnormal, being not visible or stuck to the occipital bone 25,26 . In our clinical experience, we have found that the most powerful ultrasound marker of OSB in early gestation is a BS/BSOB ratio > 1 6,9 . In the current study, among the 30 cases with appropriate images available in the midsagittal view, all had a BS/BSOB ratio > 1 and 19 had reduced IT.…”

Section: Discussionmentioning

confidence: 99%

Ratio of fetal choroid plexus to head size: simple sonographic marker of open spina bifida at 11–13 weeks' gestation

Chaoui¹,

Benoit

Entezami³

et al. 2019

Ultrasound in Obstet & Gyne

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CONTRIBUTIONWhat are the novel findings of this work? Increased fetal choroid-plexus-to-head-size ratio is a new sign for the easy detection of spina bifida in the first trimester. What are the clinical implications of this work?This sign should facilitate detection of spina bifida during the routine first-trimester scan. ABSTRACTObjectives To measure the ratio of choroid plexus (CP) size to head size in normal fetuses and to compare it to that in fetuses with open spina bifida (OSB) and quantify the subjective sign of a 'dry brain'.Methods This was a retrospective study of ultrasound images, obtained during first-trimester screening between 11 and 13 weeks of gestation, from 34 fetuses with OSB and 160 normal fetuses. From the hospital databases, we retrieved images of the fetal head in the transventricular axial plane. We measured the areas of both CPs and the head and calculated the ratio between them. We also measured the longest diameter of each CP and calculated their mean (CP length), and measured the occipitofrontal diameter (OFD) and calculated the ratio of CP length to OFD. Measurements from the OSB fetuses were plotted on crown-rump length (CRL) reference ranges constructed using data from the normal fetuses, and Z-scores were calculated. ResultsIn the normal fetuses, the CP area increased, while the ratios of CP area to head area and CP length to OFD decreased, with increasing CRL. In 30 of the 34 (88%) fetuses with OSB, both ratios were increased significantly and the CPs filled the entirety of the head, Correspondence to: Prof. R. Chaouigiving the impression of a dry brain. In these cases, the borders of the lateral ventricles could not be identified.Conclusions At 11-13 weeks, the majority of fetuses with OSB have reduced fluid in the lateral ventricles such that the CPs fill the head. The dry brain sign is easily visualized during routine first-trimester ultrasound examination while measuring the biparietal diameter, and can be quantified by comparing the size of the CPs to the head size. Until prospective data confirm the usefulness of this sign in screening for OSB, it should be considered as a hint to prompt the examiner to assess thoroughly the posterior fossa and spine.

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A novel artificial intelligence model for measuring fetal intracranial markers during the first trimester based on two‐dimensional ultrasound image

Sun,

Yu,

Yao

et al. 2024

Intl J Gynecology & Obste

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ObjectiveTo establish reference ranges of fetal intracranial markers during the first trimester and develop the first novel artificial intelligence (AI) model to measure key markers automatically.MethodsThis retrospective study used two‐dimensional (2D) ultrasound images from 4233 singleton normal fetuses scanned at 11+0–13+6 weeks of gestation at the Affiliated Suzhou Hospital of Nanjing Medical University from January 2018 to July 2022. We analyzed 10 key markers in three important planes of the fetal head. Based on these, reference ranges of 10 fetal intracranial markers were established and an AI model was developed for automated marker measurement. AI and manual measurements were compared to evaluate differences, correlations, consistency, and time consumption based on mean error, Pearson correlation analysis, intraclass correlation coefficients (ICCs), and average measurement time.ResultsThe results of AI and manual methods had strong consistency and correlation (all ICC values >0.75, all r values >0.75, and all P values <0.001). The average absolute error of both only ranged from 0.124 to 0.178 mm. AI achieved a 100% detection rate for abnormal cases. Additionally, the average measurement time of AI was only 0.49 s, which was more than 65 times faster than the manual measurement method.ConclusionThe present study first established the normal standard reference ranges of fetal intracranial markers based on a large Chinese population data set. Furthermore, the proposed AI model demonstrated its capability to measure multiple fetal intracranial markers automatically, serving as a highly effective tool to streamline sonographer tasks and mitigate manual measurement errors, which can be generalized to first‐trimester scanning.

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Non‐visualization of choroid plexus of fourth ventricle as first‐trimester predictor of posterior fossa anomalies and chromosomal defects

Cited by 30 publications

References 29 publications

Failure of getting intracranial translucency image in posterior fossa in the examination of singleton pregnancies at 11–13 weeks of gestation: reasons and outcomes

Failure of getting intracranial translucency image in posterior fossa in the examination of singleton pregnancies at 11–13 weeks of gestation: reasons and outcomes

Ratio of fetal choroid plexus to head size: simple sonographic marker of open spina bifida at 11–13 weeks' gestation

A novel artificial intelligence model for measuring fetal intracranial markers during the first trimester based on two‐dimensional ultrasound image

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