Prevalence of supratentorial anomalies assessed by magnetic resonance imaging in fetuses with open spina bifida

Abstract

What are the novel findings of this work?This study demonstrates that half of fetuses eligible for prenatal open spina bifida repair have structural brain anomalies, such as an abnormal corpus callosum or heterotopia. Such anomalies were more likely in the presence of a lumbar or higher lesion and wider lateral ventricles (≥ 15 mm). What are the clinical implications of this work?Our findings highlight the relevance of detailed prenatal and preoperative assessment of the brain in fetuses with open spina bifida. One can expect that around half of affected fetuses will present with central nervous system anomalies prior to fetal surgery, which may be considered as additional information for presurgical counseling.

Prenatal magnetic resonance imaging of cerebellar dysplasia or malformations and coexistent malformations: A retrospective study in a single institution

“…US scans were performed using transabdominal convex (3)(4)(5) probes. Some cases were detected accidently by routine US examination, which included biometric parameter measurements.…”

“…Foetal neurosonography is the modality of choice for central nervous system (CNS) malformations given that it is noninvasive, widely available, cheap and safe for both the mother and foetus [1,2]. The major disadvantages of US include tiny intracranial abnormal ndings shielding by calvaria, maternal obesity and foetal irregular head position [3]. It was reported that prenatal US yielded a sensitivity and speci city of 72.2% and 100% for diagnosis of fetal CNS abnormalities, respectively [4].…”

The Role of Fetal Brain Magnetic Resonance Imaging in Current Fetal Medicine

“…Second, we described the nature and occurrence of supratentorial abnormalities in fetuses with spina bifida [ 16 ]. Proper assessment is important for counselling women about fetal surgery [ 17 ].…”

“…Besides ventriculomegaly, evidence of damage to white matter tracts and abnormalities of the corpus callosum [ 18 ] or indications of abnormal neuronal migration are frequently observed in fetuses with open spina bifida [ 14 15 19 20 21 22 ]. When using MRI in fetuses meeting the criteria for fetal surgery on ultrasound findings, half of them were found to have corpus callosum abnormalities and/or ventricular wall abnormalities [ 16 ]. This number is in line with findings in a recent systematic review by our group [ 23 ].…”

“…Documenting in utero changes following surgery is important, as increasingly fetal surgery is being practiced, and it is expected that more of these operations will be done when minimally invasive methods will be widely implemented [ 27 28 29 ]. The shift towards prenatal repair is, at this moment changing the ‘natural history’ of open spina bifida 8 16 30 31 32 33 ].…”