Ultrasonographic Characteristics of Cortical Sulcus Development in the Human Fetus between 18 and 41 Weeks of Gestation

Chen, Xi; Li, Shengli; Luo, Guoyang; Norwitz, Errol R.; Ouyang, Shi; Wen, Huaxuan; Yuan, Ying; Tian, Xiaoxian; He, Jingyu

doi:10.4103/0366-6999.204114

Cited by 27 publications

(19 citation statements)

References 28 publications

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“…Excluded studies and reasons for exclusion are reported in Table S3 . Finally, 42 studies, reported between January 1970 and 2021, met the inclusion criteria, and these provided data for 45,626 fetuses, included in the final analysis ( Table 1 ) [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. The median sample size of participating fetuses was 372.5 (range: 50 to 8313; 25th percentile: 175.8; 75th percentile: 709.3).…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies reported more than one fetal brain structure [ 9 , 10 , 17 , 32 , 34 , 36 , 41 , 42 , 43 ]. In addition, 4 studies reported charts for POF [ 9 , 10 , 17 , 36 ], 6 for SF [ 9 , 10 , 17 , 35 , 36 , 44 ], 3 for AV [ 22 , 36 , 43 ], 14 for PV [ 7 , 8 , 14 , 19 , 23 , 26 , 27 , 30 , 32 , 34 , 36 , 38 , 40 , 43 ], 20 for TCD [ 12 , 15 , 16 , 18 , 20 , 21 , 24 , 25 , 28 , 31 , 32 , 34 , 39 , 41 , 42 , 43 , 45 ,…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of Methodology Used in Studies Aimed at Creating Charts of Fetal Brain Structures

et al. 2021

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Ultrasound-based assessment of the fetal nervous system is routinely recommended at the time of the mid-trimester anatomy scan or at different gestations based on clinical indications. This review evaluates the methodological quality of studies aimed at creating charts for fetal brain structures obtained by ultrasound, as poor methodology could explain substantial variability in percentiles reported. Electronic databases (MEDLINE, EMBASE, Cochrane Library, and Web of Science) were searched from January 1970 to January 2021 to select studies on singleton fetuses, where the main aim was to construct charts on one or more clinically relevant structures obtained in the axial plane: parieto-occipital fissure, Sylvian fissure, anterior ventricle, posterior ventricle, transcerebellar diameter, and cisterna magna. Studies were scored against 29 predefined methodological quality criteria to identify the risk of bias. In total, 42 studies met the inclusion criteria, providing data for 45,626 fetuses. Substantial heterogeneity was identified in the methodological quality of included studies, and this may explain the high variability in centiles reported. In 80% of the studies, a high risk of bias was found in more than 50% of the domains scored. In conclusion, charts to be used in clinical practice and research should have an optimal study design in order to minimise the risk of bias and to allow comparison between different studies. We propose to use charts from studies with the highest methodological quality.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Methodology Used in Studies Aimed at Creating Charts of Fetal Brain Structures

et al. 2021

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“…used transabdominal 3D multiplanar imaging and attempted to evaluate the Sylvian fissure. Thereafter, several articles have been published on the evaluation of the Sylvian fissure on neuroimaging. In a recent study by Hahner et al .…”

Section: Discussionmentioning

confidence: 99%

Increased Sylvian fissure angle as early sonographic sign of malformation of cortical development

Pooh¹,

Machida²,

Nakamura³

et al. 2019

Ultrasound in Obstet & Gyne

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Objective To evaluate Sylvian fissure development by assessing Sylvian fissure angles in fetuses with malformation of cortical development (MCD). Methods This was a retrospective study of 22 fetuses with MCD. Cases with a stored three‐dimensional (3D) brain volume acquired at 18 + 0 to 30 + 6 weeks of gestation at an ultrasound‐based research clinic between January 2010 and December 2017 were identified through a database. Of the 22 fetuses, seven had an extracranial abnormality, such as cardiac, renal, gastrointestinal and/or digital anomalies, and five had a minor abnormality such as micrognathia, low‐set ears and/or single umbilical artery. To confirm the final clinical diagnosis of brain abnormality, postmortem histological findings or prenatal or postnatal magnetic resonance images were used. For measurement of Sylvian fissure angle, an anterior coronal plane of the fetal brain on transvaginal 3D volume multiplanar imaging was visualized as a single image from the three orthogonal views. The right and left Sylvian fissure angles were measured between a horizontal reference line (0°) and a line drawn along the upper side of the respective Sylvian fissure. The Sylvian fissure angle on both sides was plotted on the graphs of the reference ranges for gestational age in weeks. Results In 21 (95.5%; 95% CI, 86.8–100.0%) of 22 fetuses with MCD, the Sylvian fissure angle on one or both sides was larger than the 90th percentile of the normal reference. There was one case with apparent focal MCD in the parietal lobe, but the Sylvian fissure angles were normal. A case with apparent unilateral cortical dysplasia and one with apparent unilateral schizencephaly had conspicuous discrepancies between the left and right Sylvian fissure angles. Abnormal genetic test results were obtained in six cases, including four cases with a mutation in a single gene. Conclusions This study has shown that the Sylvian fissures, as defined by the Sylvian fissure angle, have delayed development in most MCD cases prior to the diagnosis of the condition. The Sylvian fissure angle may potentially be a strong indicator for the subsequent development of cortical malformation, before the time point at which the gyri and sulci become obvious on the fetal brain surface. Further research is required to validate these findings. © 2018 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

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“…It has recently been shown that the development of the sylvian fissure, a landmark of gyration, can be identified on a 2D ultrasound from 16 gestational weeks onward [21,27]. Accordingly, an accurate grading of the time-dependent cortical folding for other primary fissures such as the parietooccipital fissure, calcarine fissure, and the cingulate sulcus is feasible with obligate visualization from 23 and 24 weeks onward [1,5]. There are also technical issues in the comprehensive assessment of the sylvian fissure in the same cutting plane and a lack of standardization in both plane reconstruction and the quantification of spatial-cerebral relationships [19].…”

Section: Discussionmentioning

confidence: 99%

Validation of a semiautomated volumetric approach for fetal neurosonography using 5DCNS+ in clinical data from > 1100 consecutive pregnancies

et al. 2020

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Objective The aim of this study was to evaluate the validity of a semiautomated volumetric approach (5DCNS+) for the detailed assessment of the fetal brain in a clinical setting. Methods Stored 3D volumes of > 1100 consecutive 2nd and 3rd trimester pregnancies (range 15-36 gestational weeks) were analyzed using a workflow-based volumetric approach 5DCNS+, enabling semiautomated reconstruction of diagnostic planes of the fetal central nervous system (CNS). All 3D data sets were examined for plane accuracy, the need for manual adjustment, and fetal-maternal characteristics affecting successful plane reconstruction. We also examined the potential of these standardized views to give additional information on proper gyration and sulci formation with advancing gestation. Results Based on our data, we were able to show that gestational age with an OR of 1.085 (95% CI 1.041-1.132) and maternal BMI with an OR of 1.022 (95% CI 1.041-1.054) only had a slight impact on the number of manual adjustments needed to reconstruct the complete volume, while maternal age and fetal position during acquisition (p = 0.260) did not have a significant effect. For the vast majority (958/1019; 94%) of volumes, using 5DCNS+ resulted in proper reconstruction of all nine diagnostic planes. In less than 1% (89/9171 planes) of volumes, the program failed to give sufficient information. 5DCNS+ was able to show the onset and changing appearance of CNS folding in a detailed and timely manner (lateral/parietooccipital sulcus formation seen in < 65% at 16-17 gestational weeks vs. 94.6% at 19 weeks). Conclusions The 5DCNS+ method provides a reliable algorithm to produce detailed, 3D volume-based assessments of fetal CNS integrity through a standardized reconstruction of the orthogonal diagnostic planes. The method further gives valid and reproducible information regarding ongoing cortical development retrieved from these volume sets that might aid in earlier in utero recognition of subtle structural CNS anomalies.

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Ultrasonographic Characteristics of Cortical Sulcus Development in the Human Fetus between 18 and 41 Weeks of Gestation

Cited by 27 publications

References 28 publications

A Systematic Review of Methodology Used in Studies Aimed at Creating Charts of Fetal Brain Structures

A Systematic Review of Methodology Used in Studies Aimed at Creating Charts of Fetal Brain Structures

Increased Sylvian fissure angle as early sonographic sign of malformation of cortical development

Validation of a semiautomated volumetric approach for fetal neurosonography using 5DCNS+ in clinical data from > 1100 consecutive pregnancies

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