Utilization of neurosonography for evaluation of the corpus callosum malformations in the era of fetal magnetic resonance imaging

Türkyilmaz, Gürcan; Sivrikoz, Tuğba Saraç; Erturk, Emircan; Özcan, Nahit; Tatlı, Burak; Karaman, Birsen; Toksoy, Güven; Kalelioğlu, I.; Has, Recep; Yüksel, Atıl

doi:10.1111/jog.13995

Cited by 10 publications

(20 citation statements)

References 24 publications

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“…2 iuMRI also improves diagnostic confidence and provides additional useful clinical information in 49% of women, which changes prognosis in 24%. 1 Subsequent work in smaller cohorts of women 3,4 and a meta-analysis 5 have also confirmed the superiority of iuMRI over ultrasonography, although the numbers of additional abnormalities detected by iuMRI were smaller than the MERIDIAN study.…”

Section: Introductionmentioning

confidence: 91%

Accuracy of in-utero MRI to detect fetal brain abnormalities and prognosticate developmental outcome: postnatal follow-up of the MERIDIAN cohort

Hart

Embleton

Bradburn

et al. 2020

The Lancet Child & Adolescent Health

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Background In utero MRI (iuMRI) detects fetal brain abnormalities more accurately than ultrasonography and provides additional clinical information in around half of pregnancies. We aimed to study whether postnatal neuroimaging after age 6 months changes the diagnostic accuracy of iuMRI and its ability to predict developmental outcome. MethodsFamilies enrolled in the MERIDIAN study whose child survived to age 3 years were invited to have a case note review and assessment of developmental outcome with the Bayley Scales of Infant and Toddler Development, the Ages and Stages Questionnaire, or both. A paediatric neuroradiologist, masked to the iuMRI results, reviewed the postnatal neuroimaging if the clinical report differed from iuMRI findings. Diagnostic accuracy was recalculated. A paediatric neurologist and neonatologist categorised participants' development as normal, at risk, or abnormal, and the ability of iuMRI and ultrasonography to predict developmental outcome were assessed.Findings 210 participants had case note review, of whom 81 (39%) had additional investigations after age 6 months. The diagnostic accuracy of iuMRI remained higher than ultrasonography (proportion of correct cases was 529 [92%] of 574 vs 387 [67%] of 574; absolute difference 25%, 95% CI 21 to 29; p<0·0001). Developmental outcome data were analysed in 156 participants, and 111 (71%) were categorised as normal or at risk. Of these 111 participants, prognosis was normal or favourable for 56 (51%) using ultrasonography and for 76 (69%) using iuMRI (difference in specificity 18%, 95% CI 7 to 29; p=0·0008). No statistically significant difference was seen in infants with abnormal outcome (difference in sensitivity 4%, 95% CI -10 to 19; p=0·73).Interpretation iuMRI remains the optimal tool to identify fetal brain abnormalities. It is less accurate when used to predict developmental outcome, although better than ultrasonography for identifying children with normal outcome. Further work is needed to determine how the prognostic abilities of iuMRI can be improved.

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Section: Introductionmentioning

confidence: 91%

Accuracy of in-utero MRI to detect fetal brain abnormalities and prognosticate developmental outcome: postnatal follow-up of the MERIDIAN cohort

Hart

Embleton

Bradburn

et al. 2020

The Lancet Child & Adolescent Health

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“…The interval between ultrasound and MRI was not specified [25][26][27][28][29][30][31][32]35 or varied markedly across studies, ranging from 14 days 8,33,35,36 to more than 4 weeks. 24 Therefore the role of MRI might have been overestimated due to the evolutive nature of some abnormalities (such as heterotopias) rather than the imaging method used for detecting them. Another possible limitation was the incomplete reporting of characteristics that could potentially influence diagnostic performance of ultrasound.…”

Section: Discussionmentioning

confidence: 99%

“…Another possible limitation was the incomplete reporting of characteristics that could potentially influence diagnostic performance of ultrasound. Only seven studies clearly stated that ultrasound assessment included neurosonography, [22][23][24][25][26]29,32 whereas in the remaining studies, no information on ultrasound imaging protocol could be extracted. 8,29,30,32,33,35,36 Nonetheless, we assumed that, since a classification of the anomaly in complete or partial ACC was available, the assessment included at least a mid-sagittal view of the brain.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 540 were identified; 109 were assessed with respect to their eligibility for inclusion and 14 studies were included in the systematic review (Tables 1 and S1, Figure 1). 8,[24][25][26][27][28][29][30][31][32][33][34][35][36] The results of the quality assessment of the included studies are presented in Table 2. Most of the included studies showed a good overall score.…”

Section: General Characteristicsmentioning

confidence: 99%

“…Twelve studies8,[24][25][26][27][28][29][30][31][32][33]35,36 (178 fetuses) explored the role of fetal MRI in detecting associated anomalies in fetuses with a prenatal diagnosis of isolated complete ACC on ultrasound. Overall, MRI detected 10.9% (95% CI 4.1-20.6) of fetal anomalies not detected on ultrasound, whereas the rate of additional anomalies detected only at birth and missed also at prenatal MRI was 4.3% (95% CI 1.4-8.8)…”

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confidence: 99%

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Role of prenatal magnetic resonance imaging in fetuses with isolated agenesis of corpus callosum in the era of fetal neurosonography: A systematic review and meta‐analysis

Sileo

Mascio

Rizzo

et al. 2020

Acta Obstet Gynecol Scand

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Introduction Corpus callosum agenesis (ACC) is frequently diagnosed during fetal life; its prognosis depends also on additional anomalies. The additional value of fetal magnetic resonance imaging (MRI) in fetuses with “isolated” complete (cACC) and partial (pACC) agenesis of the corpus callosum on ultrasound is still debated. Material and methods We performed a systematic literature review and meta‐analysis including fetuses with a prenatal diagnosis of cACC and pACC without associated structural anomalies on ultrasound, undergoing fetal MRI. The primary outcome was the rate of additional anomalies detected at fetal MRI. Further analyses assessed the effect of type of ultrasound assessment (neurosonography vs standard axial assessment), gestational age at fetal MRI and rate of postnatally detected brain anomalies. Random‐effect meta‐analyses of proportions were used to analyze the data. Results Fourteen studies (798 fetuses) were included. In cases with isolated cACC, 10.9% (95% CI 4.1‐20.6) and 4.3% (95% CI 1.4‐8.8) additional anomalies were detected by fetal MRI and postnatally, respectively. Stratifying according to the type of ultrasound assessment, the rate of associated anomalies detected only on fetal MRI was 5.7% (95% CI 0.5‐16.0) with dedicated neurosonography and 18.5% (95% CI 7.8‐32.4) with a standard axial assessment. In fetuses with isolated pACC, 13.4% (95% CI 4.0‐27.0) and 16.2% (95% CI 5.9‐30.3) additional anomalies were detected by fetal MRI or postnatally, respectively. Stratifying according to the type of ultrasound assessment, the rate of associated anomalies detected only on fetal MRI was 11.4% (95% CI 2.7‐25.0) when dedicated neurosonography was performed. Cortical and posterior fossa anomalies represented the most common anomalies missed at ultrasound with both cACC and pACC. Due to the very small number of included cases, stratification according to early (<24 weeks of gestation) and late (>24 weeks) fetal MRI could not be done for either cACC or pACC. Conclusions The rate of associated anomalies detected exclusively at fetal MRI in isolated ACC undergoing neurosonography is lower than previously reported. Cortical and posterior fossa anomalies are among the most common anomalies detected exclusively at MRI, thus confirming the crucial role of fetal MRI in determining the prognosis of these fetuses. However, some anomalies still go undetected prenatally and this should be stressed during parental counseling.

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Early detection of ischemic brain injuries by diffusion‐weighted imaging after radiofrequency ablation for fetal reduction in monochorionic pregnancies

Moradi

Badraqe

Rahimi-Sharbaf

et al. 2022

J of Clinical Ultrasound

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Background This study aimed to investigate the additional advantages of magnetic resonance imaging (MRI), particularly diffusion‐weighted imaging (DWI) over fetal ultrasound in the detection of acute ischemic cerebral injuries in complicated monochorionic (MC) pregnancies that underwent selective reduction by radiofrequency ablation (RFA). Methods This prospective cohort study was conducted on 40 women with complicated MC pregnancies who were treated by RFA. Fetal brain imaging by DWI and conventional MRI was performed either in the early (within 10 days after RFA) or late phase (after 3–6 weeks) in the surviving fetuses to detect both acute and chronic ischemic injuries. The presence of anemia after RFA was also evaluated by Doppler ultrasound. Results Overall, 13 of the total 43 fetuses (30.23%) demonstrated MRI abnormalities with normal brain ultrasound results including germinal matrix hemorrhage (GMH), extensive cerebral ischemia, and mild ventriculomegaly. Although seven fetuses with GMH eventually survived, fetuses that demonstrated ischemic lesions and ventriculomegaly on MRI died in the uterus. Conclusion The absence of abnormal cerebral lesions or anemia on ultrasound and Doppler exams does not necessarily rule out fetal brain ischemia. Performing early MRI, particularly DWI seems to be a reasonable option for detection of early intracranial ischemic changes and better management of complicated multiple pregnancies which were treated by RFA.

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Utilization of neurosonography for evaluation of the corpus callosum malformations in the era of fetal magnetic resonance imaging

Cited by 10 publications

References 24 publications

Accuracy of in-utero MRI to detect fetal brain abnormalities and prognosticate developmental outcome: postnatal follow-up of the MERIDIAN cohort

Accuracy of in-utero MRI to detect fetal brain abnormalities and prognosticate developmental outcome: postnatal follow-up of the MERIDIAN cohort

Role of prenatal magnetic resonance imaging in fetuses with isolated agenesis of corpus callosum in the era of fetal neurosonography: A systematic review and meta‐analysis

Early detection of ischemic brain injuries by diffusion‐weighted imaging after radiofrequency ablation for fetal reduction in monochorionic pregnancies

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