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Wu FT, Chen CP. Anomalies of the Corpus Callosum in Prenatal Ultrasound: A Narrative Review for Diagnosis and Further Counseling. J Med Ultrasound 2024; 32:99-103. [PMID: 38882617 PMCID: PMC11175368 DOI: 10.4103/jmu.jmu_49_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/14/2023] [Accepted: 06/14/2023] [Indexed: 06/18/2024] Open
Abstract
The corpus callosum is the major interhemispheric tract that plays an important role in neurological function. Understanding the etiology and embryology development helps the ultrasound diagnosis for disorders of the corpus callosum and further counseling. The nonvisualization of cavum septum pellucidum or dysmorphic cavum septum pellucidum in axial view are indirect signs for beginners to diagnose complete agenesis of corpus callosum (cACC) and partial agenesis of the corpus callosum (pACC). Further coronal view, sagittal view, and fetal magnetic resonance imaging are also important for evaluation. Genetic testing plays an essential tool in anomalies of corpus callosum by revealing the underlying genetic pathophysiology, such as chromosomal anomalies and numerous monogenetic disorders in 30%-45% of ACC. Diagnosis and prediction of prognosis for hypoplasia or hyperplasia of the corpus callosum are more difficult compared to cACC and pACC because of the limited reports in the literature. However, the complex types often had poorer prognostic outcomes compared to the isolated types. Hence, it is important to evaluate and follow fetal conditions thoroughly to rule out intracranial or extracranial anomalies in other systems.
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Affiliation(s)
- Fang-Tzu Wu
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Chih-Ping Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Institute of Clinical and Community Health Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Obstetrics and Gynecology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Laboratory Science and Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Lamon S, de Dumast P, Sanchez T, Dunet V, Pomar L, Vial Y, Koob M, Bach Cuadra M. Assessment of fetal corpus callosum biometry by 3D super-resolution reconstructed T2-weighted magnetic resonance imaging. Front Neurol 2024; 15:1358741. [PMID: 38595845 PMCID: PMC11002102 DOI: 10.3389/fneur.2024.1358741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/08/2024] [Indexed: 04/11/2024] Open
Abstract
Objective To assess the accuracy of corpus callosum (CC) biometry, including sub-segments, using 3D super-resolution fetal brain MRI (SR) compared to 2D or 3D ultrasound (US) and clinical low-resolution T2-weighted MRI (T2WS). Method Fetal brain biometry was conducted by two observers on 57 subjects [21-35 weeks of gestational age (GA)], including 11 cases of partial CC agenesis. Measures were performed by a junior observer (obs1) on US, T2WS and SR and by a senior neuroradiologist (obs2) on T2WS and SR. CC biometric regression with GA was established. Statistical analysis assessed agreement within and between modalities and observers. Results This study shows robust SR to US concordance across gestation, surpassing T2WS. In obs1, SR aligns with US, except for genu and CC length (CCL), enhancing splenium visibility. In obs2, SR closely corresponds to US, differing in rostrum and CCL. The anterior CC (rostrum and genu) exhibits higher variability. SR's regression aligns better with literature (US) for CCL, splenium and body than T2WS. SR is the method with the least missing values. Conclusion SR yields CC biometry akin to US (excluding anterior CC). Thanks to superior 3D visualization and better through plane spatial resolution, SR allows to perform CC biometry more frequently than T2WS.
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Affiliation(s)
- Samuel Lamon
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
- Ultrasound and Fetal Medicine, Department Woman-Mother-Child, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Priscille de Dumast
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Thomas Sanchez
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Vincent Dunet
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Léo Pomar
- Ultrasound and Fetal Medicine, Department Woman-Mother-Child, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Yvan Vial
- Ultrasound and Fetal Medicine, Department Woman-Mother-Child, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Mériam Koob
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Meritxell Bach Cuadra
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
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3
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Perlow HK, Nalin AP, Ritter AR, Addington M, Ward A, Liu M, Nappi C, Blakaj DM, Beyer SJ, Thomas EM, Grecula JC, Raval RR, Kotecha R, Boulter D, Dawson EL, Zoller W, Palmer JD. Advancing Beyond the Hippocampus to Preserve Cognition for Patients With Brain Metastases: Dosimetric Results From a Phase 2 Trial of Memory-Avoidance Whole Brain Radiation Therapy. Adv Radiat Oncol 2024; 9:101337. [PMID: 38405310 PMCID: PMC10885551 DOI: 10.1016/j.adro.2023.101337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/18/2023] [Indexed: 02/27/2024] Open
Abstract
Purpose Recent advances to preserve neurocognitive function in patients treated for brain metastases include stereotactic radiosurgery, hippocampal avoidance whole brain radiation therapy (WBRT), and memantine administration. The hippocampus, corpus callosum, fornix, and amygdala are key neurocognitive substructures with a low propensity for brain metastases. Herein, we report our preliminary experience using a "memory-avoidance" WBRT (MA-WBRT) approach that spares these substructures for patients with >15 brain metastases. Methods and Materials Ten consecutive patients treated with MA-WBRT on a phase 2 clinical trial were reviewed. In each patient, the hippocampi, amygdalae, corpus callosum, and fornix were contoured. Patients were not eligible for MA-WBRT if they had metastases in these substructures. A memory-avoidance region was created using a 5-mm volumetric expansion around these substructures. Hotspots were avoided in the hypothalamus and pituitary gland. Coverage of brain metastases was prioritized over memory avoidance dose constraints. Dose constraints for these avoidance structures included a D100% ≤ 9 Gy and D0.03 cm3 ≤ 16 Gy (variation acceptable to 20 Gy). LINAC-based volumetric modulated arc therapy plans were generated for a prescription dose of 30 Gy in 10 fractions. Results On average, the memory avoidance structure volume was 37.1 cm3 (range, 25.2-44.6 cm3), occupying 2.5% of the entire whole brain target volume. All treatment plans met the D100% dose constraint, and 8 of 10 plans met the D0.03 cm3 constraint, with priority given to tumor coverage for the remaining 2 cases. Target coverage (D98% > 25 Gy) and homogeneity (D2% ≤ 37.5 Gy) were achieved for all plans. Conclusions Modern volumetric modulated arc therapy techniques allow for sparing of the hippocampus, amygdala, corpus callosum, and fornix with good target coverage and homogeneity. After enrollment is completed, quality of life and cognitive data will be evaluated to assess the efficacy of MA-WBRT to mitigate declines in quality of life and cognition after whole brain radiation.
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Affiliation(s)
- Haley K. Perlow
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Ansel P. Nalin
- College of Medicine, The Ohio State University, Columbus, Ohio
| | - Alex R. Ritter
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Mark Addington
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Aubrie Ward
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Michal Liu
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Collin Nappi
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Dukagjin M. Blakaj
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Sasha J. Beyer
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Evan M. Thomas
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - John C. Grecula
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Raju R. Raval
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Rupesh Kotecha
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Florida
| | - Daniel Boulter
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Erica L. Dawson
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Wesley Zoller
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Joshua D. Palmer
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Rodríguez MA, Echevarría M, Perdomo L, Gómez-Chiari M, García S, Prats P, Serra B, Albaiges G. Prevalence of corpus callosum pathology in an unselected population. Should assessment of the corpus callosum be included in the routine 20 weeks scan? Prenat Diagn 2024. [PMID: 38161311 DOI: 10.1002/pd.6510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/08/2023] [Accepted: 12/10/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES To determine the prevalence of abnormalities of the corpus callosum (AbnCC) in a non-selected population, to propose a systematic screening protocol for AbnCC in all populations through direct assessment, and to describe the follow-up and prognosis of all AbnCC cases diagnosed in our clinical setting. METHODS This was a retrospective review of the prevalence of AbnCC over 11 years. We included a sagittal assessment of the corpus callosum (CC) in the second-trimester scan. AbnCC was classified into complete agenesis of CC (ACC) and dysgenesis of CC (DCC; including small, partial agenesis, thick and with lipoma). RESULTS Of the 38,586 second-trimester scans performed during our screening, 43 cases of AbnCC were detected (prevalence of 0.8/1000). Of the AbnCC cases, 10 cases were identified as ACC (29.40%) and 24 as DCC (70.59%). Follow-up investigations showed that in the 43 cases with AbnCC, 76.5% had other associated ultrasound abnormalities, 26.5% had genetic abnormalities, 11.8% had other MRI abnormalities, and 25% of the children had neurodevelopmental delays (8.8% of the total), which were severe in only one case. CONCLUSIONS AbnCC is found in approximately 0.8/1000 of cases in an unselected population. The findings suggest that systematic and direct assessment of the CC as part of screening ultrasound in the second trimester of gestation should be recommended as a routine practice.
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Affiliation(s)
- Mª Angeles Rodríguez
- Fetal Medicine Unit, Department of Obstetrics, Gynecology, and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
| | - Mónica Echevarría
- Fetal Medicine Unit, Department of Obstetrics, Gynecology, and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
| | - Laura Perdomo
- Fetal Medicine Unit, Department of Obstetrics, Gynecology, and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
- Obstetrics Service, Department of Obstetrics, Gynecology and Reproductive Medicine, Institut Universitari Quirón Dexeus, Barcelona, Spain
| | - Marta Gómez-Chiari
- Diagnostic Imaging Department, Hospital Sant Joan de Déu, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Sandra García
- Epidemiological Unit, Department of Obstetrics, Gynecology, and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
| | - Pilar Prats
- Fetal Medicine Unit, Department of Obstetrics, Gynecology, and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
- Obstetrics Service, Department of Obstetrics, Gynecology and Reproductive Medicine, Institut Universitari Quirón Dexeus, Barcelona, Spain
| | - Bernat Serra
- Obstetrics Service, Department of Obstetrics, Gynecology and Reproductive Medicine, Institut Universitari Quirón Dexeus, Barcelona, Spain
| | - Gerard Albaiges
- Fetal Medicine Unit, Department of Obstetrics, Gynecology, and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
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Ramirez Zegarra R, Casati D, Volpe N, Lanna M, Dall'Asta A, Chiarelli A, Ormitti F, Percesepe A, Montaguti E, Labadini C, Salsi G, di Pasquo E, Bonasoni MP, Quarello E, Pilu G, Grisolia G, Righini A, Ghi T. The "cortical invagination sign": a midtrimester sonographic marker of unilateral cortical focal dysgyria in fetuses with complete agenesis of the corpus callosum. Am J Obstet Gynecol MFM 2023; 5:101198. [PMID: 37866717 DOI: 10.1016/j.ajogmf.2023.101198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/12/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Agenesis of the corpus callosum is associated with several malformations of cortical development. Recently, features of focal cortical dysgyria have been described in fetuses with agenesis of the corpus callosum. OBJECTIVE This study aimed to describe the "cortical invagination sign," a specific sonographic feature of focal cortical dysgyria, which is consistently seen at midtrimester axial brain ultrasound in fetuses with complete agenesis of the corpus callosum. STUDY DESIGN This was a retrospective analysis of prospectively collected data from 2018 to 2021, including patients referred to 5 fetal medicine centers in the second trimester of pregnancy (19 0/7 to 22 0/7 weeks of gestation) with suspected complete agenesis of the corpus callosum. All cases with the diagnosis of complete agenesis of the corpus callosum were submitted to an axial sonographic assessment of the fetal brain on the transventricular plane. In this scanning section, the mesial profile of both cerebral hemispheres at the level of the frontal-parietal cortex was investigated. In this area, the operator looked for an abnormal invagination of the cortical surface along the widened interhemispheric fissure, which was referred to as the "cortical invagination sign." All fetuses were submitted to dedicated antenatal magnetic resonance imaging to reassess the ultrasound findings. Cases with additional brain anomalies, which did not involve the cortex, were excluded. The final diagnosis was confirmed at postnatal brain magnetic resonance imaging or postmortem examination, for cases undergoing termination of pregnancy. The primary outcome of this study was to evaluate the presence and laterality of the "cortical invagination sign" in fetuses with complete agenesis of the corpus callosum at antenatal ultrasound and magnetic resonance imaging. RESULTS During the study period, 64 cases of complete agenesis of the corpus callosum were included; of those cases, 50 (78.1%) resulted in termination of pregnancy, and 14 (21.9%) resulted in a live birth. The "cortical invagination sign" was detected at ultrasound in 13 of 64 cases (20.3%) and at targeted brain magnetic resonance imaging in 2 additional cases (23.4%), all of which were electively terminated. Moreover, the "cortical invagination sign" was found to be exclusively unilateral and on the left cerebral hemisphere in all the cases. There was a predominant number, although nonsignificant, of male fetuses (80.0% of cases; P=.06) in the group of complete agenesis of the corpus callosum with the "cortical invagination sign." CONCLUSION The "cortical invagination sign" is a specific marker of focal cortical dysgyria, which seems to characterize at midtrimester of pregnancy in a large group of fetuses with complete agenesis of the corpus callosum. The etiology, pathophysiology, and prognostic significance of this finding remain to be elucidated.
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Affiliation(s)
- Ruben Ramirez Zegarra
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy (Drs Ramirez Zegarra and Volpe, Prof Dall'Asta, Drs Chiarelli, Labadini, di Pasquo, and Ghi)
| | - Daniela Casati
- Fetal Therapy Unit "U. Nicolini", Department of Women, Mother and Neonate, Vittore Buzzi Children's Hospital, Milan, Italy (Drs Casati and Lanna)
| | - Nicola Volpe
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy (Drs Ramirez Zegarra and Volpe, Prof Dall'Asta, Drs Chiarelli, Labadini, di Pasquo, and Ghi)
| | - Mariano Lanna
- Fetal Therapy Unit "U. Nicolini", Department of Women, Mother and Neonate, Vittore Buzzi Children's Hospital, Milan, Italy (Drs Casati and Lanna)
| | - Andrea Dall'Asta
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy (Drs Ramirez Zegarra and Volpe, Prof Dall'Asta, Drs Chiarelli, Labadini, di Pasquo, and Ghi)
| | - Annasole Chiarelli
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy (Drs Ramirez Zegarra and Volpe, Prof Dall'Asta, Drs Chiarelli, Labadini, di Pasquo, and Ghi)
| | - Francesca Ormitti
- Neuroradiology Unit, University Hospital of Parma, Parma, Italy (Dr Ormitti)
| | - Antonio Percesepe
- Department of Medicine and Surgery, Medical Genetics, University of Parma, Italy (Prof Percesepe)
| | - Elisa Montaguti
- Department of Obstetrics and Fetal Medicine, Policlinico di Sant'Orsola Malpighi, Bologna, Italy (Drs Montaguti, Salsi, and Prof Pilu)
| | - Corinne Labadini
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy (Drs Ramirez Zegarra and Volpe, Prof Dall'Asta, Drs Chiarelli, Labadini, di Pasquo, and Ghi)
| | - Ginevra Salsi
- Department of Obstetrics and Fetal Medicine, Policlinico di Sant'Orsola Malpighi, Bologna, Italy (Drs Montaguti, Salsi, and Prof Pilu)
| | - Elvira di Pasquo
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy (Drs Ramirez Zegarra and Volpe, Prof Dall'Asta, Drs Chiarelli, Labadini, di Pasquo, and Ghi)
| | - Maria Paola Bonasoni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy (Dr Bonasoni)
| | - Edwin Quarello
- Department of Obstetrics and Gynecology, Hospital Saint Joseph, Marseille, France (Dr Quarello)
| | - Gianluigi Pilu
- Department of Obstetrics and Fetal Medicine, Policlinico di Sant'Orsola Malpighi, Bologna, Italy (Drs Montaguti, Salsi, and Prof Pilu)
| | - Giampaolo Grisolia
- Department of High-Risk Pregnancy, Mantova Ospedale C. Poma, Mantua, Italy (Dr Grisolia)
| | - Andrea Righini
- Department of Radiology and Pediatric Neuroradiology, Vittore Buzzi Children's Hospital, Milan, Italy (Prof Righini)
| | - Tullio Ghi
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy (Drs Ramirez Zegarra and Volpe, Prof Dall'Asta, Drs Chiarelli, Labadini, di Pasquo, and Ghi).
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Tsai P, Shinar S. Agenesis of the corpus callosum: What to tell expecting parents? Prenat Diagn 2023; 43:1527-1535. [PMID: 37794643 DOI: 10.1002/pd.6447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 09/09/2023] [Accepted: 09/14/2023] [Indexed: 10/06/2023]
Abstract
Agenesis of the corpus callosum (ACC) is one of the most common brain malformations, with an incidence estimated to range from 0.5 to 70 in 10,000 among the general population. Prenatal diagnosis is made via ultrasound; however, fetal MRI is useful to confirm or exclude the presence of associated cerebral abnormalities-mostly cortical malformations-that may affect postnatal prognosis. When no additional central nervous system (CNS) or extra CNS anomalies are identified and no genetic cause is found, an isolated ACC is diagnosed. Overall, in cases of ACC, an underlying genetic cause can be identified in up to 12.5% with chromosomal microarray (CMA) and up to 47% with whole exome sequencing (WES). In cases where ACC is the only anomaly detected, the yield of WES is 30%. Postnatal outcomes are variable and depend on whether the condition is isolated or not. In truly isolated ACC, outcomes range from normal in 65% of cases through mild to severe neurodevelopmental impairments in 35% of cases. An interdisciplinary team of medical experts is key in guiding parents toward informed decision-making in pregnancies complicated by ACC. Considering current and expected advancements in genetic testing and imaging technologies in upcoming years, we herein summarize current recommendations for the management and prenatal counseling of expecting parents of fetuses with ACC. Our review pertains primarily to expecting parents of fetuses with complete ACC.
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Affiliation(s)
- Pascale Tsai
- Michael G. DeGroote School of Medicine, Waterloo Regional Campus, McMaster University, Hamilton, Ontario, Canada
| | - Shiri Shinar
- Fetal Medicine Unit, Ontario Fetal Center, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
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7
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Nguyen T, Heide S, Guilbaud L, Valence S, Perre SV, Blondiaux E, Keren B, Quenum-Miraillet G, Jouannic JM, Mandelbrot L, Picone O, Guet A, Tsatsaris V, Milh M, Girard N, Vincent M, Nizon M, Poirsier C, Vivanti A, Benachi A, Portes VD, Guibaud L, Patat O, Spentchian M, Frugère L, Héron D, Garel C. Abnormalities of the corpus callosum. Can prenatal imaging predict the genetic status? Correlations between imaging phenotype and genotype. Prenat Diagn 2023; 43:746-755. [PMID: 37173814 DOI: 10.1002/pd.6382] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Recent studies have evaluated prenatal exome sequencing (pES) for abnormalities of the corpus callosum (CC). The objective of this study was to compare imaging phenotype and genotype findings. METHOD This multicenter retrospective study included fetuses with abnormalities of the CC between 2018 and 2020 by ultrasound and/or MRI and for which pES was performed. Abnormalities of the CC were classified as complete (cACC) or partial (pACC) agenesis of the CC, short CC (sCC), callosal dysgenesis (CD), interhemispheric cyst (IHC), or pericallosal lipoma (PL), isolated or not. Only pathogenic (class 5) or likely pathogenic (class 4) (P/LP) variants were considered. RESULTS 113 fetuses were included. pES identified P/LP variants for 3/29 isolated cACC, 3/19 isolated pACC, 0/10 isolated sCC, 5/10 isolated CD, 5/13 non-isolated cACC, 3/6 non-isolated pACC, 8/11 non-isolated CD and 0/12 isolated IHC and PL. Associated cerebellar abnormalities were significantly associated with P/LP variants (OR = 7.312, p = 0.027). No correlation was found between phenotype and genotype, except for fetuses with a tubulinopathy and an MTOR pathogenic variant. CONCLUSIONS P/LP variants were more frequent in CD and in non-isolated abnormalities of the CC. No such variants were detected for fetuses with isolated sCC, IHC and PL.
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Affiliation(s)
- Toan Nguyen
- Service de radiologie pédiatrique, Hôpital Armand-Trousseau, Médecine Sorbonne Université, APHP, DMU DIAMENT, GRC Images, Paris, France
| | - Solveig Heide
- Service de génétique médicale, Hôpital Pitié-Salpêtrière, Paris, France
| | - Lucie Guilbaud
- Service de médecine fœtale, Hôpital Armand-Trousseau, Sorbonne Université, APHP, DMU ORIGYNE, Paris, France
| | | | - Saskia Vande Perre
- Service de radiologie pédiatrique, Hôpital Armand-Trousseau, Médecine Sorbonne Université, APHP, DMU DIAMENT, GRC Images, Paris, France
| | - Eléonore Blondiaux
- Service de radiologie pédiatrique, Hôpital Armand-Trousseau, Médecine Sorbonne Université, APHP, DMU DIAMENT, GRC Images, Paris, France
| | - Boris Keren
- Service de génétique médicale, Hôpital Pitié-Salpêtrière, Paris, France
| | | | - Jean-Marie Jouannic
- Service de médecine fœtale, Hôpital Armand-Trousseau, Sorbonne Université, APHP, DMU ORIGYNE, Paris, France
| | - Laurent Mandelbrot
- Service de gynécologie obstétrique, Hôpital Louis-Mourier, Colombes, France
| | - Olivier Picone
- Service de gynécologie obstétrique, Hôpital Louis-Mourier, Colombes, France
| | - Agnès Guet
- Service de neuropédiatrie, Hôpital Louis-Mourier, Colombes, France
| | - Vassilis Tsatsaris
- Service de gynécologie obstétrique, Hôpital Cochin-Port Royal, Paris, France
| | - Mathieu Milh
- Service de neuropédiatrie, CHU de Marseille, AP-HM, Marseille, France
| | - Nadine Girard
- Service de neuroradiologie, CHU de Marseille, AP-HM, Marseille, France
| | | | | | | | - Alexandre Vivanti
- Service de gynécologie obstétrique, CHU Antoine Béclère, Clamart, France
| | - Alexandra Benachi
- Service de gynécologie obstétrique, CHU Antoine Béclère, Clamart, France
| | | | - Laurent Guibaud
- Service d'imagerie pédiatrique et fœtale, Hôpital Femme Mère Enfant, Lyon, France
| | - Olivier Patat
- Service de génétique médicale, Hôpital Purpan, Toulouse, France
| | | | - Lisa Frugère
- Service de génétique médicale, Hôpital Pitié-Salpêtrière, Paris, France
| | - Delphine Héron
- Service de génétique médicale, Hôpital Pitié-Salpêtrière, Paris, France
| | - Catherine Garel
- Service de radiologie pédiatrique, Hôpital Armand-Trousseau, Médecine Sorbonne Université, APHP, DMU DIAMENT, GRC Images, Paris, France
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Scelsa B. Fetal Neurology: From Prenatal Counseling to Postnatal Follow-Up. Diagnostics (Basel) 2022; 12:diagnostics12123083. [PMID: 36553090 PMCID: PMC9776544 DOI: 10.3390/diagnostics12123083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/30/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022] Open
Abstract
Brain abnormalities detected in fetal life are being increasingly recognized. Child neurologists are often involved in fetal consultations, and specific fetal neurology training has been implemented in many countries. Pediatric neurologists are asked to examine the data available and to contribute to the definition of the long-term outcomes. Ventriculomegaly, posterior fossa malformations, and agenesis/dysgenesis of corpus callosum are among the most common reasons for antenatal neurological consultations. Fetuses with central nervous system and extra-CNS anomalies should ideally be managed in secondary/tertiary hospitals where obstetricians who are experts in fetal medicine and pediatric specialists are available. Obstetricians play a critical role in screening, performing detailed neurosonography, and referring to other specialists for additional investigations. Clinical geneticists are frequently asked to propose diagnostic tests and counsel complex fetal malformations whose phenotypes may differ from those during postnatal life. Advances in fetal MRI and genetic investigations can support the specialists involved in counseling. Nevertheless, data interpretation can be challenging, and it requires a high level of expertise in a multidisciplinary setting. Postnatally, child neurologists should be part of an integrated multidisciplinary follow-up, together with neonatologists and pediatricians. The neurodevelopmental outcomes should be assessed at least up to school age. Children should be evaluated with formal tests of their gross motor, cognitive, language, fine motor/visuo-perceptual skills, and their behavior. In this perspective, fetal neurology can be regarded as the beginning of a long journey which continues with a prolonged, structured follow-up, support to the families, and transition to adult life. A review of the most common conditions is presented, along with the long-term outcomes and a proposal of the neurodevelopmental follow-up of children with CNS malformation which are diagnosed in uterus.
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Affiliation(s)
- Barbara Scelsa
- Department of Pediatric Neurology and Psychiatry, V. Buzzi Children's Hospital, ASST-FBF-Sacco, via Castelvetro 32, 20154 Milan, Italy
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Lanna M, Scelsa B. Reply. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 60:588. [PMID: 36183350 DOI: 10.1002/uog.26066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- M Lanna
- Fetal Therapy Unit 'U. Nicolini', Vittore Buzzi Children's Hospital, Milan, Italy
- Department of Women, Mother and Neonate, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - B Scelsa
- Department of Pediatric Neurology, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
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Jiang F, Li DZ. Outcomes associated with isolated agenesis of the corpus callosum diagnosed in utero. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 60:587-588. [PMID: 36183349 DOI: 10.1002/uog.26065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/14/2022] [Indexed: 05/27/2023]
Affiliation(s)
- F Jiang
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center affiliated to Guangzhou Medical University, Guangzhou, Guangdong, China
| | - D-Z Li
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center affiliated to Guangzhou Medical University, Guangzhou, Guangdong, China
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