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Paladini D, Biancotto G, Della Sala F, Severino M, Rossi A. Neurosonographic and MRI diagnosis of fetal cerebral lesions heralding polymicrogyria. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2024; 63:293-302. [PMID: 37671454 DOI: 10.1002/uog.27460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 09/07/2023]
Affiliation(s)
- D Paladini
- Fetal Medicine and Surgery Unit - IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - G Biancotto
- Fetal Medicine and Surgery Unit - IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - F Della Sala
- Fetal Medicine and Surgery Unit - IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - M Severino
- Neuroradiology Unit - IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - A Rossi
- Neuroradiology Unit - IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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Marathu KK, Vahedifard F, Kocak M, Liu X, Adepoju JO, Bowker RM, Supanich M, Cosme-Cruz RM, Byrd S. Fetal MRI Analysis of Corpus Callosal Abnormalities: Classification, and Associated Anomalies. Diagnostics (Basel) 2024; 14:430. [PMID: 38396468 PMCID: PMC10887608 DOI: 10.3390/diagnostics14040430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Corpus callosal abnormalities (CCA) are midline developmental brain malformations and are usually associated with a wide spectrum of other neurological and non-neurological abnormalities. The study aims to highlight the diagnostic role of fetal MRI to characterize heterogeneous corpus callosal abnormalities using the latest classification system. It also helps to identify associated anomalies, which have prognostic implications for the postnatal outcome. METHODS In this study, retrospective data from antenatal women who underwent fetal MRI between January 2014 and July 2023 at Rush University Medical Center were evaluated for CCA and classified based on structural morphology. Patients were further assessed for associated neurological and non-neurological anomalies. RESULTS The most frequent class of CCA was complete agenesis (79.1%), followed by hypoplasia (12.5%), dysplasia (4.2%), and hypoplasia with dysplasia (4.2%). Among them, 17% had isolated CCA, while the majority (83%) had complex forms of CCA associated with other CNS and non-CNS anomalies. Out of the complex CCA cases, 58% were associated with other CNS anomalies, while 8% were associated with non-CNS anomalies. 17% of cases had both. CONCLUSION The use of fetal MRI is valuable in the classification of abnormalities of the corpus callosum after the confirmation of a suspected diagnosis on prenatal ultrasound. This technique is an invaluable method for distinguishing between isolated and complex forms of CCA, especially in cases of apparent isolated CCA. The use of diffusion-weighted imaging or diffusion tensor imaging in fetal neuroimaging is expected to provide further insights into white matter abnormalities in fetuses diagnosed with CCA in the future.
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Affiliation(s)
- Kranthi K. Marathu
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Chicago, IL 60612, USA; (F.V.); (M.K.); (X.L.); (J.O.A.); (S.B.)
| | - Farzan Vahedifard
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Chicago, IL 60612, USA; (F.V.); (M.K.); (X.L.); (J.O.A.); (S.B.)
| | - Mehmet Kocak
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Chicago, IL 60612, USA; (F.V.); (M.K.); (X.L.); (J.O.A.); (S.B.)
| | - Xuchu Liu
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Chicago, IL 60612, USA; (F.V.); (M.K.); (X.L.); (J.O.A.); (S.B.)
| | - Jubril O. Adepoju
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Chicago, IL 60612, USA; (F.V.); (M.K.); (X.L.); (J.O.A.); (S.B.)
| | - Rakhee M. Bowker
- Department of Pediatrics, Division of Neonatology, Rush Medical College, Chicago, IL 60612, USA;
| | - Mark Supanich
- Department of Radiology and Nuclear Medicine, Division for Diagnostic Medical Physics, Rush University Medical Center, Chicago, IL 60612, USA;
| | - Rosario M. Cosme-Cruz
- Department of Psychiatry and Behavioral Sciences, Rush Medical College, Chicago, IL 60612, USA;
| | - Sharon Byrd
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Chicago, IL 60612, USA; (F.V.); (M.K.); (X.L.); (J.O.A.); (S.B.)
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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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Yang R, Cao Y, He D, Dang W, Qiu C, Zhang W. Social anxiety disorder in an adolescent with agenesis of the corpus callosum: a case report. BMC Psychiatry 2022; 22:714. [PMID: 36384487 PMCID: PMC9670649 DOI: 10.1186/s12888-022-04332-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 10/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The agenesis of corpus callosum (ACC) could impair the connectivity of the hemispheres of the cerebral cortex and cause cognitive impairments, social and behavioral issues, and even psychiatric disorders. Although social deficits are common in ACC patients, it is rare for a social anxiety disorder to occur. CASE PRESENTATION To report a 17-year-old adolescent with complete ACC associated with social anxiety disorder, depression, impulsive behavior, and other neurodevelopmental defects such as intellectual disabilities. His avoidance and fear were improved after treatment with sertraline. CONCLUSIONS This is the first report of social anxiety disorder in ACC patients. The possible relationship between brain structural abnormities and anxiety syndrome should be investigated in more studies.
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Affiliation(s)
- Runnan Yang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital, Sichuan University, 28 Dianxin Street, Chengdu, Sichuan China
| | - Yuan Cao
- grid.412901.f0000 0004 1770 1022Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan China ,grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Danmei He
- grid.412901.f0000 0004 1770 1022West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Wen Dang
- grid.412901.f0000 0004 1770 1022West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Changjian Qiu
- Mental Health Center, West China Hospital, Sichuan University, 28 Dianxin Street, Chengdu, Sichuan, China.
| | - Wei Zhang
- Mental Health Center, West China Hospital, Sichuan University, 28 Dianxin Street, Chengdu, Sichuan, China.
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Imaging of Congenital Malformations of the Brain. Clin Perinatol 2022; 49:587-601. [PMID: 36113924 DOI: 10.1016/j.clp.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Brain formation is a continuous and complicated process that is historically categorized by the timing of development. The earliest disorders of dorsal induction occur in the first month of gestation and include anencephaly and cephalocele. Disorders of ventral induction occur during the second month of gestation and include the holoprosencephaly and septo-optic dysplasia spectrums. The third and longest timeframe include the disorders of neuronal migration and proliferation (gestational weeks eight-25) and include malformations of cortical development: lissencephaly, polymicrogyria, schizencephaly, gray matter heterotopia, and corpus callosal dysgenesis. This review will highlight the neuroimaging of these malformations.
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Leibovitz Z, Lerman-Sagie T, Haddad L. Fetal Brain Development: Regulating Processes and Related Malformations. Life (Basel) 2022; 12:life12060809. [PMID: 35743840 PMCID: PMC9224903 DOI: 10.3390/life12060809] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
This paper describes the contemporary state of knowledge regarding processes that regulate normal development of the embryonic–fetal central nervous system (CNS). The processes are described according to the developmental timetable: dorsal induction, ventral induction, neurogenesis, neuronal migration, post-migration neuronal development, and cortical organization. We review the current literature on CNS malformations associated with these regulating processes. We specifically address neural tube defects, holoprosencephaly, malformations of cortical development (including microcephaly, megalencephaly, lissencephaly, cobblestone malformations, gray matter heterotopia, and polymicrogyria), disorders of the corpus callosum, and posterior fossa malformations. Fetal ventriculomegaly, which frequently accompanies these disorders, is also reviewed. Each malformation is described with reference to the etiology, genetic causes, prenatal sonographic imaging, associated anomalies, differential diagnosis, complimentary diagnostic studies, clinical interventions, neurodevelopmental outcome, and life quality.
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Affiliation(s)
- Zvi Leibovitz
- Obstetrics-Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Fetal Neurology Clinic, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 5822012, Israel;
- Obstetrics-Gynecology Ultrasound Unit, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, The Technion, Haifa 31048, Israel;
- Correspondence:
| | - Tally Lerman-Sagie
- Obstetrics-Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Fetal Neurology Clinic, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 5822012, Israel;
- Pediatric Neurology Unit, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 5822012, Israel
| | - Leila Haddad
- Obstetrics-Gynecology Ultrasound Unit, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, The Technion, Haifa 31048, Israel;
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Clinical Applications of Fetal MRI in the Brain. Diagnostics (Basel) 2022; 12:diagnostics12030764. [PMID: 35328317 PMCID: PMC8947742 DOI: 10.3390/diagnostics12030764] [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: 01/24/2022] [Revised: 03/04/2022] [Accepted: 03/10/2022] [Indexed: 11/24/2022] Open
Abstract
Fetal magnetic resonance imaging (MRI) has become a widely used tool in clinical practice, providing increased accuracy in prenatal diagnoses of congenital abnormalities of the brain, allowing for more accurate prenatal counseling, optimization of perinatal management, and in some cases fetal intervention. In this article, a brief description of how fetal ultrasound (US) and fetal MRI are used in clinical practice will be followed by an overview of the most common reasons for referral for fetal MRI of the brain, including ventriculomegaly, absence of the cavum septi pellucidi (CSP) and posterior fossa anomalies.
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Diogo MC, Glatter S, Prayer D, Gruber GM, Bettelheim D, Weber M, Dovjak G, Seidl R, Kasprian G. Improved neurodevelopmental prognostication in isolated corpus callosal agenesis: fetal magnetic resonance imaging-based scoring system. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2021; 58:34-41. [PMID: 32484578 PMCID: PMC8362015 DOI: 10.1002/uog.22102] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/07/2020] [Accepted: 05/18/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Corpus callosal agenesis (CCA) is one of the most common brain malformations and is generally associated with a good outcome when isolated. However, up to 25% of patients are at risk of neurodevelopmental delay, which currently available clinical and imaging parameters are inadequate to predict. The objectives of this study were to apply and validate a fetal magnetic resonance imaging (MRI) anatomical scoring system in a cohort of fetuses with isolated CCA and to evaluate the correlation with postnatal neurodevelopmental outcome. METHODS This was a retrospective cohort study of cases of prenatally diagnosed isolated CCA (as determined on ultrasound and MRI), with normal karyotype and with known postnatal neurodevelopmental outcome assessed by standardized testing. A fetal brain MRI anatomical scoring system based on seven categories (gyration, opercularization, temporal lobe symmetry, lamination, hippocampal position, basal ganglia and ventricular size) was developed and applied to the cohort; a total score of 0-11 points could be given, with a score of 0 representing normal anatomy. Images were scored independently by two neuroradiologists blinded to the outcome. For the purpose of assessing the correlation between fetal MRI score and neurodevelopmental outcome, neurodevelopmental test results were scored as follows: 0, 'below average' (poor outcome); 1, 'average'; and 2, 'above average' (good outcome). Spearman's rank coefficient was used to assess correlation, and inter-rater agreement in the assessment of fetal MRI score was calculated. RESULTS Twenty-one children (nine females (42.9%)) fulfilled the inclusion criteria. Thirty-seven fetal MRI examinations were evaluated. Mean gestational age was 28.3 ± 4.7 weeks (range, 20-38 weeks). All fetuses were delivered after 35 weeks' gestation with no perinatal complications. Fetal MRI scores ranged from 0 to 6 points, with a median of 3 points. Inter-rater agreement in fetal MRI score assessment was excellent (intraclass correlation coefficient, 0.959 (95% CI, 0.921-0.979)). Neurodevelopmental evaluation was performed on average at 2.6 ± 1.46 years (range, 0.5-5.8 years). There was a significant negative correlation between fetal MRI score and neurodevelopmental outcome score in the three areas tested: cognitive (ρ = -0.559, P < 0.0001); motor (ρ = -0.414, P = 0.012) and language (ρ = -0.565, P < 0.0001) skills. Using fetal MRI score cut-offs of ≤ 3 (good outcome) and ≥ 4 points (high risk for poor outcome), the correct prognosis could be determined in 20/21 (95.2% (95% CI, 77.3-99.2%)) cases. CONCLUSION By assessing structural features of the fetal brain on MRI, it may be possible to better stratify prenatally the risk of poor neurodevelopmental outcome in CCA patients. © 2020 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M. C. Diogo
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
- Neuroradiology DepartmentHospital Garcia de OrtaAlmadaPortugal
| | - S. Glatter
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric NeurologyMedical University of ViennaViennaAustria
| | - D. Prayer
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
| | - G. M. Gruber
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
- Department of Anatomy and BiomechanicsKarl Landsteiner University of Health SciencesKremsAustria
| | - D. Bettelheim
- Department of Gynecology and ObstetricsMedical University of ViennaViennaAustria
| | - M. Weber
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
| | - G. Dovjak
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
| | - R. Seidl
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric NeurologyMedical University of ViennaViennaAustria
| | - G. Kasprian
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
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Incidental Massive Hydrocephalus Associated With an Unruptured Choroid Plexus Arteriovenous Malformation and Complete Agenesis of the Corpus Callosum Found in an Adult at Autopsy. Am J Forensic Med Pathol 2021; 41:327-330. [PMID: 32568882 DOI: 10.1097/paf.0000000000000562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Undiagnosed significant hydrocephalus is an uncommon finding at forensic autopsy as many cases present in life with complex neurological symptoms. We present a case of a 46-year-old man with no neurological deficits or history of head trauma that was incidentally found to have a massive hydrocephalus at autopsy. This was found to be associated with an unruptured arteriovenous malformation completely confined to the choroid plexus as well as complete agenesis of the corpus callosum. The arteriovenous malformation was found to form a calcified obstruction at the foramen of Monro analogous to a mass lesion, such as a colloid cyst of the third ventricle. The association of this malformation and agenesis of the corpus callosum has never been described. Histologic examination of the brain confirmed significant loss of white matter tracts and thinning of the cortical ribbon due to pressure atrophy of the ependymal lining without significant gliosis, cortical dysplasia, or evidence of other developmental malformations. Autopsy is a vital tool in the evaluation of such rare cases, enhances epidemiologic data, and increases the understanding of these pathophysiological associations.
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Sileo FG, Di Mascio D, Rizzo G, Caulo M, Manganaro L, Bertucci E, Masmejan S, Liberati M, D'Amico A, Nappi L, Buca D, Van Mieghem T, Khalil A, D'Antonio F. 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. Acta Obstet Gynecol Scand 2021; 100:7-16. [PMID: 32652537 DOI: 10.1111/aogs.13958] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/28/2020] [Accepted: 07/07/2020] [Indexed: 02/06/2023]
Abstract
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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Affiliation(s)
- Filomena Giulia Sileo
- Fetal Medicine Unit, Saint George's Hospital, London, UK
- Prenatal Medicine Unit, Obstetrics and Gynecology Unit, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Di Mascio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Rizzo
- Division of Maternal and Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy
- Department of Obstetrics and Gynecology, The First I.M. Sechenov Moscow State Medical University, Moscow, Russia
| | - Massimo Caulo
- ITAB Institute of Advanced Biomedical Technologies, University "G. d'Annunzio", Chieti, Italy
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", SS Annunziata Hospital, Chieti, Italy
| | - Lucia Manganaro
- Department of Radiology, Sapienza University of Rome, Rome, Italy
| | - Emma Bertucci
- Prenatal Medicine Unit, Obstetrics and Gynecology Unit, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - Sophie Masmejan
- Obstetrics Unit, Department of Mother and Child, Center Hospitalier Universitaire Vaudois, Lausanne, Switzerland
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Mount Sinai Hospital and University of Toronto, Toronto, Canada
| | - Marco Liberati
- Center for Fetal Care and High-risk Pregnancy, Department of Obstetrics and Gynecology, University Hospital of Chieti, Chieti, Italy
| | - Alice D'Amico
- Center for Fetal Care and High-risk Pregnancy, Department of Obstetrics and Gynecology, University Hospital of Chieti, Chieti, Italy
| | - Luigi Nappi
- Department of Obstetrics and Gynecology, University of Foggia, Foggia, Italy
| | - Danilo Buca
- Department of Obstetrics and Gynecology, University of Foggia, Foggia, Italy
| | - Tim Van Mieghem
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Mount Sinai Hospital and University of Toronto, Toronto, Canada
| | - Asma Khalil
- Fetal Medicine Unit, Saint George's Hospital, London, UK
- Vascular Biology Research Center, Molecular and Clinical Sciences Research Institute, St George's Hospital, University of London, London, UK
| | - Francesco D'Antonio
- Center for Fetal Care and High-risk Pregnancy, Department of Obstetrics and Gynecology, University Hospital of Chieti, Chieti, Italy
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11
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Ghassemi N, Rupe E, Perez M, Lamale-Smith L, Fratto VM, Farid N, Hahn M, Ramos GA, Ho Y, Rakow-Penner R, Horton K, Khan S, Jones M, Pretorius DH. Ultrasound and Magnetic Resonance Imaging of Agenesis of the Corpus Callosum in Fetuses: Frontal Horns and Cavum Septi Pellucidi Are Clues to Earlier Diagnosis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:2389-2403. [PMID: 32597533 DOI: 10.1002/jum.15348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES We hypothesized that: (1) fetal frontal horn (FH) morphology and their proximity to the cavum septi pellucidi (CSP) can assist in suspecting complete agenesis of the corpus callosum (cACC) and partial agenesis of the corpus callosum (pACC) earlier than known indirect ultrasound (US) findings; (2) FHs assist in differentiating a true CSP from a pseudocavum; and (3) magnetic resonance imaging (MRI) is useful in learning FH morphology and pseudocavum etiology. METHODS Thirty-two patients with cACC and 9 with pACC were identified on an Institutional Review Board-approved retrospective review. Of the 41 cases, 40 had prenatal US, and 21 had prenatal MRI; 17 had follow-up neonatal US, and 14 had follow-up neonatal MRI. Variables evaluated retrospectively were the presence of a CSP or a pseudocavum, ventricle size and shape, and FH shape (comma, trident, parallel, golf club, enlarged, or fused). Displacement between the inferior edge of the FH and the midline or cavum/pseudocavum was measured. RESULTS Fetal FHs had an abnormal shape in 77% ≤20 weeks' gestation, 86% ≤24 weeks, and 90% >24 weeks. Frontal horns were laterally displaced greater than 2 mm in 85% ≤20 weeks, 91% ≤24 weeks, and 95% >24 weeks. The CSP was absent in 100% of cACC cases and 78% of pACC cases, and a pseudocavum was present in 88% of cACC cases and 78% of pACC cases across gestation. Magnetic resonance imaging confirmed US pseudocavums to be focal interhemispheric fluid or an elevated/dilated third ventricle. CONCLUSIONS Frontal horns assist in assessing ACC ≤24 weeks and throughout gestation. Pseudocavums, often simulating CSPs, are common in ACC. Frontal horn lateral displacement and abnormal morphology, recognized by MRI correlations, are helpful in differentiating a pseudocavum from a true CSP. A normal CSP should not be cleared on screening US unless normally shaped FHs are seen directly adjacent to it.
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Affiliation(s)
- Neda Ghassemi
- University of California, San Diego, School of Medicine (N.G.)
| | - Eric Rupe
- University of California, San Diego, Maternal-Fetal Care and Genetics (M.P., L.L.-S., V.M.F., M.H., G.A.R., M.J., D.H.P.), USA
| | - Mishella Perez
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
- Obstetrics, Gynecology and Reproductive Sciences (M.P., L.L.-S., V.M.F., G.A.R.), USA
| | - Leah Lamale-Smith
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
- Obstetrics, Gynecology and Reproductive Sciences (M.P., L.L.-S., V.M.F., G.A.R.), USA
| | - Victoria M Fratto
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
- Obstetrics, Gynecology and Reproductive Sciences (M.P., L.L.-S., V.M.F., G.A.R.), USA
| | - Nikdokht Farid
- University of California, San Diego, Maternal-Fetal Care and Genetics (M.P., L.L.-S., V.M.F., M.H., G.A.R., M.J., D.H.P.), USA
| | - Michael Hahn
- University of California, San Diego, Maternal-Fetal Care and Genetics (M.P., L.L.-S., V.M.F., M.H., G.A.R., M.J., D.H.P.), USA
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
| | - Gladys A Ramos
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
- Obstetrics, Gynecology and Reproductive Sciences (M.P., L.L.-S., V.M.F., G.A.R.), USA
| | - Yoona Ho
- University of California, San Diego, Maternal-Fetal Care and Genetics (M.P., L.L.-S., V.M.F., M.H., G.A.R., M.J., D.H.P.), USA
| | - Rebecca Rakow-Penner
- University of California, San Diego, Maternal-Fetal Care and Genetics (M.P., L.L.-S., V.M.F., M.H., G.A.R., M.J., D.H.P.), USA
| | - Katelyn Horton
- University of California, Berkeley, California, USA (K.H.), USA
| | - Sohini Khan
- University of California, Berkeley, California, USA (K.H.), USA
| | - Marilyn Jones
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
- General Surgery (S.K.) and Pediatrics (M.J.), University of California, USA
| | - Dolores H Pretorius
- University of California, San Diego, Maternal-Fetal Care and Genetics (M.P., L.L.-S., V.M.F., M.H., G.A.R., M.J., D.H.P.), USA
- Departments of Radiology (E.R., N.F., M.H., Y.H., R.R.-P., D.H.P.), USA
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12
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Choi JJ, Yang E, Soul JS, Jaimes C. Fetal magnetic resonance imaging: supratentorial brain malformations. Pediatr Radiol 2020; 50:1934-1947. [PMID: 33252760 DOI: 10.1007/s00247-020-04696-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/16/2020] [Accepted: 04/23/2020] [Indexed: 11/29/2022]
Abstract
Fetal MRI is the modality of choice to study supratentorial brain malformations. To accurately interpret the MRI, the radiologist needs to understand the normal sequence of events that occurs during prenatal brain development; this includes familiarity with the processes of hemispheric cleavage, formation of interhemispheric commissures, neuro-glial proliferation and migration, and cortical folding. Disruption of these processes results in malformations observed on fetal MRI including holoprosencephaly, callosal agenesis, heterotopic gray matter, lissencephaly and other malformations of cortical development (focal cortical dysplasia, polymicrogyria). The radiologist should also be familiar with findings that have high association with specific conditions affecting the central nervous system or other organ systems. This review summarizes and illustrates common patterns of supratentorial brain malformations and emphasizes aspects that are important to patient care.
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Affiliation(s)
- Jungwhan John Choi
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA.,Harvard Medical School, Boston, MA, USA
| | - Edward Yang
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA.,Harvard Medical School, Boston, MA, USA
| | - Janet S Soul
- Harvard Medical School, Boston, MA, USA.,Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Camilo Jaimes
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA. .,Harvard Medical School, Boston, MA, USA. .,Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA.
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13
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Paradiso S, Brown WS, Porcerelli JH, Tranel D, Adolphs R, Paul LK. Integration Between Cerebral Hemispheres Contributes to Defense Mechanisms. Front Psychol 2020; 11:1534. [PMID: 32733338 PMCID: PMC7359856 DOI: 10.3389/fpsyg.2020.01534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 06/09/2020] [Indexed: 11/26/2022] Open
Abstract
Defense mechanisms are mental functions which facilitate coping when real or imagined events challenge personal wishes, needs, and feelings. Whether defense mechanisms have a specific neural basis is unknown. The present research tested the hypothesis that interhemispheric integration plays a critical role in defense mechanism development, by studying a unique sample of patients born without the corpus callosum (agenesis of the corpus callosum; AgCC). Adults with AgCC (N = 27) and matched healthy volunteers (N = 30) were compared on defense mechanism use across increasing levels of developmental maturity (denial, least; projection, intermediate; identification, most). Narratives generated in response to Thematic Apperception Test images were scored according to the Defense Mechanism Manual. Greater use of denial and less identification was found in persons with AgCC, compared to healthy comparisons. This difference emerged after age 18 when full maturation of defenses among healthy individuals was expected. The findings provide clinically important characterization of social and emotional processing in persons with AgCC. More broadly, the results support the hypothesis that functional integration across the hemispheres is important for the development of defense mechanisms.
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Affiliation(s)
- Sergio Paradiso
- Institute of Cognitive and Translational Neuroscience, INECO Foundation, Favaloro University, CONICET, Buenos Aires, Argentina
| | - Warren S Brown
- Travis Research Institute, Fuller Graduate School of Psychology, Pasadena, CA, United States.,International Research Consortium for the Corpus Callosum and Cerebral Connectivity (IRC5), Pasadena, CA, United States
| | - John H Porcerelli
- Department of Psychology, University of Detroit Mercy, Detroit, MI, United States
| | - Daniel Tranel
- Department of Neurology and Psychology and Neuroscience Program, The University of Iowa, Iowa City, IA, United States
| | - Ralph Adolphs
- Division of Biology, California Institute of Technology, Pasadena, CA, United States.,Division of the Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, United States
| | - Lynn K Paul
- Travis Research Institute, Fuller Graduate School of Psychology, Pasadena, CA, United States.,Division of the Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, United States.,International Research Consortium for the Corpus Callosum and Cerebral Connectivity (IRC5), Pasadena, CA, United States
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14
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Cater SW, Boyd BK, Ghate SV. Abnormalities of the Fetal Central Nervous System: Prenatal US Diagnosis with Postnatal Correlation. Radiographics 2020; 40:1458-1472. [PMID: 32706613 DOI: 10.1148/rg.2020200034] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Fetal central nervous system (CNS) abnormalities are second only to cardiac malformations in their frequency of occurrence. Early and accurate diagnosis at prenatal US is therefore essential, allowing improved prenatal counseling and facilitating appropriate referral. Thorough knowledge of normal intracranial anatomy and adoption of a logical sonographic approach can improve depiction of abnormal findings, leading to a more accurate differential diagnosis earlier in pregnancy. Four standard recommended views-transventricular, falx, cavum, and posterior fossa or transcerebellar views-provide an overview of fetal intracranial anatomy during the second trimester anatomy scan. Essential elements surveyed in the head and neck include the lateral cerebral ventricles, choroid plexus, midline falx, cavum septi pellucidi, cerebellum, cisterna magna, upper lip, and nuchal fold. CNS abnormalities can be organized into six main categories at prenatal US. Developmental anomalies include neural tube defects and neuronal migration disorders. Posterior fossa disorders include Dandy-Walker malformation variants and Chiari II malformation. Ventricular anomalies include aqueductal stenosis. Midline disorders include those on the spectrum of holoprosencephaly, agenesis of the corpus callosum, and septo-optic dysplasia. Vascular anomalies include vein of Galen malformations. Miscellaneous disorders include hydranencephaly, porencephaly, tumors, and intracranial hemorrhage. Correlation with postnatal MRI is helpful for confirmation and clarification of suspected diagnoses after birth. The authors discuss a standard US imaging approach to the fetal CNS and review cases in all categories of CNS malformations, providing postnatal MRI correlation when available.©RSNA, 2020.
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Affiliation(s)
- Sarah W Cater
- From the Department of Radiology (S.W.C., S.V.G.) and Department of Obstetrics & Gynecology (B.K.B.), Duke University, 2301 Erwin Rd, Box 3808, Durham, NC 27710
| | - Brita K Boyd
- From the Department of Radiology (S.W.C., S.V.G.) and Department of Obstetrics & Gynecology (B.K.B.), Duke University, 2301 Erwin Rd, Box 3808, Durham, NC 27710
| | - Sujata V Ghate
- From the Department of Radiology (S.W.C., S.V.G.) and Department of Obstetrics & Gynecology (B.K.B.), Duke University, 2301 Erwin Rd, Box 3808, Durham, NC 27710
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Scoping Review of the Prenatal Diagnosis of Agenesis of the Corpus Callosum. J Obstet Gynecol Neonatal Nurs 2020; 49:423-436. [PMID: 32687791 DOI: 10.1016/j.jogn.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To map and summarize the literature related to the prenatal diagnosis of agenesis of the corpus callosum (ACC) to inform nursing practice. DATA SOURCES We searched MEDLINE, CINAHL, PyscINFO, and Academic Search Complete with the use of strings of curated terms to cover the broad ACC nomenclature. Documents were published in English between 2009 and June 1, 2020. We also hand searched the reference lists of included documents. STUDY SELECTION We screened 582 abstracts and retrieved the full texts of primary research articles, reviews, discussion papers, and peer-reviewed book chapters if the abstracts specifically mentioned ACC and the prenatal period. We excluded case reports, conference and poster abstracts, papers on broader anomalies, and animal studies. We reviewed 84 full-text documents and identified 61 for inclusion. DATA EXTRACTION We charted the data through an iterative process under headings for location, article type, study design, participant age, ACC type, recruitment, method, tools/assessments, results, key recommendations, gestational age at diagnosis, termination of pregnancy rate, the definition of isolated ACC, and our notes of critique of the document. DATA SYNTHESIS We constructed a narrative synthesis from thematically arranged data. In the included documents, ACC was diagnosed between 17 and 38 weeks gestation and was frequently described as heterogeneous because of different causes, presentations, and outcomes. Whether the ACC was isolated as the only anomaly or present with other anomalies was considered the key factor for prenatal counseling. However, the definition of isolated ACC was inconsistent. CONCLUSION The inconsistent nomenclature and definitions of an isolated presentation of ACC increase the ambiguity in the prenatal diagnosis and must be considered when the outcome and diagnostic efficacy studies are interpreted. There is an absence of research on parents' experiences of prenatal diagnoses of ACC to inform holistic nursing interventions and the provision of psychosocial support.
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16
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Ibrahim RSM, Emad-Eldin S. Beyond fetal magnetic resonance diagnosis of corpus callosum agenesis. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-00182-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Corpus callosum agenesis (CCA) is a midline congenital anomaly. Routine prenatal 2D ultrasonography (2D US) can suggest CCA. A definitive diagnosis and identification of more subtle associated neurological or non-neurological abnormalities are difficult to be detected by prenatal 2D US; therefore, a further study by fetal magnetic resonance imaging (MRI) is needed. This study highlights the role and evaluates the diagnostic value of fetal MRI in the diagnosis of CCA and identifying the associated anomalies, which is a prognostic of the postnatal developmental outcome.
Results
Out of 27 fetuses that were suspected to have CCA on prenatal US, fetal MRI diagnosed 25/27 fetuses (92.5%) with CCA, while the last 2/27 (7.5%) were ruled out; being false positive (FP) on prenatal US, they had normal corpus callosum (CC). Cases diagnosed as CCA were either complete 77.7% (n = 21) or partial agenesis 14.8% (n = 4). They were classified as followed: Only 5/25 (18.5%) had isolated CCA, while the majority 20/25 (74%) of CCA were complex form associated with other anomalies (most of them 14 cases (70%) associated with other neurological anomalies, while 4 cases (20%) associated with other non-neurological anomalies, and last 2 cases (10%) were having both anomalies). The diagnostic performance of fetal MRI in diagnosis of CCA was as follows: sensitivity 100%, specificity 67%, positive predictive value (PPV) 96%, negative predictive value (NPV) 100%, and accuracy 96.3%. The sensitivity of the detection of associated neurological abnormalities was 100% by fetal MRI for 75% by 2D US.
Conclusion
The prevalence of the complex CCA is higher than the isolated form. Fetal MRI is a valuable adjunctive complementary imaging to prenatal 2D US with high diagnostic performance in the diagnosis of fetuses with CCA. It confirms the diagnosis, assesses the extent of agenesis, and detects coexisting anomalies, which is a prognostic of the postnatal developmental outcome.
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Charvet CJ, Das A, Song JW, Tindal-Burgess DJ, Kabaria P, Dai G, Kane T, Takahashi E. High Angular Resolution Diffusion MRI Reveals Conserved and Deviant Programs in the Paths that Guide Human Cortical Circuitry. Cereb Cortex 2020; 30:1447-1464. [PMID: 31667494 PMCID: PMC7132938 DOI: 10.1093/cercor/bhz178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/13/2019] [Accepted: 07/10/2019] [Indexed: 02/07/2023] Open
Abstract
Diffusion magnetic resonance (MR) tractography represents a novel opportunity to investigate conserved and deviant developmental programs between humans and other species such as mice. To that end, we acquired high angular resolution diffusion MR scans of mice [embryonic day (E) 10.5 to postnatal week 4] and human brains [gestational week (GW) 17-30] at successive stages of fetal development to investigate potential evolutionary changes in radial organization and emerging pathways between humans and mice. We compare radial glial development as well as commissural development (e.g., corpus callosum), primarily because our findings can be integrated with previous work. We also compare corpus callosal growth trajectories across primates (i.e., humans and rhesus macaques) and rodents (i.e., mice). One major finding is that the developing cortex of humans is predominated by pathways likely associated with a radial glial organization at GW 17-20, which is not as evident in age-matched mice (E 16.5, 17.5). Another finding is that, early in development, the corpus callosum follows a similar developmental timetable in primates (i.e., macaques and humans) as in mice. However, the corpus callosum grows for an extended period of time in primates compared with rodents. Taken together, these findings highlight deviant developmental programs underlying the emergence of cortical pathways in the human brain.
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Affiliation(s)
| | - Avilash Das
- Medical Sciences in the College of Arts and Sciences, Boston University, Boston, MA 02215, USA
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02215, USA
- Fetal-Neonatal Brain Imaging and Developmental Science Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Jae W Song
- Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
| | | | - Priya Kabaria
- Department of Behavioral Neuroscience, Northeastern University, Boston, MA 02115, USA
| | - Guangping Dai
- Science Center, Wellesley College, Wellesley, MA 02481, USA
| | - Tara Kane
- Department of Behavioral Neuroscience, Northeastern University, Boston, MA 02115, USA
| | - Emi Takahashi
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02215, USA
- Fetal-Neonatal Brain Imaging and Developmental Science Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02215, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
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Guadarrama-Ortiz P, Choreño-Parra JA, de la Rosa-Arredondo T. Isolated agenesis of the corpus callosum and normal general intelligence development during postnatal life: a case report and review of the literature. J Med Case Rep 2020; 14:28. [PMID: 32046774 PMCID: PMC7014647 DOI: 10.1186/s13256-020-2359-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 01/28/2020] [Indexed: 01/04/2023] Open
Abstract
Background Agenesis of the corpus callosum can occur isolated or as part of a complex congenital syndrome. Patients with isolated agenesis of the corpus callosum may present with severe intellectual disability, although a proportion of affected individuals develop normal intelligence. However, even in patients with no apparent deficits, subtle neuropsychological alterations may occur as the cognitive demand increases with age. Hence, patients with this deffect require a strict follow-up during their postnatal life. Thus, physicians require a better knowledge of the cognitive features of agenesis of the corpus callosum to improve their approach to this cerebral malformation. Here, we report an illustrative case of a school-age child with isolated agenesis of the corpus callosum and normal intelligence. We also provide a literature review about the postnatal screening of neurocognitive deficits in patients with agenesis of the corpus callosum. Case presentation An 8-year-old Hispanic boy with total agenesis of the corpus callosum attended for medical follow-up. The defect was identified during the neonatal period by cranial ultrasonography and brain computed tomography scan. However, he did not present any craniofacial or non-cerebral malformation suggestive of a congenital syndrome. Furthermore, he showed no neuropsychiatric disorder or intellectual disability during his early childhood. At the age of 4, he was subjected to a control brain magnetic resonance imaging that showed total agenesis of the corpus callosum and colpocephaly. At his arrival, a neurological examination was normal with no signs of intracranial hypertension. His intelligence quotient was unaltered and he scored normal in the Mini-Mental State Examination test. The literature reviewed here suggested that patients with agenesis of the corpus callosum require a strict neurocognitive follow-up during postnatal life, as they may present neuropsychological deficits during adolescence, when development of the corpus callosum is completed and there is maximum reliance on this structure. Thus, our patient was scheduled for future annual neurocognitive testing. Conclusions Isolated agenesis of the corpus callosum is not innocuous, and patients with this defect require a strict neurocognitive follow-up. We provide an informative reference tool useful for the postnatal neuropsychological screening of patients with isolated agenesis of the corpus callosum.
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Affiliation(s)
- Parménides Guadarrama-Ortiz
- Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Tlaxcala & Manzanillo, Roma Sur, 06760, Mexico City, Mexico.
| | - José Alberto Choreño-Parra
- Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Tlaxcala & Manzanillo, Roma Sur, 06760, Mexico City, Mexico
| | - Tania de la Rosa-Arredondo
- Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Tlaxcala & Manzanillo, Roma Sur, 06760, Mexico City, Mexico
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Jiang Y, Qian YQ, Yang MM, Zhan QT, Chen Y, Xi FF, Sagnelli M, Dong MY, Zhao BH, Luo Q. Whole-Exome Sequencing Revealed Mutations of MED12 and EFNB1 in Fetal Agenesis of the Corpus Callosum. Front Genet 2019; 10:1201. [PMID: 31824579 PMCID: PMC6886535 DOI: 10.3389/fgene.2019.01201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 10/30/2019] [Indexed: 11/29/2022] Open
Abstract
Agenesis of the corpus callosum (ACC) is a birth defect in which the corpus callosum is either partially or completely missing. With recent advances in prenatal ultrasound, detection of ACC in obstetric practices is becoming more common. Etiologies of ACC include chromosome errors, genetic factors, prenatal infections, and other factors related to the prenatal environment. In an effort to elucidate more about the genetic influence in the pathogenesis of ACC, we identified, through whole-exome sequencing (WES), two gene mutations in two families with complete agenesis of the corpus callosum. These two mutations are located on chromosome X: one is a hemizygous missense mutation c.3746T>C (p. L1249P) in the gene mediator complex subunit 12 (MED12); the other one is a heterozygous missense mutation c.128+5G>C in gene ephrin B1 (EFNB1). Historically, early diagnosis of complete ACC during pregnancy has been difficult; however, WES has provided us with a creative avenue of diagnosis, combining identification of genetic mutations with prenatal imaging.
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Affiliation(s)
- Ying Jiang
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ye-Qing Qian
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Meng-Meng Yang
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qi-Tao Zhan
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuan Chen
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fang-Fang Xi
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Matthew Sagnelli
- University of Connecticut School of Medicine, Farmington, CT, United States
| | - Min-Yue Dong
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Bai-Hui Zhao
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qiong Luo
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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20
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Tarui T, Madan N, Farhat N, Kitano R, Ceren Tanritanir A, Graham G, Gagoski B, Craig A, Rollins CK, Ortinau C, Iyer V, Pienaar R, Bianchi DW, Grant PE, Im K. Disorganized Patterns of Sulcal Position in Fetal Brains with Agenesis of Corpus Callosum. Cereb Cortex 2019; 28:3192-3203. [PMID: 30124828 DOI: 10.1093/cercor/bhx191] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 07/11/2017] [Indexed: 12/22/2022] Open
Abstract
Fetuses with isolated agenesis of the corpus callosum (ACC) are associated with a broad spectrum of neurodevelopmental disability that cannot be specifically predicted in prenatal neuroimaging. We hypothesized that ACC may be associated with aberrant cortical folding. In this study, we determined altered patterning of early primary sulci development in fetuses with isolated ACC using novel quantitative sulcal pattern analysis which measures deviations of regional sulcal features (position, depth, and area) and their intersulcal relationships in 7 fetuses with isolated ACC (27.1 ± 3.8 weeks of gestation, mean ± SD) and 17 typically developing (TD) fetuses (25.7 ± 2.0 weeks) from normal templates. Fetuses with ACC showed significant alterations in absolute sulcal positions and relative intersulcal positional relationship compared to TD fetuses, which were not detected by traditional gyrification index. Our results reveal altered sulcal positional development even in isolated ACC that is present as early as the second trimester and continues throughout the fetal period. It might originate from altered white matter connections and portend functional variances in later life.
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Affiliation(s)
- Tomo Tarui
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital,Harvard Medical School, Boston, MA, USA.,Mother Infant Research Institute, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.,Department of Pediatrics, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Neel Madan
- Department of Radiology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Nabgha Farhat
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital,Harvard Medical School, Boston, MA, USA
| | - Rie Kitano
- Mother Infant Research Institute, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Asye Ceren Tanritanir
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital,Harvard Medical School, Boston, MA, USA
| | - George Graham
- Department of Obstetrics and Gynecology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Borjan Gagoski
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexa Craig
- Department of Pediatrics, Maine Medical Center, ME, USA
| | - Caitlin K Rollins
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Cynthia Ortinau
- Department of Pediatrics Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Vidya Iyer
- Mother Infant Research Institute, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Rudolph Pienaar
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Diana W Bianchi
- Medical Genetics Branch, National Human Genome Research Institute, Bethesda, MD, USA
| | - P Ellen Grant
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital,Harvard Medical School, Boston, MA, USA.,Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kiho Im
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Newborn Medicine, Boston Children's Hospital,Harvard Medical School, Boston, MA, USA
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21
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Stoll C, Dott B, Roth MP. Associated anomalies in cases with agenesis of the corpus callosum. Am J Med Genet A 2019; 179:2101-2111. [PMID: 31444900 DOI: 10.1002/ajmg.a.61330] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/19/2019] [Accepted: 08/01/2019] [Indexed: 12/11/2022]
Abstract
Agenesis of corpus callosum (ACC) is an uncommon congenital anomaly, its etiology is unclear and its pathogenesis is controversial. Cases with ACC often have other non-ACC associated congenital anomalies. The purpose of this study was to assess the prevalence and the types of these associated anomalies in a defined population. The associated anomalies in cases with ACC were collected in all live births, stillbirths, and terminations of pregnancy during 29 years in 387,067 consecutive births in the area covered by our population-based registry of congenital malformations. Of the 99 cases with ACC, representing a prevalence of 2.56 per 10,000, 73 (73.7%) had associated anomalies. There were 16 (16.2%) cases with chromosomal abnormalities, and 13 (13.2%) nonchromosomal recognized dysmorphic conditions including syndromes two each: Aicardi, Dandy-Walker, and fetal alcoholism. Forty-four (44.4%) of the cases had nonsyndromic multiple congenital anomalies (MCA). Anomalies in the musculoskeletal, the urogenital, the central nervous, the cardiovascular, and the digestive systems were the most common other anomalies in the cases with MCA. The anomalies associated with ACC could be classified into a recognizable malformation syndrome in 29 out of the 73 cases (39.7%) with associated anomalies. This study included special strengths: it is population-based, each affected child was examined by a geneticist, all elective terminations were ascertained, and the surveillance for anomalies was continued until 2 years of age. In conclusion the overall prevalence of associated anomalies, three of four cases, emphasizes the need for a screening for other anomalies in cases with ACC.
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Affiliation(s)
- Claude Stoll
- Laboratoire de Génétique Médicale, Faculté de Médecine, Strasbourg Cedex, France
| | - Beatrice Dott
- Laboratoire de Génétique Médicale, Faculté de Médecine, Strasbourg Cedex, France
| | - Marie-Paule Roth
- Laboratoire de Génétique Médicale, Faculté de Médecine, Strasbourg Cedex, France
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22
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Turkyilmaz G, Sarac Sivrikoz T, Erturk E, Ozcan N, Tatlı B, Karaman B, Toksoy G, Kalelioglu İH, Has R, Yuksel A. Utilization of neurosonography for evaluation of the corpus callosum malformations in the era of fetal magnetic resonance imaging. J Obstet Gynaecol Res 2019; 45:1472-1478. [PMID: 31155818 DOI: 10.1111/jog.13995] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 04/14/2019] [Indexed: 01/26/2023]
Abstract
AIM We evaluated the ability of fetal neurosonography and magnetic resonance imaging (MRI) to asses callosal anomalies (CA) and associated cranial malformations. We also aimed to determine the long-term prognosis of the cases. METHODS Thirty-six cases of CA diagnosed combined with neurosonography and MRI between January 2012 and October 2017 were retrospectively reviewed. RESULTS Seventeen of 36 fetuses were diagnosed complete agenesis of corpus callosum (CACC) (47.2%), 9 had partial agenesis of corpus callosum (PACC) (25%) and 10 was dysgenesis of the corpus callosum (DCC) (27.2%) at ultrasonography (US) examination. Fetal MRI reported 16 of cases as CACC (44.4%), 11 PACC (30.5%) and nine (25%) DCC. The overall consistency between neurosonography and MRI in the definition of CA were 91% of cases. Sulcation anomalies were present in 9 cases in the US (25%) and 11 cases in MRI (30.4%). Seven of cases showed posterior fossa abnormalities in the US (19.4%) and eight cases in MRI (22.1%). Neonatal MRI added new findings to fetal MRI and neurosonography including grade-1 intraventricular hemorrhage and periventricular leukomalacia in two cases (12.5%). Eighteen cases were terminated (50%), 17 cases were followed up and mean follow up interval was 39 ± 5.1 months. The neurologic outcome was abnormal in seven (41.7%) patients. Presence of associated brain anomalies worsened the prognosis. CONCLUSION Fetal neurosonography has a comparable performance with MRI in the diagnosis of CA and associated anomalies. It should be used in collaboration with MRI to achieve accurate diagnosis which is crucial for counseling.
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Affiliation(s)
- Gurcan Turkyilmaz
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tugba Sarac Sivrikoz
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Emircan Erturk
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Nahit Ozcan
- Department of Radiology, Sonomed Radiology Center, Istanbul, Turkey
| | - Burak Tatlı
- Department of Pediatric Neurology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Birsen Karaman
- Department of Medical Genetics, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Güven Toksoy
- Department of Medical Genetics, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - İbrahim H Kalelioglu
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Recep Has
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Atil Yuksel
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
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23
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Pacheva I, Todorov T, Halil Z, Yordanova R, Todorova A, Geneva I, Galabova F, Ivanov I. First case of Roma ethnic origin with Andermann syndrome: A novel frameshift mutation in exon 20 of SLC12A6 gene. Am J Med Genet A 2019; 179:1020-1024. [PMID: 30868738 DOI: 10.1002/ajmg.a.61110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 12/21/2022]
Abstract
Andermann syndrome (AS) is caused by mutation of SLC12A6 gene. It comprises severe progressive sensory and motor neuropathy with early onset, varying degree of agenesis of corpus callosum (ACC) and mental retardation. AS occurs occasionally among population outside the northeastern Quebec-Saguenay-Lac- St-Jean and Charlevoix regions, inhabited by French Canadians. None of the described patients were of Roma ethnic origin. We present an 8-month-old infant of Roma ethnic origin with AS, caused by a novel frame shift mutation c.2604delT,p.(Asp868GlufsTer11) in exon 20 of SLC12A6 gene. Our case presented with several atypical findings: clinical presentation resembling "spinal muscular atrophy plus" syndrome; tongue fasciculations, which are not reported in the literature; early contractures of the wrists; normal motor action potentials and preserved sensory action potentials. Our patient is the first of Roma origin from nonconsanguineous parents, which suggests that this mutation might be widespread in the Roma population, although screening for this mutation in 140 alleles from Roma individuals originating from the same geographic region did not reveal further carriers, implying the mutation is rare. We recommend that Roma patients presenting with the clinical phenotype of AS should be tested for this mutation primarily.
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Affiliation(s)
- Iliyana Pacheva
- Department of Pediatrics and Medical Genetics, Medical University, Plovdiv, Bulgaria.,Department of Pediatrics, University Hospital, St. George, Plovdiv, Bulgaria
| | - Tihomir Todorov
- Genetic Medico-Diagnostic Laboratory "Genica", Sofia, Bulgaria
| | - Zeyra Halil
- Department of Pediatrics and Medical Genetics, Medical University, Plovdiv, Bulgaria
| | - Ralitsa Yordanova
- Department of Pediatrics and Medical Genetics, Medical University, Plovdiv, Bulgaria.,Department of Pediatrics, University Hospital, St. George, Plovdiv, Bulgaria
| | - Albena Todorova
- Genetic Medico-Diagnostic Laboratory "Genica", Sofia, Bulgaria.,Department of Medical Chemistry and Biochemistry, Medical University, Sofia, Bulgaria
| | - Ina Geneva
- Department of Pediatrics and Medical Genetics, Medical University, Plovdiv, Bulgaria.,Department of Pediatrics, University Hospital, St. George, Plovdiv, Bulgaria
| | - Fani Galabova
- Department of Pediatrics, University Hospital, St. George, Plovdiv, Bulgaria
| | - Ivan Ivanov
- Department of Pediatrics and Medical Genetics, Medical University, Plovdiv, Bulgaria.,Department of Pediatrics, University Hospital, St. George, Plovdiv, Bulgaria
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24
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Abstract
BACKGROUND Agenesis of the corpus callosum (AgCC) involves congenital absence of all or part of the corpus callosum. Because the disorder can only be firmly diagnosed via neuroradiology, it has a short research history, and only recently has the cognitive syndrome become clear. PURPOSE Our purpose is to review the primary deficits in AgCC that constitute the core syndrome. CONCLUSIONS The cores syndrome includes: (1) reduced interhemispheric transfer of sensory-motor information; (2) reduced cognitive processing speed; and (3) deficits in complex reasoning and novel problem-solving. These domains do not appear to reflect different neuroanatomical abnormalities, but rather different domains of expression of reduced interhemispheric communication from callosal absence. IMPLICATIONS These core deficits are expressed across various domains of cognitive, behavioral, and social functioning. The impact of these deficits varies across development and may be moderated by individual factors such as co-occurrence of other neurodevelopmental conditions, general intellectual capacity, and environmental support. (JINS, 2019, 25, 324-330).
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25
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Nagwa S, Saran S, Sharma Y, Kharbanda A. Imaging features of complete agenesis of corpus callosum in a 3-year-old child. Sudan J Paediatr 2019; 18:69-71. [PMID: 30799905 DOI: 10.24911/sjp.106-1523336915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sunil Nagwa
- Department of Pediatrics, Subharti Medical College, Meerut, India
| | - Sonal Saran
- Department of Radiology, Subharti Medical College, Meerut, India
| | - Yash Sharma
- Department of Radiology, Subharti Medical College, Meerut, India
| | - Anna Kharbanda
- Department of Radiology, Subharti Medical College, Meerut, India
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26
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Oh KY, Gibson TJ, Pinter JD, Pettersson D, Shaffer BL, Selden NR, Sohaey R. Clinical outcomes following prenatal diagnosis of asymmetric ventriculomegaly, interhemispheric cyst, and callosal dysgenesis (AVID). Prenat Diagn 2018; 39:26-32. [PMID: 30511781 DOI: 10.1002/pd.5393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 11/17/2018] [Accepted: 11/21/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVES When identified prenatally, the imaging triad of asymmetric ventriculomegaly, interhemispheric cyst, and dysgenesis of the corpus callosum (AVID) can indicate a more serious congenital brain anomaly. In this follow-up series of 15 fetuses, we present the neurodevelopmental outcomes of a single institution cohort of children diagnosed prenatally with AVID. METHODS Our fetal ultrasound database was queried for cases of AVID between 2000 and 2016. All available fetal MR imaging studies were reviewed for the presence of (a) interhemispheric cysts or ventricular diverticula and (b) dysgenesis or agenesis of the corpus callosum. Clinical records were reviewed for perinatal management, postnatal surgical management, and neurodevelopmental outcomes. RESULTS Fifteen prenatal cases of AVID were identified. Twelve were live-born and three pregnancies were terminated. Of the 12 patients, 11 underwent neurosurgical intervention. Of the eight patients surviving past infancy, seven of eight have moderate to severe neurodevelopmental delays or disabilities, encompassing both motor and language skills, and all have variable visual abnormalities. CONCLUSION In our cohort of 15 prenatally diagnosed fetuses with AVID, eight survived past infancy and all have neurodevelopmental disabilities, including motor and language deficits, a wide range of visual defects, craniofacial abnormalities, and medical comorbidities.
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Affiliation(s)
- Karen Y Oh
- Department of Radiology, Oregon Health & Science University, Portland, Oregon
| | - Thomas J Gibson
- Department of Radiology, Oregon Health & Science University, Portland, Oregon
| | - Joseph D Pinter
- Department of Pediatrics (Institute on Development & Disability, and Pediatric Neurology), Oregon Health & Science University, Portland, Oregon
| | - David Pettersson
- Department of Radiology, Oregon Health & Science University, Portland, Oregon
| | - Brian L Shaffer
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Oregon Health & Science University, Portland, Oregon
| | - Nathan R Selden
- Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon
| | - Roya Sohaey
- Department of Radiology, Oregon Health & Science University, Portland, Oregon
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27
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Abstract
Chudley-McCullough syndrome (CMS), an autosomal recessive condition first reported by Chudley et al., in 1997, comprises profound sensorineural hearing loss and specific brain abnormalities. The hearing loss may be congenital or early onset. Brain abnormalities are striking, but despite these brain malformations, individuals with CMS do not present significant neurodevelopmental abnormalities. Recently, the cause of CMS has been shown to be the inactivating mutations in G protein signaling modulator 2. We aimed to present a 36-year-old male who has the characteristic clinical and neuroimaging findings of CMS.
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Affiliation(s)
- Meltem Özdemir
- Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Alper Dilli
- Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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28
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Leombroni M, Khalil A, Liberati M, D'Antonio F. Fetal midline anomalies: Diagnosis and counselling Part 1: Corpus callosum anomalies. Eur J Paediatr Neurol 2018; 22:951-962. [PMID: 30448279 DOI: 10.1016/j.ejpn.2018.08.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/26/2018] [Accepted: 08/27/2018] [Indexed: 12/26/2022]
Abstract
Midline anomalies encompasses a heterogeneous group of conditions caused by an abnormal process of ventral induction after the end of primary neurulation. Advances in prenatal imaging techniques have led to an increase in the detection rate of such anomalies since the first trimester of pregnancy although a significant proportion of them remain undiagnosed until birth. Ultrasound is the primary technique in detecting such anomalies while fetal magnetic resonance imaging (MRI) is commonly performed to confirm the diagnosis and detect additional anomalies, especially those involving the cortical surface of the brain, which may potentially impact post-natal outcome. Neurodevelopmental outcome of cerebral anomalies involving the midline is directly related to the type of anomaly, cause and presence of associated anomalies. However, even in case of isolated anomalies prenatal counselling is challenging. The aim of this review is to provide an up to date on the diagnosis, counselling and management of the most common supra-tentorial anomalies involving the midline and diagnosed on prenatal ultrasound.
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Affiliation(s)
- Martina Leombroni
- Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Asma Khalil
- Fetal Medicine Unit, Division of Developmental Sciences, St. George's University of London, London, United Kingdom
| | - Marco Liberati
- Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Francesco D'Antonio
- Womenś Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway; Department of Obstetrics and Gynaecology, University Hospital of Northern Norway, Tromsø, Norway.
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29
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Abnormalities Associated With the Cavum Septi Pellucidi on Fetal MRI: What Radiologists Need to Know. AJR Am J Roentgenol 2018; 210:989-997. [DOI: 10.2214/ajr.17.19219] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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30
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McVige JW. Imaging of Congenital Malformations. Continuum (Minneap Minn) 2018; 22:1480-1498. [PMID: 27740985 DOI: 10.1212/con.0000000000000379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW Intracranial congenital malformations are anomalies of brain development caused by genetic and environmental influences. This article discusses common intracranial congenital malformations, presents the associated neuroimaging findings, and discusses how appropriate identification of intracranial anomalies can impact diagnosis and treatment. RECENT FINDINGS Advances in neuroimaging techniques and genetic research have led to a better understanding of the pathogenesis of many congenital malformations, adding insight into their clinical relevance and the intricate relationship between critical periods of development, genetic predisposition, and environmental insults. When one malformation is discovered, a high likelihood of more malformations exists. In some instances, the intracranial anomalies will lead to the diagnosis of a particular neurologic syndrome, which may, in turn, lead to modification of a plan of care. SUMMARY Knowledge of congenital malformations and their appearance on imaging sequences is essential to improve clinical outcomes and quality of life for patients.
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31
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Huras H, Nowak M, Herman-Sucharska I, Radon-Pokracka M, Nocun A, Wiechec M. Screening performance for callosal agenesis in prenatal life. Single center study. Clin Imaging 2017; 46:116-120. [DOI: 10.1016/j.clinimag.2017.07.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 07/12/2017] [Accepted: 07/27/2017] [Indexed: 11/25/2022]
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32
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Siffredi V, Spencer-Smith M, Barrouillet P, Vaessen M, Leventer R, Anderson V, Vuilleumier P. Neural correlates of working memory in children and adolescents with agenesis of the corpus callosum: An fMRI study. Neuropsychologia 2017; 106:71-82. [DOI: 10.1016/j.neuropsychologia.2017.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/19/2017] [Accepted: 09/07/2017] [Indexed: 11/16/2022]
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33
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Werner H, Gasparetto TD, Daltro P, Leandro Gasparetto E, Araujo Júnior E. Typical lesions in the fetal nervous system: correlations between fetal magnetic resonance imaging and obstetric ultrasonography findings. Ultrasonography 2017; 37:261-274. [PMID: 29325241 PMCID: PMC6044224 DOI: 10.14366/usg.17040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 10/21/2017] [Indexed: 11/23/2022] Open
Abstract
Central nervous system (CNS) malformations play a role in all fetal malformations. Ultrasonography (US) is the best screening method for identifying fetal CNS malformations. A good echographic study depends on several factors, such as positioning, fetal mobility and growth, the volume of amniotic fluid, the position of the placenta, the maternal wall, the quality of the apparatus, and the sonographer’s experience. Although US is the modality of choice for routine prenatal follow-up because of its low cost, wide availability, safety, good sensitivity, and real-time capability, magnetic resonance imaging (MRI) is promising for the morphological evaluation of fetuses that otherwise would not be appropriately evaluated using US. The aim of this article is to present correlations of fetal MRI findings with US findings for the major CNS malformations.
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Affiliation(s)
- Heron Werner
- Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI), Rio de Janeiro, Brazil
| | | | - Pedro Daltro
- Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI), Rio de Janeiro, Brazil
| | | | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
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34
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Touraine R, Laquerrière A, Petcu CA, Marguet F, Byrne S, Mein R, Yau S, Mohammed S, Guibaud L, Gautel M, Jungbluth H. Autopsy findings in EPG5-related Vici syndrome with antenatal onset. Am J Med Genet A 2017; 173:2522-2527. [PMID: 28748650 DOI: 10.1002/ajmg.a.38342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 05/18/2017] [Accepted: 06/06/2017] [Indexed: 11/11/2022]
Abstract
Vici syndrome is one of the most extensive inherited human multisystem disorders and due to recessive mutations in EPG5 encoding a key autophagy regulator with a crucial role in autophagosome-lysosome fusion. The condition presents usually early in life, with features of severe global developmental delay, profound failure to thrive, (acquired) microcephaly, callosal agenesis, cataracts, cardiomyopathy, hypopigmentation, and combined immunodeficiency. Clinical course is variable but usually progressive and associated with high mortality. Here, we present a fetus, offspring of consanguineous parents, in whom callosal agenesis and other developmental brain abnormalities were detected on fetal ultrasound scan (US) and subsequent MRI scan in the second trimester. Postmortem examination performed after medically indicated termination of pregnancy confirmed CNS abnormalities and provided additional evidence for skin hypopigmentation, nascent cataracts, and hypertrophic cardiomyopathy. Genetic testing prompted by a suggestive combination of features revealed a homozygous EPG5 mutation (c.5870-1G>A) predicted to cause aberrant splicing of the EPG5 transcript. Our findings expand the phenotypical spectrum of EPG5-related Vici syndrome and suggest that this severe condition may already present in utero. While callosal agenesis is not an uncommon finding in fetal medicine, additional presence of hypopigmentation, cataracts and cardiomyopathy is rare and should prompt EPG5 testing.
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Affiliation(s)
- Renaud Touraine
- CHU-Hôpital Nord, Service de Génétique, Saint Etienne, France
| | - Annie Laquerrière
- Pathology Laboratory, Rouen University Hospital, Rouen, France
- Normandie Univ, UNIROUEN, NéoVasc, Rouen, France
| | | | - Florent Marguet
- Pathology Laboratory, Rouen University Hospital, Rouen, France
- Normandie Univ, UNIROUEN, NéoVasc, Rouen, France
| | - Susan Byrne
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK
| | | | - Shu Yau
- GSTS Pathology, Guy's Hospital, London, UK
| | | | - Laurent Guibaud
- Imagerie Pédiatrique et Fœtale, Hôpital Femme Mère Enfant, Lyon-Bron, France
| | - Mathias Gautel
- Randall Division for Cell and Molecular Biophysics, Muscle Signaling Section, King's College, London, UK
| | - Heinz Jungbluth
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK
- Randall Division for Cell and Molecular Biophysics, Muscle Signaling Section, King's College, London, UK
- Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK
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35
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Jarre A, Llorens Salvador R, Montoliu Fornas G, Montoya Filardi A. Valor de la resonancia magnética cerebral en fetos con sospecha ecográfica de agenesia del cuerpo calloso. RADIOLOGIA 2017; 59:226-231. [DOI: 10.1016/j.rx.2017.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/02/2017] [Accepted: 01/03/2017] [Indexed: 02/01/2023]
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Jarre A, Llorens Salvador R, Montoliu Fornas G, Montoya Filardi A. Value of brain MRI when sonography raises suspicion of agenesis of the corpus callosum in fetuses. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.rxeng.2017.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Govil-Dalela T, Kumar A, Agarwal R, Chugani HT. Agenesis of the Corpus Callosum and Aicardi Syndrome: A Neuroimaging and Clinical Comparison. Pediatr Neurol 2017; 68:44-48.e2. [PMID: 28214165 DOI: 10.1016/j.pediatrneurol.2016.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 12/02/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Agenesis of the corpus callosum can occur in individuals with epilepsy, either in isolation or as part of various neurological conditions, such as Aicardi syndrome. In this study, we evaluated the clinical and neuroradiological differences between children with nonsyndromic agenesis of the corpus callosum and those with Aicardi syndrome. METHODS We evaluated 31 children with epilepsy and agenesis of the corpus callosum (11 males, 20 females), 14 of whom had Aicardi syndrome (all females). We compared their clinical evaluations, radiological and electrophysiological findings, treatments, and their outcome. RESULTS Median age at seizure onset was lower in the Aicardi syndrome group compared with nonsyndromic agenesis of the corpus callosum (two versus five months, P = 0.006). The developmental impairment in terms of verbalization and ambulation was significantly worse in patients with Aicardi syndrome. The severity of magnetic resonance imaging (MRI) and glucose metabolism positron emission tomography (PET) involvement was more extensive in children with Aicardi syndrome than in nonsyndromic agenesis of the corpus callosum. In both groups, the PET scan showed a much more extensive area of involvement than suggested by the MRI scan. Four children underwent epilepsy surgery with significant improvement, but were not seizure free. Outcome was worse in those with PET showing abnormalities in the nonsurgical hemisphere despite normal appearance on MRI. All children who did not undergo surgery also continued to have seizures at last follow-up. CONCLUSIONS Children with Aicardi syndrome have earlier seizure onset, worse developmental outcome, and larger areas of brain abnormalities on neuroimaging compared with nonsyndromic agenesis of the corpus callosum patients. PET reveals larger area of abnormalities, compared with MRI. Although epilepsy surgery in agenesis of the corpus callosum may offer some palliative benefit in seizure frequency, none of our patients became seizure free.
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Affiliation(s)
- T Govil-Dalela
- PET Center, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan
| | - A Kumar
- PET Center, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan; Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan; Department of Neurology, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan; Department of Radiology, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan.
| | - R Agarwal
- Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan; Department of Neurology, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit Medical Center, Detroit, Michigan
| | - H T Chugani
- Division of Pediatric Neurology, Nemours Alfred I. duPont Hospital for Children, Wilmington, Delaware; Department of Neurology, Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania; Department of Pediatrics, Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania
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Manganaro L, Bernardo S, De Vito C, Antonelli A, Marchionni E, Vinci V, Saldari M, Di Meglio L, Giancotti A, Silvestri E, Catalano C, Pizzuti A. Role of fetal MRI in the evaluation of isolated and non-isolated corpus callosum dysgenesis: results of a cross-sectional study. Prenat Diagn 2017; 37:244-252. [PMID: 27992967 DOI: 10.1002/pd.4990] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 11/23/2016] [Accepted: 12/08/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE The aims of this study were to characterize isolated and non-isolated forms of corpus callosum dysgenesis (CCD) at fetal magnetic resonance imaging (MRI) and to identify early predictors of associated anomalies. METHODS We retrospectively analyzed 104 fetuses with CCD undergoing MRI between 2006 and 2016. Corpus callosum, cavum septi pellucidi, biometry, presence of ventriculomegaly, gyration anomalies, cranio-encephalic abnormalities and body malformations were evaluated. Results of genetic tests were also recorded. RESULTS At MRI, isolated CCD was 26.9%, the rest being associated to other abnormalities. In the isolated group, median gestational age at MRI was lower in complete agenesis than in hypoplasia (22 vs 28 weeks). In the group with additional findings, cortical dysplasia was the most frequently associated feature (P = 0.008), with a more frequent occurrence in complete agenesis (70%) versus other forms; mesial frontal lobes were more often involved than other cortical regions (P = 0.006), with polymicrogyria as the most frequent cortical malformation (40%). Multivariate analysis confirmed the association between complete agenesis and cortical dysplasia (odds ratio = 7.29, 95% confidence interval 1.51-35.21). CONCLUSIONS CCD is often complicated by other intra-cranial and extra-cranial findings (cortical dysplasias as the most prevalent) that significantly affect the postnatal prognosis. The present study showed CCD with associated anomalies as more frequent than isolated (73.1%). In isolated forms, severe ventriculomegaly was a reliable herald of future appearance of associated features. © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Lucia Manganaro
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Silvia Bernardo
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Amanda Antonelli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrica Marchionni
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.,Casa Sollievo della Sofferenza, Istituto Mendel, Rome, Italy
| | - Valeria Vinci
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Matteo Saldari
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Letizia Di Meglio
- Private Prenatal Diagnostic Centre 'Diagnostica ecografica Aniello Di Meglio s.r.l.', Naples, Italy
| | - Antonella Giancotti
- Department of Obstetrics, Gynecology and Urologic Sciences, Sapienza, University of Rome, Rome, Italy
| | - Evelina Silvestri
- Surgical Pathology Unit, San Camillo Forlanini Hospital, Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.,Casa Sollievo della Sofferenza, Istituto Mendel, Rome, Italy
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Ingram DG, Churchill SS. Sleep Problems in Children With Agenesis of the Corpus Callosum. Pediatr Neurol 2017; 67:85-90. [PMID: 28089768 DOI: 10.1016/j.pediatrneurol.2016.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/21/2016] [Accepted: 10/01/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND Very little is known about sleep habits in children with agenesis of the corpus callosum (ACC). The purpose of this investigation was to evaluate sleep problems in children with ACC and examine the association with quality of life. METHODS We performed a cross-sectional, anonymous, internet-based survey offered to parents of children with ACC, aged five to 18 years. The Children's Sleep Habits Questionnaire (CSHQ) and pediatric quality of life (PedsQL) were used to assess sleep habits and quality of life, respectively. Associations between the total and all subdomains of CSHQ and PedsQL were tested. RESULTS The final sample included 66 parents of children with ACC. Overall, 78% of the children had clinically significant sleep problems, using a cutoff score of 41 on the CSHQ. Compared with a prior national sample of typically developing children, children with ACC scored significantly higher overall and in all subdomains of the CSHQ. The overall CSHQ and PedsQL were moderately correlated (r = -0.485, P < 0.001), indicating that children with more sleep problems had worse quality of life. In addition, the total CSHQ correlated with all subdomains of the pediatric quality of life, including emotional (r = -0.515, P < 0.01), social (r = -0.394, P < 0.01), physical (r = -0.263, P < 0.01), and school (r = -0.362, P < 0.01). These associations remained statistically significant in multivariable regression models controlling for age and gender. CONCLUSIONS Sleep problems are common and associated with lower quality of life in children with ACC.
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Affiliation(s)
- David G Ingram
- Division of Pulmonary and Sleep Medicine, Children's Mercy Hospital, Kansas City, Missouri.
| | - Shervin S Churchill
- Department of Family and Child Nursing, University of Washington, Seattle, Washington
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Kim SE, Jang HI, Chang KHJ, Sung JH, Lee J, Lee J, Choi SJ, Oh SY, Roh CR, Kim JH. Clinical outcomes and neurodevelopmental outcome of prenatally diagnosed agenesis of corpus callosum in single center of Korea. Obstet Gynecol Sci 2017; 60:8-17. [PMID: 28217666 PMCID: PMC5313369 DOI: 10.5468/ogs.2017.60.1.8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 07/29/2016] [Accepted: 08/06/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE With recent advances and frequent use of prenatal ultrasound, the antenatal diagnosis of agenesis of the corpus callosum (ACC) is not rare in obstetrics practices. However, information regarding the long-term neurological outcome remains uncertain. The aim of this study was to investigate clinical outcomes of prenatally diagnosed ACC and to analyze postnatal neurodevelopmental outcomes of ACC neonates born in our single center. METHODS We retrospectively reviewed 56 cases of prenatally suspected ACC referred to our center. RESULTS Fifty-six fetuses were diagnosed with ACC, and 12 of those were followed-up in our center until delivery. Of the remaining 44, 7 were delivered after being referred back to the original hospital, 23 were lost to follow-up, and 14 had unknown outcomes. Among all 56, 29 were considered to have isolated ACC and 27 were considered to have non-isolated ACC. Of the 10 live fetuses delivered in our center, four had isolated ACC, three had non-isolated ACC, and the rest had outcomes unrelated to ACC. Neurodevelopmental outcome was followed-up until approximately age 3 years. Of the four with isolated ACC, three (75%) had normal neurodevelopmental outcomes. CONCLUSION Similar to other studies, the results of our single-center study included positive neurodevelopmental outcomes for those with isolated ACC. However, despite our endeavor to counsel patients with prenatally diagnosed ACC, the delivery rate in our center was quite low. Therefore, larger, multicenter, retrospective studies including long-term neurological development outcomes are crucial and urgently needed to provide better counseling.
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Affiliation(s)
- Sung Eun Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye-In Jang
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kylie Hae-jin Chang
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Hee Sung
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jiwon Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeehun Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Joo Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-young Oh
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheong-Rae Roh
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong-Hwa Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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D'Antonio F, Pagani G, Familiari A, Khalil A, Sagies TL, Malinger G, Leibovitz Z, Garel C, Moutard ML, Pilu G, Bhide A, Acharya G, Leombroni M, Manzoli L, Papageorghiou A, Prefumo F. Outcomes Associated With Isolated Agenesis of the Corpus Callosum: A Meta-analysis. Pediatrics 2016; 138:peds.2016-0445. [PMID: 27581855 DOI: 10.1542/peds.2016-0445] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2016] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Antenatal counseling in cases of agenesis of the corpus callosum (ACC) is challenging. OBJECTIVES To ascertain the outcome in fetuses with isolated complete ACC and partial ACC. DATA SOURCES Medline, Embase, CINAHL, and Cochrane databases. STUDY SELECTION Studies reporting a prenatal diagnosis of ACC. The outcomes observed were: chromosomal abnormalities at standard karyotype and chromosomal microarray (CMA) analysis, additional anomalies detected only at prenatal MRI and at postnatal imaging or clinical evaluation, concordance between prenatal and postnatal diagnosis and neurodevelopmental outcome. DATA EXTRACTION Meta-analyses of proportions were used to combine data. RESULTS Twenty-seven studies were included. In cACC, chromosomal anomalies occurred in 4.81% (95% confidence interval [CI], 2.2-8.4) of the cases. Gross and fine motor control were abnormal in 4.40% (95% CI, 0.6-11.3) and 10.98% (95% CI, 4.1-20.6) of the cases, respectively, whereas 6.80% (95% CI, 1.7-14.9) presented with epilepsy. Abnormal cognitive status occurred in 15.16% (95% CI, 6.9-25.9) of cases. In partial ACC, the rate of chromosomal anomalies was 7.45% (95% CI, 2.0-15.9). Fine motor control was affected in 11.74% (95% CI, 0.9-32.1) of the cases, and 16.11% (95% CI, 2.5-38.2) presented with epilepsy. Cognitive status was affected in 17.25% (95% CI, 3.0-39.7) of cases. LIMITATIONS Different neurodevelopmental tools and time of follow-up of the included studies. CONCLUSIONS Children wih a prenatal diagnosis of isolated ACC show several degrees of impairment in motor control, coordination, language, and cognitive status. However, in view of the large heterogeneity in outcomes measures, time at follow-up, and neurodevelopmental tools used, large prospective studies are needed to ascertain the actual occurrence of neuropsychological morbidity of children with isolated ACC.
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Affiliation(s)
- Francesco D'Antonio
- Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Artic University of Norway, Tromsø, Norway;
| | - Giorgio Pagani
- Department of Obstetrics and Gynecology, Fondazione Poliambulanza, Brescia, Italy
| | - Alessandra Familiari
- Department of Maternal-Fetal Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Asma Khalil
- Fetal Medicine Unit, Division of Developmental Sciences, St. George's University of London, London, United Kingdom
| | - Tally-Lerman Sagies
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Fetal Neurology Clinic and Paediatric Neurology Unit, Wolfson Medical Centre, Holon, Israel
| | - Gustavo Malinger
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; GYN Ultrasound Division, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Zvi Leibovitz
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Fetal Neurology Clinic and Institute of Medical Genetics, Wolfson Medical Center, Holon, Israel
| | - Catherine Garel
- Service de Radiologie, Hôpital d'Enfants Armand-Trousseau, Paris, France
| | - Marie Laure Moutard
- Service de Neuropédiatrie, Hôpital Trousseau, Hôpitaux Universitaires de l'Est Parisien, Université Pierre et Marie Curie, Paris, France
| | - Gianluigi Pilu
- Department of Obstetrics and Gynaecology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Amar Bhide
- Fetal Medicine Unit, Division of Developmental Sciences, St. George's University of London, London, United Kingdom
| | - Ganesh Acharya
- Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Artic University of Norway, Tromsø, Norway
| | - Martina Leombroni
- Department of Obstetrics and Gynecology, University of Chieti-Pescara, Chieti, Italy
| | - Lamberto Manzoli
- Department of Medicine and Aging Sciences, University of Chieti-Pescara, Chieti, Italy; EMISAC, Ce.S.I. Biotech, Chieti, Italy; and
| | - Aris Papageorghiou
- Fetal Medicine Unit, Division of Developmental Sciences, St. George's University of London, London, United Kingdom
| | - Federico Prefumo
- Department of Obstetrics and Gynaecology, University of Brescia, Brescia, Italy
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Margari L, Palumbi R, Campa MG, Operto FF, Buttiglione M, Craig F, Matricardi S, Verrotti A. Clinical manifestations in children and adolescents with corpus callosum abnormalities. J Neurol 2016; 263:1939-45. [PMID: 27383641 DOI: 10.1007/s00415-016-8225-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 12/16/2022]
Abstract
Corpus callosum abnormality (CCA) outcomes are quite unpredictable and variable, from asymptomatic forms to mild or severe neurodevelopment disorders. The aim of this study was to examine clinical outcomes in CCA patients. The study included 61 children and adolescents in whom brain magnetic resonance imaging (MRI) scans showed CCA, isolated or associated to other central nervous system lesions. All patients underwent anamnesis, physical and neurological examination, routine laboratory tests, electroencephalogram (EEG), and MRI scans. In all participants, the intelligence quotient (IQ) was determined. We divided the participants into two subgroups: the first subgroup included patients with an isolated CCA, and the second subgroup included patients with CCA associated with extra-callosal brain lesions (complex CCA). We found that CCA were associated with elevated frequency to intellectual disability (ID), other neurodevelopment disorders, epilepsy, and isolated EEG anomalies. Mild ID (p = 0.003) was more frequent in the isolated subgroup, while epilepsy (p = 0.036) and pre-perinatal risk factors (p = 0.023) were more frequent in the complex CCA subgroup. Although the role of the CC in the interhemispheric communication is known, neurological and neurodevelopment outcomes of CCA are extremely variable and unpredictable. The presence of extra-callosal brain anomalies is one of the major prognostic factor, and probably, they have an important impact on the clinical outcome.
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Affiliation(s)
- Lucia Margari
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, Italy.
| | - Roberto Palumbi
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, Italy
| | - Maria Gloria Campa
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, Italy
| | - Francesca Felicia Operto
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, Italy
| | - Maura Buttiglione
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, Italy
| | - Francesco Craig
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, Italy
| | - Sara Matricardi
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Alberto Verrotti
- Department of Pediatrics, University of L'Aquila, L'Aquila, Italy
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Unterberger I, Bauer R, Walser G, Bauer G. Corpus callosum and epilepsies. Seizure 2016; 37:55-60. [DOI: 10.1016/j.seizure.2016.02.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 02/01/2016] [Accepted: 02/25/2016] [Indexed: 11/16/2022] Open
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Irwin K, Henry A, Gopikrishna S, Taylor J, Welsh AW. Utility of fetal MRI for workup of fetal central nervous system anomalies in an Australian maternal-fetal medicine cohort. Aust N Z J Obstet Gynaecol 2016; 56:267-73. [DOI: 10.1111/ajo.12440] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 12/26/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Kathryn Irwin
- Department of Maternal Fetal Medicine; Royal Hospital for Women; Sydney New South Wales Australia
| | - Amanda Henry
- Department of Maternal Fetal Medicine; Royal Hospital for Women; Sydney New South Wales Australia
- School of Women's and Children's Health; University of New South Wales; Sydney New South Wales Australia
- Women's and Children's Health; St George Hospital; Sydney New South Wales Australia
- Australian Centre for Perinatal Science; University of New South Wales; Randwick New South Wales Australia
| | - Saranya Gopikrishna
- School of Women's and Children's Health; University of New South Wales; Sydney New South Wales Australia
| | - Jeanette Taylor
- Department of Radiology; Prince of Wales Hospital; Randwick New South Wales Australia
| | - Alec W. Welsh
- Department of Maternal Fetal Medicine; Royal Hospital for Women; Sydney New South Wales Australia
- School of Women's and Children's Health; University of New South Wales; Sydney New South Wales Australia
- Australian Centre for Perinatal Science; University of New South Wales; Randwick New South Wales Australia
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45
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Conte G, Parazzini C, Falanga G, Cesaretti C, Izzo G, Rustico M, Righini A. Diagnostic Value of Prenatal MR Imaging in the Detection of Brain Malformations in Fetuses before the 26th Week of Gestational Age. AJNR Am J Neuroradiol 2015; 37:946-51. [PMID: 26721771 DOI: 10.3174/ajnr.a4639] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 11/05/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In several countries, laws and regulations allow abortion for medical reasons within 24-25 weeks of gestational age. We investigated the diagnostic value of prenatal MR imaging for brain malformations within 25 weeks of gestational age. MATERIALS AND METHODS We retrospectively included fetuses within 25 weeks of gestational age who had undergone both prenatal and postnatal MR imaging of the brain between 2002 and 2014. Two senior pediatric neuroradiologists evaluated prenatal MR imaging examinations blinded to postnatal MR imaging findings. With postnatal MR imaging used as the reference standard, we calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the prenatal MR imaging in detecting brain malformations. RESULTS One-hundred nine fetuses (median gestational age at prenatal MR imaging: 22 weeks; range, 21-25 weeks) were included in this study. According to the reference standard, 111 malformations were detected. Prenatal MR imaging failed to detect correctly 11 of the 111 malformations: 3 midline malformations, 5 disorders of cortical development, 2 posterior fossa anomalies, and 1 vascular malformation. Prenatal MR imaging misdiagnosed 3 findings as pathologic in the posterior fossa. CONCLUSIONS The diagnostic value of prenatal MR imaging between 21 and 25 weeks' gestational age is very high, with limitations of sensitivity regarding the detection of disorders of cortical development.
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Affiliation(s)
- G Conte
- From the Departments of Radiology and Neuroradiology (G.C., C.P., C.C., G.I., A.R.) Department of Health Sciences (G.C.), University of Milan, Milan, Italy
| | - C Parazzini
- From the Departments of Radiology and Neuroradiology (G.C., C.P., C.C., G.I., A.R.)
| | - G Falanga
- Department of Biopathology and Medical and Forensic Biotechnologies (G.F.), Section of Radiological Sciences, University of Palermo, Palermo, Italy
| | - C Cesaretti
- From the Departments of Radiology and Neuroradiology (G.C., C.P., C.C., G.I., A.R.)
| | - G Izzo
- From the Departments of Radiology and Neuroradiology (G.C., C.P., C.C., G.I., A.R.)
| | - M Rustico
- Gynecology and Obstetrics (M.R.), Children's Hospital Vittore Buzzi, Milan, Italy
| | - A Righini
- From the Departments of Radiology and Neuroradiology (G.C., C.P., C.C., G.I., A.R.)
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Alby C, Malan V, Boutaud L, Marangoni MA, Bessières B, Bonniere M, Ichkou A, Elkhartoufi N, Bahi-Buisson N, Sonigo P, Millischer AE, Thomas S, Ville Y, Vekemans M, Encha-Razavi F, Attié-Bitach T. Clinical, genetic and neuropathological findings in a series of 138 fetuses with a corpus callosum malformation. ACTA ACUST UNITED AC 2015; 106:36-46. [DOI: 10.1002/bdra.23472] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Caroline Alby
- INSERM U1163, Institut Imagine, Hôpital Necker-Enfants Malades
- Service de Gynécologie-Obstétrique, Hôpital Necker-Enfants Malades, APHP; Paris France
| | - Valérie Malan
- INSERM U1163, Institut Imagine, Hôpital Necker-Enfants Malades
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP; Paris France
- Université Paris Descartes, Paris Sorbonne Cité
| | - Lucile Boutaud
- INSERM U1163, Institut Imagine, Hôpital Necker-Enfants Malades
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP; Paris France
- Université Paris Descartes, Paris Sorbonne Cité
| | | | - Bettina Bessières
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP; Paris France
| | - Maryse Bonniere
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP; Paris France
| | - Amale Ichkou
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP; Paris France
| | - Nadia Elkhartoufi
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP; Paris France
| | - Nadia Bahi-Buisson
- INSERM U1163, Institut Imagine, Hôpital Necker-Enfants Malades
- Université Paris Descartes, Paris Sorbonne Cité
- Service de Neuropédiatrie, Hôpital Necker-Enfants Malades, APHP; Paris France
| | - Pascale Sonigo
- Service de Radiologie Pédiatrique, Hôpital Necker-Enfants Malades, APHP; Paris France
| | | | - Sophie Thomas
- INSERM U1163, Institut Imagine, Hôpital Necker-Enfants Malades
- Université Paris Descartes, Paris Sorbonne Cité
| | - Yves Ville
- Service de Gynécologie-Obstétrique, Hôpital Necker-Enfants Malades, APHP; Paris France
- Université Paris Descartes, Paris Sorbonne Cité
| | - Michel Vekemans
- INSERM U1163, Institut Imagine, Hôpital Necker-Enfants Malades
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP; Paris France
- Université Paris Descartes, Paris Sorbonne Cité
| | - Férechté Encha-Razavi
- INSERM U1163, Institut Imagine, Hôpital Necker-Enfants Malades
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP; Paris France
- Université Paris Descartes, Paris Sorbonne Cité
| | - Tania Attié-Bitach
- INSERM U1163, Institut Imagine, Hôpital Necker-Enfants Malades
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP; Paris France
- Université Paris Descartes, Paris Sorbonne Cité
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47
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Jayakumar PN, Verghese R, Paul D. Absent circle of Willis with vascular pollarding in an adult with colpocephaly: A developmental perspective. Neuroradiol J 2015; 28:609-16. [PMID: 26443299 PMCID: PMC4757135 DOI: 10.1177/1971400915609876] [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] [Indexed: 11/16/2022] Open
Abstract
Absent circle of Willis (COW) has been described in cases of severe forms of cerebral developmental anomalies such as alobar prosencephaly. However, there are no reports of absent COW in patients with a milder form of cerebral abnormality such as colpocephaly. We report a unique case of an adult with colpocephaly and absent COW and discuss their association from a developmental perspective.
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48
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Nagaraj UD, Peiro JL, Bierbrauer KS, Kline-Fath BM. Evaluation of Subependymal Gray Matter Heterotopias on Fetal MRI. AJNR Am J Neuroradiol 2015; 37:720-5. [PMID: 26585262 DOI: 10.3174/ajnr.a4585] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 09/08/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE Subependymal grey matter heterotopias are seen in a high proportion of children with Chiari II malformation and are potentially clinically relevant. However, despite its growing use, there is little in the literature describing its detection on fetal MRI. Our aim was to evaluate the accuracy in diagnosing subependymal gray matter heterotopias in fetuses with spinal dysraphism on fetal MR imaging. MATERIALS AND METHODS This study is a retrospective analysis of 203 fetal MRIs performed at a single institution for spinal dysraphism during a 10-year period. Corresponding obstetric sonography, postnatal imaging, and clinical/operative reports were reviewed. RESULTS Of the fetal MRIs reviewed, 95 fetuses were included in our analysis; 23.2% (22/95) were suspected of having subependymal gray matter heterotopias on fetal MR imaging prospectively. However, only 50% (11/22) of these cases were confirmed on postnatal brain MR imaging. On postnatal brain MR imaging, 28.4% (27/95) demonstrated imaging findings consistent with subependymal gray matter heterotopia. Only 40.7% (11/27) of these cases were prospectively diagnosed on fetal MR imaging. CONCLUSIONS Fetal MR imaging is limited in its ability to identify subependymal gray matter heterotopias in fetuses with spinal dysraphism. It is believed that this limitation relates to a combination of factors, including artifacts from fetal motion, the very small size of fetal neuroanatomy, differences in imaging techniques, and, possibly, irregularity related to denudation of the ependyma/subependyma in the presence of spinal dysraphism and/or stretching of the germinal matrix in ventriculomegaly.
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Affiliation(s)
- U D Nagaraj
- From the Departments of Radiology and Medical Imaging (U.D.N., B.M.K.-F) University of Cincinnati College of Medicine (U.D.N., J.L.P., K.S.B., B.M.K.-F), Cincinnati, Ohio.
| | - J L Peiro
- Pediatric Surgery (J.L.P.) University of Cincinnati College of Medicine (U.D.N., J.L.P., K.S.B., B.M.K.-F), Cincinnati, Ohio
| | - K S Bierbrauer
- Pediatric Neurosurgery (K.S.B.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio University of Cincinnati College of Medicine (U.D.N., J.L.P., K.S.B., B.M.K.-F), Cincinnati, Ohio
| | - B M Kline-Fath
- From the Departments of Radiology and Medical Imaging (U.D.N., B.M.K.-F) University of Cincinnati College of Medicine (U.D.N., J.L.P., K.S.B., B.M.K.-F), Cincinnati, Ohio
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49
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Kidron D, Shapira D, Ben Sira L, Malinger G, Lev D, Cioca A, Sharony R, Lerman Sagie T. Agenesis of the corpus callosum. An autopsy study in fetuses. Virchows Arch 2015; 468:219-30. [PMID: 26573426 DOI: 10.1007/s00428-015-1872-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 09/23/2015] [Accepted: 10/21/2015] [Indexed: 11/27/2022]
Abstract
Agenesis of the corpus callosum is currently diagnosed prenatally with ultrasound and MRI. While the diagnostic aspects of callosal defects are widely addressed, anatomo-histological data from fetal autopsies are sparse. Callosal defects were present in 50 fetal autopsies. Four distinct groups of complete, partial, hypoplastic, and mixed defects were determined by the gross and histologic details of the corpus callosum. These details helped to rule out other midline defects such as holoprosencephaly. Additional autopsy findings enabled specific diagnoses and suggested etiopathogeneses. Hypoplastic and mixed defects were associated with more abnormalities of the cerebral hemispheres and internal organs. The four groups did not differ according to gender, external dysmorphism, or cerebellar and brainstem anomalies. Defects were classified as syndromic (68 %), encephaloclastic (8 %), undetermined (14 %), or isolated (10 %) based on the autopsy findings. Isolated agenesis of the corpus callosum was diagnosed in only 10 % of the cases in this series, compared to higher numbers diagnosed by prenatal ultrasonography and MRI. Therefore, the autopsy, through its detailed, careful evaluation of external, as well as gross and histological internal features, can elucidate the etiopathogenesis of agenesis of the corpus callosum and suggest specific diagnoses which cannot be ascertained by prenatal imaging.
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Affiliation(s)
- Debora Kidron
- Department of Pathology, Meir Medical Center, 59 Tshernichovsky St., Kfar Saba, 44281, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Daniel Shapira
- Child Development Center, Maccabi Health Services, Rishon Lezion, Israel.
| | - Liat Ben Sira
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Pediatric Radiology Unit, Tel Aviv Medical Center, Tel Aviv, Israel.
| | - Gustavo Malinger
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. .,GYN Ultrasound Division, Tel Aviv Medical Center, Tel Aviv, Israel.
| | - Dorit Lev
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Fetal Neurology Clinic and Institute of Medical Genetics, Wolfson Medical Center, Holon, Israel.
| | - Andreea Cioca
- Department of Pathology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Reuven Sharony
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Institute of Genetics and Ob/Gyn Department, Meir Medical Center, Kfar Saba, Israel.
| | - Tally Lerman Sagie
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Fetal Neurology Clinic and Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel.
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50
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Weisstanner C, Kasprian G, Gruber GM, Brugger PC, Prayer D. MRI of the Fetal Brain. Clin Neuroradiol 2015; 25 Suppl 2:189-96. [PMID: 26063004 DOI: 10.1007/s00062-015-0413-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 05/12/2015] [Indexed: 12/17/2022]
Abstract
The purpose of this article is to provide an overview of the possibilities for fetal magnetic resonance imaging (MRI) in the evaluation of the fetal brain. For brain pathologies, fetal MRI is usually performed when an abnormality is detected by previous prenatal ultrasound, and is, therefore, an important adjunct to ultrasound. The most commonly suspected brain pathologies referred to fetal MRI for further evaluation are ventriculomegaly, missing corpus callosum, and abnormalities of the posterior fossa. We will briefly discuss the most common indications for fetal brain MRI, as well as recent advances.
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Affiliation(s)
- C Weisstanner
- Department of Radiology, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
| | - G Kasprian
- Department of Radiology, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - G M Gruber
- Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Vienna, Austria
| | - P C Brugger
- Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Vienna, Austria
| | - D Prayer
- Department of Radiology, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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