Detection of Fetal Corpus Callosum Abnormalities by Means of 3D Ultrasound

 

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Abstract

Purpose: The objective of this study was to prenatally detect corpus callosum pathologies such as agenesis, partial agenesis, hypo- and hyperplasia and enhanced echogenicity.

Materials and Methods: Between 2009 and 2013 detailed 3D ultrasound examinations of the fetal corpus callosum were carried out as part of a level III examination for fetal anomalies. All scans were performed using Voluson E8 equipment (GE, Zipf, Austria) with a 5 – 8 MHz 3D transabdominal and 5 – 9 MHz 3D transvaginal transducer. All cases were evaluated for the following variables: inner, outer and curved length of the corpus callosum, height of the different segments of the corpus callosum and the corpus callosum area. All parameters were compared with normal growth charts. In all cases of suspected corpus callosum anomaly direct and indirect signs for corpus callosum agenesis and associated malformations were observed.

Results: 31 fetuses with pathological corpus callosum were diagnosed with 3D ultrasound. Gestational age at the time of diagnosis ranged from 20 to 38 weeks. 12 cases showed agenesis, 11 cases partial agenesis, 5 cases hypoplasia, 2 cases a combination of partial hyper- and hypoplasia and one case a lipoma of the corpus callosum. In corpus callosum underdevelopment, the more affected parts were the body and splenium. Associated anomalies were present in 25 of the 31 cases (80.6%) of corpus callosum pathologies.

Conclusion: 3D neurosonography serves as an excellent tool to precisely demonstrate the pathological development of the fetal corpus callosum. By correlating the measures with the function of each affected corpus callosum segment, we can try to get a vague prediction of the neurological prognosis.

Zusammenfassung

Ziel: Ziel der Studie war die pränatale Entdeckung von Corpus callosum-Anomalien wie Agenesie, partielle Agenesie, Hypoplasie und Hyperplasie oder dem Nachweis einer erhöhten Echogenität.

Material und Methoden: Im Rahmen einer Level-III-Ultraschalluntersuchung zur Erkennung fetaler Anomalien wurde zwischen 2009 und 2013 eine detaillierte Überprüfung des fetalen Corpus callosum vorgenommen. Alle Ultraschalluntersuchungen wurden mit einem Voluson E8-Gerät (GE, Zipf, Österreich) durchgeführt, wobei ein abdominaler 5 – 8-MHz- und ein transvaginaler 5 – 9-MHz-Ultraschallkopf zum Einsatz kamen. In allen Fällen wurden die innere, äußere und gebogene Länge des Corpus callosum und die Höhe der jeweiligen Corpus callosum-Segmente gemessen. Ebenso wurde die Corpus callosum-Fläche bestimmt. Alle Parameter wurden mit den jeweiligen Normkurven verglichen. Bei jedem Verdacht einer Corpus callosum-Anomalie wurden die direkten und indirekten Hinweiszeichen für eine Corpus callosum-Agenesie wie auch die assoziierten Fehlbildungen erfasst.

Ergebnisse: Mittels 3D-Sonografie konnten 31 Feten mit einer Corpus callosum-Pathologie entdeckt werden. Das Gestationsalter zum Zeitpunkt der Diagnose variierte von 20 bis 38 Schwangerschaftswochen. 12 Fälle zeigten eine Agenesie, 11 Fälle eine partielle Agenesie, 5 Fälle eine Hypoplasie, ein Fall eine Hyperplasie und ein Fall eine Kombination aus partieller Hyper- und Hypoplasie. Zudem konnte in einem Fall ein Corpus callosum-Lipom entdeckt werden. Bei den Feten mit einer Unterentwicklung des Corpus callosum zeigten sich der Truncus und das Splenium als die am meisten betroffenen Strukturen. Assoziierte Fehlbildungen konnten in 25 der 31 Fälle (80,6 %) gefunden werden.

Schlussfolgerung: Die 3D-Neurosonografie stellt eine exzellente Methode dar, um pathologische Formen des fetalen Corpus callosum zu entdecken. Durch Korrelation der Corpus callosum-Maße mit der Funktion der einzelnen Segmente kann eine vorsichtige Einschätzung der neurologischen Prognose vorgenommen werden.

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