La radiologia medica

, Volume 115, Issue 2, pp 301–312 | Cite as

Agenesis of the corpus callosum in fetuses with mild ventriculomegaly: role of MR imaging

  • R. Manfredi
  • A. Tognolini
  • C. Bruno
  • R. Raffaelli
  • M. Franchi
  • R. Pozzi Mucelli
Paediatric Radiology/Radiologia Pediatrica

Abstract

Purpose

We evaluated the role of magnetic resonance (MR) imaging in the diagnosis of corpus callosum agenesis — isolated or associated with other anomalies — in fetuses with mild cerebral ventriculomegaly, as depicted at prenatal sonography.

Material and methods

Between January 2005 and March 2007, 33 fetuses with a mean gestational age of 28.9 weeks (range 17–37) and mild ventriculomegaly diagnosed at prenatal sonography were included in this prospective study. All fetuses underwent MR imaging according to the following protocol: half-Fourier T2-weighted images along the three orthogonal plane according to the longitudinal axis of the mother, and subsequently three orthogonal planes were acquired according to the fetal brain. Quantitative image analysis included the size of the transverse diameter of the lateral ventricles, in the axial plane, and the thickness of the adjacent cerebral cortex. Qualitative image analysis included morphology of the lateral ventricles (normal, parallel pattern colpocephaly), signal intensity changes of the fetal brain, interruption of the germinative matrix, agenesis of the corpus callosum (complete/partial) and associated malformations. Postnatal physical examination and diagnostic imaging, as well as surgery, were the standard of diagnosis.

Results

Mean axial diameter of the lateral ventricle was 11.6 mm (range 10–15 mm), and mean thickness of the adjacent cerebral cortex was 2.1 mm (range 1.8–3 mm); 23/33 fetuses (70%) showed normal morphology of the lateral ventricles, and 8/33 (24%) showed abnormal morphology (parallel pattern, colpocephaly). The entire corpus callosum was visualised in 20/33 fetuses (60%). In 8/33 fetuses (25%), partial agenesis was diagnosed, whereas in 5/33 (15%), there was hypogenesis. In 6/13 fetuses (46%), isolated corpus callosum agenesis was detected, and two cases of hypogenesis of the corpus callosum were misinterpreted — overestimated in one case and underestimated in another.

Conclusions

MR imaging may prove to be a useful second-line imaging modality in the prenatal diagnosis of corpus callosum agenesis in fetuses with mild ventriculomegaly.

Keywords

Corpus callosum Fetal imaging MR imaging Obstetric 

Agenesia del corpo calloso in feti con ventricolomegalia lieve: ruolo della RM

Riassunto

Obiettivo

L’obiettivo di questo lavoro è la valutazione della risonanza magnetica (RM) fetale nella diagnosi di agenesia del corpo calloso, isolata o associata ad altre anomalie, in presenza di riscontro ecografico di ventricolomegalia cerebrale lieve.

Materiali e metodi

Tra gennaio 2005 e marzo 2007, 33 feti con età gestazionale media di 28,9 settimane (range 17–37) e ventricolomegalia lieve all’ecografia, sono stati inclusi in questo studio prospettico. Sono state eseguite immagini T2-dipendenti half-Fourier lungo i tre piani ortogonali all’asse longitudinale materno e all’encefalo fetale. L’analisi quantitativa ha compreso la misura del diametro trasversale ventricolare sul piano assiale e lo spessore della corteccia cerebrale adiacente. L’analisi qualitativa ha compreso: morfologia dei ventricoli laterali, alterazioni dell’intensità di segnale, focali o diffuse, del tessuto nervoso encefalico, soluzioni di continuo della matrice germinativa, agenesia del corpo calloso (completa/parziale) e malformazioni associate. L’esame obiettivo neonatologico, la diagnostica per immagini e la chirurgia post-natale hanno costituito il gold standard di riferimento.

Risultati

Il diametro trasversale medio ventricolare è stato di 11,6 mm (range 10–15 mm) con spessore corticale adiacente di 2,1 mm (range 1,8–3 mm). Ventitre/33 (70%) feti hanno dimostrato morfologia ventricolare normale; 8/33 (24%) anomala (corna frontali parallele, colpocefalia). Il corpo calloso è stato completamente visualizzato in 20/33 (60%) feti; in 8/33 (25%) feti vi era agenesia totale mentre in 5/33 (15%) un’ipogenesia. Sei feti su 13 (46%) mostravano agenesie isolate. Due ipogenesie erano state misinterpretate: in un caso sovrastimata e nell’altro sottostimata.

Conclusioni

La RM può rappresentare una metodica di secondo livello nell’identificazione pre-natale delle forme di agenesia del corpo calloso associata a ventricolomegalia lieve.

Parole chiave

Corpo calloso Imaging fetale RM Ostetricia 

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Copyright information

© Springer-Verlag Italia 2010

Authors and Affiliations

  • R. Manfredi
    • 1
  • A. Tognolini
    • 1
  • C. Bruno
    • 1
  • R. Raffaelli
    • 2
  • M. Franchi
    • 2
  • R. Pozzi Mucelli
    • 1
  1. 1.Istituto di RadiologiaUniversità di Verona, Policlinico “G.B. Rossi”VeronaItaly
  2. 2.Ginecologia ed OstetriciaUniversità di Verona, Policlinico “G.B. Rossi”VeronaItaly

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