A novel technique to assess fetal corpus callosum by two-dimensional axial plane

Eur Radiol. 2020 Nov;30(11):5871-5880. doi: 10.1007/s00330-020-06981-9. Epub 2020 Jun 16.

Abstract

Objective: The definition of new normal values of the corpus callosum (CC) in axial sonographic scans and evaluation of their feasibility in diagnosing abnormal CC.

Methods: A cross-sectional study assessed CC from 20-gestational-week to full-term. CC observations across three axial planes (the largest CC length plane, trans-genu-and-splenium plane, and trans-body plane) were developed. The largest CC length, genu and splenium thickness, and body width and thickness were compared with compound scatter plots. Ultrasonographic features of normal and abnormal CC were described and the feasibility of the new approach studied. Intra-class correlation coefficient (ICC) was used for assessing the intra- and inter-observer agreements.

Results: Six hundred seventy normal and 42 abnormal fetuses from 20-gestational-week to full-term were studied. The mean normal and abnormal group maternal ages were 30.46 ± 4.36 years and 29.69 ± 4.49 years (p = 0.269). The success rate in obtaining satisfactory axial planes reached 100% but only 13.9% for sagittal plane in the normal group. The success rate of abnormal cases obtaining satisfactory axial planes was 100% and 59.5% by sagittal plane (p < 0.05). The compound scatter plots of abnormal and normal groups showed that the largest CC length and body width were significantly lower in normal fetuses, and the thickness of the genu and splenium with CC hypoplasia was significantly lower than normal fetuses. The intra- and inter-observer agreements were reproducible (all ICC > 0.850).

Conclusions: The feasibility of incorporating an evaluation of CC into routine anatomical screening was demonstrated. Additionally, a focused examination of the craniocerebral axial planes exploring CC at the time of central nervous system scanning might facilitate CC anomaly detection.

Key points: • Three axial planes with direct CC measurements can detect CC anomalies more accurately compared with indirect CC signs. Besides, this method is simpler, more convenient, and time-saving compared with the sagittal plane. • Assessing fetal CC on the axial plane helps clinicians to diagnose fetuses with abnormal CC. • A prospective single-center study showed that our new technique provides enough diagnostic confidence.

Keywords: Congenital abnormalities; Corpus callosum; Prenatal diagnosis; Ultrasound.

MeSH terms

  • Adult
  • Agenesis of Corpus Callosum / diagnosis*
  • Agenesis of Corpus Callosum / embryology
  • Corpus Callosum / diagnostic imaging*
  • Corpus Callosum / embryology
  • Cross-Sectional Studies
  • Female
  • Fetal Diseases / diagnosis*
  • Gestational Age
  • Humans
  • Pregnancy
  • Prospective Studies
  • Reference Values
  • Ultrasonography, Prenatal / methods*