P D Griffiths1, K Brackley2, M Bradburn3, D J A Connolly4, M L Gawne-Cain2, D I Griffiths5, M D Kilby6, L Mandefield3, C Mooney3, S C Robson7, B Vollmer8, G Mason9. 1. Academic Unit of Radiology, University of Sheffield and INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK. 2. University Hospital Southampton NHS Foundation Trust, Southampton, UK. 3. Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK. 4. Department of Radiology, Sheffield Children's Hospital and the Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. 5. Academic Unit of Radiology, University of Sheffield, Sheffield, UK. 6. Centre for Women's & Newborn Health, Institute of Metabolism & Systems Research, University of Birmingham and Fetal Medicine Centre, Birmingham Women's Foundation Trust (Birmingham Health Partners), Birmingham, UK. 7. Newcastle University, Newcastle upon Tyne, UK. 8. Clinical and Experimental Sciences University of Southampton and Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK. 9. Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Abstract
OBJECTIVE: To assess the contribution of fetal magnetic resonance imaging (MRI) in fetuses of the MERIDIAN cohort diagnosed with either agenesis or hypogenesis of the corpus callosum (referred to collectively as failed commissuration) on antenatal ultrasound. METHODS: This was a subgroup analysis of the MERIDIAN study of fetuses with failed commissuration (with or without ventriculomegaly) diagnosed on ultrasound in women who had MRI assessment within 2 weeks of ultrasound and for whom outcome reference data were available. The diagnostic accuracy of ultrasound and MRI was studied, as well as indicators of diagnostic confidence and effects on prognosis/clinical management. Appropriate diagnostic confidence was assessed by the score-based weighted average method, which combines diagnostic accuracy with diagnostic confidence data. RESULTS: In the MERIDIAN cohort, 79 fetuses were diagnosed with failed commissuration on ultrasound (55 with agenesis and 24 with hypogenesis of the corpus callosum). The diagnostic accuracy for detecting failed commissuration was 34.2% for ultrasound and 94.9% for MRI (difference, 60.7% (95% CI, 47.6-73.9%), P < 0.0001). The diagnostic accuracy for detecting hypogenesis of the corpus callosum as a discrete entity was 8.3% for ultrasound and 87.5% for MRI, and for detecting agenesis of the corpus callosum as a distinct entity was 40.0% for ultrasound and 92.7% for MRI. There was a statistically significant improvement in 'appropriate' diagnostic confidence when using MRI as assessed by the score-based weighted average method (P < 0.0001). Prognostic information given to the women changed in 36/79 (45.6%) cases after MRI and its overall effect on clinical management was 'significant', 'major' or 'decisive' in 35/79 cases (44.3%). CONCLUSIONS: Our data suggest that any woman whose fetus has failed commissuration as the only intracranial finding detected on ultrasound should have MRI examination for further evaluation.
OBJECTIVE: To assess the contribution of fetal magnetic resonance imaging (MRI) in fetuses of the MERIDIAN cohort diagnosed with either agenesis or hypogenesis of the corpus callosum (referred to collectively as failed commissuration) on antenatal ultrasound. METHODS: This was a subgroup analysis of the MERIDIAN study of fetuses with failed commissuration (with or without ventriculomegaly) diagnosed on ultrasound in women who had MRI assessment within 2 weeks of ultrasound and for whom outcome reference data were available. The diagnostic accuracy of ultrasound and MRI was studied, as well as indicators of diagnostic confidence and effects on prognosis/clinical management. Appropriate diagnostic confidence was assessed by the score-based weighted average method, which combines diagnostic accuracy with diagnostic confidence data. RESULTS: In the MERIDIAN cohort, 79 fetuses were diagnosed with failed commissuration on ultrasound (55 with agenesis and 24 with hypogenesis of the corpus callosum). The diagnostic accuracy for detecting failed commissuration was 34.2% for ultrasound and 94.9% for MRI (difference, 60.7% (95% CI, 47.6-73.9%), P < 0.0001). The diagnostic accuracy for detecting hypogenesis of the corpus callosum as a discrete entity was 8.3% for ultrasound and 87.5% for MRI, and for detecting agenesis of the corpus callosum as a distinct entity was 40.0% for ultrasound and 92.7% for MRI. There was a statistically significant improvement in 'appropriate' diagnostic confidence when using MRI as assessed by the score-based weighted average method (P < 0.0001). Prognostic information given to the women changed in 36/79 (45.6%) cases after MRI and its overall effect on clinical management was 'significant', 'major' or 'decisive' in 35/79 cases (44.3%). CONCLUSIONS: Our data suggest that any woman whose fetus has failed commissuration as the only intracranial finding detected on ultrasound should have MRI examination for further evaluation.
Authors: Ruth Batty; Mary L Gawne-Cain; Cara Mooney; Laura Mandefield; Michael Bradburn; Gerald Mason; Paul D Griffiths Journal: Eur Radiol Date: 2018-06-15 Impact factor: 5.315
Authors: Romina Romaniello; Filippo Arrigoni; Patrizia De Salvo; Maria Clara Bonaglia; Elena Panzeri; Maria Teresa Bassi; Cecilia Parazzini; Andrea Righini; Renato Borgatti Journal: Ann Clin Transl Neurol Date: 2021-12-01 Impact factor: 4.511