目的:评估皮质发育畸形(MCD)胎儿的call体(CC)大小,并探讨三种CC长度(CCL)比值在识别皮质异常中的诊断价值。
方法:这是一项针对2017年4月至2022年8月妊娠20-37周的单胎胎儿的单中心回顾性研究。获得胎儿大脑的中矢状平面,并评估以下变量:长度,高度,call体的区域,和相关标记,包括call体长度与颅内枕额尺寸之比(CCL/ICOFD),call体长度到股骨长度(CCL/FL),和call体长度到小脑Vermian直径(CCL/VD)。采用类内相关系数(ICC)评价测量一致性。使用接受者操作特征曲线(AUC)下的面积评估了生物计量测量在MCD预测中的准确性。
结果:患有MCD的胎儿CCL明显降低,高度(genu和splenium),和面积与正常胎儿相比(P<0.05),但身高没有显着差异(P=0.326)。CCL/ICOFD,CCL/FL,与对照组相比,患有MCD的胎儿的CCL/VD比值显着降低(P<0.05)。CCL/ICOFD比率为MCD提供了最高的预测准确性,AUC为0.856(95%CI:0.774-0.938,P<.001),其次是CCL/FL比率(AUC,0.780(95%CI:0.657-0.904),P<.001),CCL/VD比值(AUC,0.677(95%CI:0.559-0.795),P<.01)。
结论:患有MCD的胎儿的call体生物特征参数降低。从超声测量得出的CCL/ICOFD比率被认为是产前检测皮质畸形的有前途的工具。这些发现和前瞻性研究的外部验证是必要的。
OBJECTIVE: To evaluate corpus callosum (CC) size in fetuses with malformations of cortical development (MCD) and to explore the diagnostic value of three CC length (CCL) ratios in identifying cortical abnormalities.
METHODS: This is a single-center retrospective study in singleton fetuses at 20-37 weeks of gestation between April 2017 and August 2022. The midsagittal plane of the fetal brain was obtained and evaluated for the following variables: length, height, area of the corpus callosum, and relevant markers, including the ratios of corpus callosum length to internal cranial occipitofrontal dimension (CCL/ICOFD), corpus callosum length to femur length (CCL/FL), and corpus callosum length to cerebellar vermian diameter (CCL/VD). Intra-class correlation coefficient (ICC) was used to evaluate measurement consistency. The accuracy of biometric measurements in prediction of MCD was assessed using the area under the receiver-operating-characteristics curves (AUC).
RESULTS: Fetuses with MCD had a significantly decreased CCL, height (genu and splenium), and area as compared with those of normal fetuses (P < .05), but there was no significant difference in body height (P = .326). The CCL/ICOFD, CCL/FL, and CCL/VD ratios were significantly decreased in fetuses with MCD when compared with controls (P < .05). The CCL/ICOFD ratio offered the highest predictive accuracy for MCD, yielding an AUC of 0.856 (95% CI: 0.774-0.938, P < .001), followed by CCL/FL ratio (AUC, 0.780 (95% CI: 0.657-0.904), P < .001), CCL/VD ratio (AUC, 0.677 (95% CI: 0.559-0.795), P < .01).
CONCLUSIONS: The corpus callosum biometric parameters in fetuses with MCD are reduced. The CCL/ICOFD ratio derived from sonographic measurements is considered a promising tool for the prenatal detection of cortical malformations. External validation of these findings and prospective studies are warranted.