SPECTRUM OF CNS AND EXTRA CNS FINDINGS IN COMMISURAL AGENESIS, A FETAL MRI STUDY

Authors

1 Shiraz University of Medical Science

2 Medical Imaging Center, Shiraz University of Medical Sciences,Shiraz, IR

3 Department of Radiology, University of California Davis Medical Center

4 Medical Imaging Centre, Shiraz University of Medical Sciences, Shiraz, Iran

5 (SUMS)

10.22034/icrj.2019.100888

Abstract

Purpose:
To categorize structural CNS and extra-CNS
anomalies associated with abnormalities of the corpus   callosum,.
 
Material and Methods:
The   university   ethics   committee   approved   this
retrospective study. 821fetal MRI’s were done during 2017-2018 in our institution, including 34corpus callosum  and  commissural  anomalies.  MRI’s were done on a Seimens Avanto 1.5T Scanner and interpreted with prior knowledge of the mid trimester anatomical survey. Post-delivery follow-ups and images were obtained when available using patients phone numbers and national registry results.
 
Result:
The MR imaging studies of 167 fetal suspected  with ventriculomegaly with ultrasound were reviewed to evaluate  types  of  abnormalities  of  the corpus callosum. MRI confirmed presence of ventriculomegaly in 94 cases. In 45 (47.8%) out of 94 cases with ventriculomegaly the anomaly of corpus callosum was the suspected in ultrasound. Complete corpus callosum agenesis in 19 Cases and partial agenesis of the corpus callosum in 11 cases were identified, and the remaining 15 Cases had normal corpus callosum. Additional abnormalities were also implemented in the reviewed cases, categorized in two groups as “extra CNS” and “additional CNS” abnormalities. Anterior commissure was  seen  in  15 cases of complete agenesis while hippocampal commissure was seen in only one.
In    complete    CCA    extra    CNS    abnormalities
documented in 4cases consisted of Renal hypoplasia (1), pulmonary agenesis (1)  lower  extremimty palsy (1) and bilateral cleft lip (1). The additional CNS anomalies documented in 9 cases include; polymicrogyria (3), shallow insula (2), heterotopia
(2) , cerebellar hypoplasia (2).
In partial CCA, 1 case of extra CNS anomaly include bilateral cleft lip and palate (1) and 7 cases with additional CNS abnormalities documented constituted of; hydrocephaly(1), closed lip schizencephaly (1), polymicrogyria (2), septo optic dysplasia (2)  ,  dandy  walker  malformation  (1).  In both groups all the  extra-CNS  findings  had  also been detected in ultrasound, while out of the extraCNS findings only the cerebellar hypoplasia was seen in ultrasound.
 
Conclusion:
MRI can detect additional CNS anomalies in patients with ACC and can help rule out callosal agenesis with confidence. Given the heterogeneous clinical outcome of ACC, this can have prognostic and counseling value.
Iranian Congress of Radiology
Volume 35, Issue 4
September 2019
Pages 93-93

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History

  • Receive Date: 06 January 2020
  • Accept Date: 06 January 2020

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