Transvaginal three-dimensional ultrasound assessment of Sylvian fissures at 18-30 weeks' gestation
Publication in refereed journal

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其它資訊
摘要Objective
To (i) evaluate the normal development of the Sylvian fissures in the anterior coronal view of the fetal brain at 18-30 weeks’ gestation by transvaginal 3D ultrasound; (ii) develop reference ranges of measurements of the right and left Sylvian fissure angles during normal pregnancy at 18-30 weeks’ gestation; and (iii) examine the intra-observer and inter-observer repeatability of the measurements of the right and left Sylvian fissure angles.
Methods
This was a prospective cross-sectional study of 422 women with singleton pregnancy attending an ultrasound-based research clinic between March 2017 and December 2017. The entry criteria for the study were appropriately grown live fetus with no suspected structural and chromosomal defects between 18+0 and 30+6 weeks’ gestation. The normal development of the Sylvian fissures was assessed by the anterior coronal plane of the fetal brain through transvaginal 3D volume multiplanar imaging. The coronal view was visualized as a single image from the three orthogonal views. Subsequently, the right and left Sylvian fissure angles were measured between a horizontal reference line (0 degree) and two lines drawn along the right and left upper sides of the Sylvian fissures. Intra and inter-observer repeatability of the Sylvian fissure angles were assessed by Bland Altman plots. Reference equations were constructed for right and left Sylvian fissure angles for gestational age (GA) and head circumference (HC) by the Generalised Additive Models for Location Scale and Shape package.
Results
In the anterior coronal view of the fetal brain, we observed an inward rotation of the upper portion of Sylvian fissures across the second and third trimesters of pregnancy. There was a significant negative polynomial association between the Sylvian fissure angles with GA and HC. Both Sylvian fissure angles cross the reference line (zero) from being positive to negative at near 25 weeks’ gestation or at HC of 22 cm. Z-score difference between the right and left smoothed percentiles of the Sylvian fissure angles indicated that median, 10th and 90th smoothed percentiles were closest and almost identical for GA based reference between 18 and 28 weeks and for HC based reference between 14 and 24 cm. The intra-class correlation (95\% confidence interval) of the right and left Sylvian fissure angles between the two sonographers was near perfect at 0.993 (0.988-0.996) and 0.991 (0.985-0.995), respectively. In Bland-Altman analysis, the mean difference between sonographer A and B in right Sylvian fissure angle was 0.4 degree (95\% CI -10.2 to 10.1) and in left Sylvian fissure angle was 1.0 degree (95\% CI -9.6 to 11.6).
Conclusions
The assessment of the Sylvian fissure angles is highly reproducible. The Sylvian fissure angle reference charts can serve as a screening tool for malformations of cortical development, guiding subsequent follow up and referral for fetal brain magnetic resonance imaging and / or assessment by an expert neurosonologist.
出版社接受日期19.10.2018
著者Poon Liona C., Sahota Daljit, Chaemsaithong Piya, Nakamura Takako, Machida Megumi, Naruse Katsuhiko, Wah Isabella Y.M., Leung Tak Yeung, Pooh Ritsuko K.
期刊名稱Ultrasound in Obstetrics and Gynaecology
出版年份2019
月份8
卷號54
期次2
出版社Wiley
頁次190 - 198
國際標準期刊號0960-7692
電子國際標準期刊號1469-0705
語言英式英語
關鍵詞Normal development, Sylvian fissure angle, 3D transvaginal ultrasound, Neurosonography, Reference range

上次更新時間 2020-04-07 於 03:43