Anatomical subgroup analysis of the MERIDIAN cohort: failed commissuration: iuMR for Failed commissuration

Paul D Griffiths, Karen Brackley, Michael Bradburn, Daniel Ja Connolly, Mary L Gawne-cain, Daniel I Griffiths, Mark D Kilby, Laura Mandefield, Cara Mooney, Stephen C Robson, Brigitte Vollmer, Gerald Mason

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)
100 Downloads (Pure)

Abstract

Objective To assess the contribution of in utero magnetic resonance (iuMR) imaging in fetuses diagnosed with either agenesis of the corpus callosum or hypogenesis of the corpus callosum (grouped as failed commissuration) on antenatal ultrasonography (USS) from the MERIDIAN cohort. Methods We report a sub-group analysis of fetuses with failed commissuration diagnosed on USS (with or without ventriculomegaly) from the MERIDIAN study who had iuMR imaging within 2 weeks of USS and outcome reference data were available. The diagnostic accuracy of USS and iuMR are reported as well as indicators of diagnostic confidence and effects on prognosis/clinical management. Results 79 fetuses with failed commissuration are reported (55 with agenesis and 24 with hypogenesis as the USS diagnoses). The diagnostic accuracy for detecting ‘failed commissuration’ as a group label was 34.2% for USS and 94.9% for iuMR (difference = 60.7%, 95% confidence interval 47.6% to 73.9%, p < 0.0001). The diagnostic accuracy for detecting hypogenesis of the corpus callosum as a discrete entity was 8.3% for USS and 87.5% for iuMR whilst the diagnostic accuracy for detecting agenesis of the corpus callosum as a distinct entity was 40.0% for USS and 92.7% for iuMR. There was a statistically significant improvement in ‘appropriate’ diagnostic confidence when using iuMR imaging as assessed by a score-based weighted average’ method (p < 0.0001). Prognostic information given to the women changed in 36/79 (45.6%) cases after iuMR imaging and its overall effect on clinical management was ‘significant’, ‘major’ or ‘decisive’ in 35/79 cases (44.3%). Conclusions Our data suggests that any woman whose fetus has failed commissuration as the only intracranial finding detected on USS should have iuMR imaging for further evaluation.
Original languageEnglish
JournalUltrasound in Obstetrics and Gynecology
Early online date24 Apr 2017
DOIs
Publication statusE-pub ahead of print - 24 Apr 2017

Fingerprint

Dive into the research topics of 'Anatomical subgroup analysis of the MERIDIAN cohort: failed commissuration: iuMR for Failed commissuration'. Together they form a unique fingerprint.

Cite this