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Anatomical subgroup analysis of the MERIDIAN cohort: failed commissuration

Anatomical subgroup analysis of the MERIDIAN cohort: failed commissuration
Anatomical subgroup analysis of the MERIDIAN cohort: failed commissuration
ObjectiveTo 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.MethodsWe 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.Results79 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%).ConclusionsOur 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.
Griffiths, Paul D.
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Brackley, Karen
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Bradburn, Michael
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Connolly, Daniel J.A.
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Gawne-Cain, Mary L.
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Griffiths, Daniel I.
735e61ab-7cae-4965-9c02-68dc2f8ee307
Mandefield, Laura
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Kilby, Mark D.
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Mooney, Cara
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Robson, Stephen C.
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Vollmer, Brigitte
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Mason, Gerald
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Griffiths, Paul D.
903ae433-8711-4693-95e0-612a86fed710
Brackley, Karen
0a4c7155-8300-44cd-b463-c629faafdecf
Bradburn, Michael
02085bb8-0d49-4713-8c27-4b6d6c1cdf08
Connolly, Daniel J.A.
90242ec0-504f-4e22-be64-9d210a9dd0d7
Gawne-Cain, Mary L.
965db1c3-79ca-455a-82e0-1cdc9b8042c4
Griffiths, Daniel I.
735e61ab-7cae-4965-9c02-68dc2f8ee307
Mandefield, Laura
50d35200-6d9f-4622-8569-516dcca091c8
Kilby, Mark D.
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Mooney, Cara
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Robson, Stephen C.
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Vollmer, Brigitte
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Mason, Gerald
a3297c38-d36c-4ce7-865a-ebd5ccbf2244

Griffiths, Paul D., Brackley, Karen, Bradburn, Michael, Connolly, Daniel J.A., Gawne-Cain, Mary L., Griffiths, Daniel I., Mandefield, Laura, Kilby, Mark D., Mooney, Cara, Robson, Stephen C., Vollmer, Brigitte and Mason, Gerald (2017) Anatomical subgroup analysis of the MERIDIAN cohort: failed commissuration. Ultrasound in Obstetrics & Gynecology. (doi:10.1002/uog.17502).

Record type: Article

Abstract

ObjectiveTo 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.MethodsWe 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.Results79 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%).ConclusionsOur 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.

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Griffiths_et_al-2017-Ultrasound_in_Obstetrics_&_Gynecology - Accepted Manuscript
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Accepted/In Press date: 10 April 2017
e-pub ahead of print date: 24 April 2017
Organisations: Clinical & Experimental Sciences

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Local EPrints ID: 408420
URI: https://eprints.soton.ac.uk/id/eprint/408420
PURE UUID: 1c6572d1-a5a0-4154-81f4-87fb51b17b9b
ORCID for Brigitte Vollmer: ORCID iD orcid.org/0000-0003-4088-5336

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Date deposited: 20 May 2017 04:03
Last modified: 10 Dec 2019 06:03

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Contributors

Author: Paul D. Griffiths
Author: Karen Brackley
Author: Michael Bradburn
Author: Daniel J.A. Connolly
Author: Mary L. Gawne-Cain
Author: Daniel I. Griffiths
Author: Laura Mandefield
Author: Mark D. Kilby
Author: Cara Mooney
Author: Stephen C. Robson
Author: Gerald Mason

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