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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.
753-760
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.
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Kilby, Mark D.
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Mandefield, Laura
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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
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Connolly, Daniel J.A.
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Gawne-Cain, Mary L.
965db1c3-79ca-455a-82e0-1cdc9b8042c4
Griffiths, Daniel I.
735e61ab-7cae-4965-9c02-68dc2f8ee307
Kilby, Mark D.
dc85a6f2-acb0-4a0b-afbc-2aed41cb9ad5
Mandefield, Laura
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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., Brackley, Karen, Bradburn, Michael, Connolly, Daniel J.A., Gawne-Cain, Mary L., Griffiths, Daniel I., Kilby, Mark D., Mandefield, Laura, Mooney, Cara, Robson, Stephen C., Vollmer, Brigitte and Mason, Gerald (2017) Anatomical subgroup analysis of the MERIDIAN cohort: failed commissuration. Ultrasound in Obstetrics & Gynecology, 50 (6), 753-760. (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: 3 November 2017
Published date: 1 December 2017
Organisations: Clinical & Experimental Sciences

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Local EPrints ID: 408420
URI: http://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: 16 Mar 2024 05:18

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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: Mark D. Kilby
Author: Laura Mandefield
Author: Cara Mooney
Author: Stephen C. Robson
Author: Gerald Mason

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