Distortion of the anterior part of the interhemispheric fissure: significance and implications for prenatal diagnosis

• Published in: Ultrasound in obstetrics & gynecology 2014-03, Vol.43 (3), p.346-352
• Main Authors: Vinurel, N., Van Nieuwenhuyse, A., Cagneaux, M., Garel, C., Quarello, E., Brasseur, M., Picone, O., Ferry, M., Gaucherand, P., des Portes, V., Guibaud, L.
• Format: Article
• Language: English
• Subjects: Cerebral Cortex - abnormalities; Cerebral Cortex - diagnostic imaging; Female; fetus; Follow-Up Studies; Gestational Age; Humans; Infant, Newborn; interhemispheric fissure; Magnetic Resonance Imaging; Malformations of Cortical Development - diagnostic imaging; Malformations of Cortical Development - embryology; Malformations of Cortical Development - pathology; midline; Predictive Value of Tests; Pregnancy; prenatal diagnosis; Retrospective Studies; Ultrasonography, Prenatal; ultrasound
• ISSN: 0960-7692; 1469-0705
• DOI: 10.1002/uog.12498

ABSTRACT In order to illustrate the significance of a new anatomical finding, distortion of the interhemispheric fissure (DIHF) associated with impacted medial borders of the frontal lobes, we report a retrospective observational study of 13 fetuses in which DIHF was identified on prenatal imaging. In 10 cases there were associated anatomical anomalies, including mainly midline anomalies (syntelencephaly (n = 2), lobar holoprosencephaly (n = 1), Aicardi syndrome (n = 2)), but also schizencephaly (n = 1), cortical dysplasia (n = 1) and more complex cerebral malformations (n = 3), including neural tube defect in two cases. Chromosomal anomaly was identified in two cases, including 6p deletion in a case without associated central nervous system anomalies and a complex mosaicism in one of the cases with syntelencephaly. In two cases, the finding was apparently isolated on both pre‐ and postnatal imaging, and the children were doing well at follow‐up, aged 4 and 5 years. The presence of DIHF on prenatal imaging may help in the diagnosis of cerebral anomalies, especially those involving the midline. If DIHF is apparently isolated on prenatal ultrasound, magnetic resonance imaging is recommended for careful analysis of gyration and midline, especially optic and olfactory structures. Karyotyping is also recommended. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd