Is the presence of corpus callosum predictable in the first trimester?

Abstract

Corpus callosum agenesis (CCA) is a clinical condition accompanied by various aneuploidy and genetic syndromes. We identified the development of the corpus callosum (CC) in 278 patients before 18 weeks of gestational age by visualising the pericallosal artery (PCA) in the callosal sulcus and changes in the lengths and ratios of the midbrain (MB) and falx (F), which suggested elevation of the third ventricle and thalamus due to CCA in the first trimester. We succeeded in visualising the path of the PCA in 273 patients. As expected, we observed an increase in the lengths of the MB and F throughout the pregnancies. The MB:F ratio was 0.5–0.6, and it was independent of gestational age. In all 278 patients, the MB:F ratio was <0.6 (95th percentile = 0.79). We observed the presence of the CC during anatomical screening at gestational weeks 18–24. Visualisation of the PCA path (98% sensitivity) and calculation of the MB:F ratio <95th percentile (0.79–100% sensitivity) had very high sensitivity that indirectly confirmed the presence of the CC in the first trimester of pregnancy.Impact statementWhat is already known on this subject: After reading the articles for detecting the absence of corpus callosum (CC) at first trimester with midbrain (MB) and falx (F) measurement by Lachmann et al. (2013) and visualising pericallosal artery (PCA) as an indirect sign of CC agenesis by Pati et al. (2012), we aimed to have a look for our records visualising PCA in callosal sulcus and measure MB–F, as well as their ratios for an indirect sign of ‘presence’ of CC at first trimester.What the results of this study add: In recent literature, it is not possible to find many articles suggesting the presence of CC between 11 and 13 weeks of gestation. Díaz-Guerrero et al. (2013) and Pati et al. (2012) has researched visualising PCA path. Lachmann et al. (2013) reported an article for MB and F measurements in early suspicion of CC agenesis. Our study will be the first article in visualising PCA path and measuring MB–F lengths as well as their ratios for ‘presence’ of CC with high sensitivity rates (98% and 100%).What are the implications of these findings for clinical practice and/or further research: This study encourages clinicians visualising PCA path and measure MB–F lengths when they will try to visualise repetitive times and see how it is an easy procedure when you get used to it.