Cavum Septi Pellucidi Width Research Articles

Sonographic visualization and measurement of the fetal optic chiasm and optic tract and association with the cavum septum pellucidum.

To assess the sonographic visualization of thefetal optic chiasm (OC) and optic tracts (OTs), establish mid-trimester reference values, and assess the relationship between OC and OT dimensions and cavum septum pellucidum (CSP) measurements. This prospective cross-sectional study included 154 morphologically normal fetuses between 19 and 23weeks of gestation. The diameters of the fetal OC and OTs were measured using two-dimensional transabdominal ultrasound in a transventricular axial section angled approximately 20-40° caudally. CSP length as well as anterior, middle, and posterior widths were measured by placing the cursor on the inner surfaces in the transventricular section. The average CSP width was included in the analysis. The OC and OTs were successfully visualized in 109 fetuses and included in the analysis. Visualization success in transabdominal axial sections at 19-23weeks was 70.8 %, with high intraobserver and interobserver reproducibility. Additionally, visualization rates were higher in advanced gestational weeks and in fetuses with breech presentation (p=0.007 and p=0.017, respectively). OC and OT dimensions were positively correlated with CSP length and width, biparietal diameter (BPD), head circumference (HC), and gestational age (p<0.05, for all). The OC and OTs were successfully visualized transabdominally in axial sections with high intraobserver and interobserver reproducibility. Additionally, OC and OT dimensions were positively correlated with gestational age, as well as with BPD, HC, and CSP measurements.

Can cavum septum pellucidum width and length measurements also be reliable indicators of corpus callosum measurements in normal fetuses?

Can cavum septum pellucidum width and length measurements also be reliable indicators of corpus callosum measurements in normal fetuses?

Revisiting the Implications of a Wide or Narrow Fetal Cavum Septi Pellucidi.

To investigate short-term neonatal developmental outcomes in fetuses with an isolated wide or narrow cavum septi pellucidi (CSP) using new reference ranges. A cross-sectional study on fetuses at 16 + 0 to 36 + 6 weeks of gestation between December 2020 and January 2022. CSP width reference ranges were constructed from low-risk pregnancies. Wide and narrow CSPs were defined as measurements above the 95th percentile and below the 5th percentile, respectively. For the primary outcome fetuses with normal neurosonograms were included. Neonatal developmental outcomes were assessed using the Survey of Well-being of Young Children (SWYC). A total of 352 fetuses were included in this study, of whom 138 were healthy and had uncomplicated neonatal outcomes. These fetuses constituted the control group and were used to construct the CSP width reference ranges. Of 185 fetuses in the neurosonography group, 9.7% had wide and 7.6% had narrow CSPs, of whom 33.3% and 22.2%, respectively, scored below the SWYC threshold for expected developmental milestones, a rate similar to that reported in the general population. The presence of a prenatally isolated wide or narrow CSP does not appear to increase the risk of neonatal neurodevelopmental delay.

Neurosonographic Measurements of the Fetal Anterior Complex in Singleton Pregnancies.

To construct reference ranges of the fetal cerebral anterior complex, including ventricular index (VI), anterior horn of lateral ventricle width (AW), and cavum septi pellucidi (CSP) width, as a function of gestational age (GA), in Thai fetuses. Low-risk pregnancies were recruited to measure fetal anterior complex on axial transventricular and coronal transcaudate planes using transabdominal ultrasound. The downside and upside hemisphere were defined as cerebral hemisphere located distal and proximal to the transducer, respectively. The five variables, downside/upside VI, downside/upside AW and CSP width, were measured from each fetus. Best-fit models in predicting mean and standard deviation for each value as a function of GA were constructed, using regression analysis. Distributions of Z-scores of all values based on GA were created to evaluate the fitness of models. Intraclass correlation coefficients were used to assess inter-/intraobserver variability. A total of 395 fetuses were measured for anterior complex. All parameters changed with GA with quadratic function. The models for predicting means and standard deviation of the five parameters as well as percentile charts were created. All models were proven well-fitted. The intra-/interobserver reliability coefficients of all values showed excellent agreement. The reference ranges of the fetal anterior complex, including VI, AW, and CSP, in axial transventricular and coronal transcaudate planes have been established and available for clinical use.

Fetal cavum septum pellucidum nomogram and its relationship with fetal Doppler: a prospective study of a Turkish population

Aim: Septum pellucidum is a thin membrane with right and left leaves, and cavum septum pellucidum (CSP) is formed in the intermembrane region. This study investigates CSP nomogram dimensions for all trimesters in the Turkish population. In addition, the relationship between fetal Doppler flow and CSP size was investigated in this study.&#x0D; Methods: This study was designed as a prospective cohort between 2019-2020. Pregnant women between 19-42 weeks who were followed up at XXX, Department of Obstetrics and Gynecology were included in the study. (blind review)&#x0D; Results: A total of 517 fetuses meeting our criteria were included in this prospective study. In the second trimester (19-28 weeks) CSP width (4.12±0.88 vs. 4.91±1.42, p &lt; 0.001) and length (7.95±1.04 vs. 9.48±2.19, p &lt; 0.001) were significantly higher than in the third trimester (28-42 weeks). While the mean CSP width increased up to 32th weeks, there was no clear increase-decrease pattern between 32th-38th weeks, and it was observed to decrease after 38th weeks. The mean CSP length increased up to 29th weeks, while there was no clear increase-decrease pattern between 29th-38th weeks, but decreased after 38th weeks. While a significant correlation was observed between gestational week and CSP width (r = 0.118, p = 0.010), there was no significant correlation between CSP length (r = 0.086, p =0.062). A significant correlation was observed between biparietal diameter (BPD) and CSP width (r = 0.180, p &lt; 0.001) and length (r = 0.202, p &lt; 0.001), but not with head circumference (HC). There was a significant correlation between middle cerebral artery (MCA) systolic/diastolic ratio (S/D) (r = 0.185, p &lt; 0.001), pulsatility index (PI) (r = 0.210, p &lt; 0.001) and resistive index (RI) (r = 0.233, p &lt; 0.001) and CSP length, but not with CSP width.&#x0D; Conclusion: Turkish population fetal CSP nomogram is presented in this study. Fetal middle cerebral artery Doppler measurements (S/D, PI, and RI) showing cerebral blood flow correlate with CSP length, but not with CSP width. There was no correlation between fetal umbilical artery Doppler measurements and CSP sizes. The results pave the way for population-based studies with much larger samples.

45 Using fetal ultrasound to predict developmental outcomes in children born with cardiac defects in Manitoba: A historical cohort study

Abstract Background The cavum septum pellucidum (CSP) is a normal anatomical cavity found in the mid-brain of the fetus and is routinely imaged at the time of mid-pregnancy obstetrical ultrasound as part of anatomic survey. Presence of the CSP reflects intact intrahemispheric connections and an intact corpus callosum. The CSP space then closes by the time of birth or early infancy, however persistence of the CSP into adulthood has been described in those with the schizophrenic phenotype of DiGeorge syndrome. Preliminary work by our group in Manitoba has shown utility in measurement of CSP width to improve non-invasive prenatal diagnosis of DiGeorge syndrome among fetuses with and without conotruncal cardiac defects. However, there exists no information about the relationship between fetal CSP width and future neurodevelopmental outcomes, such as Bayley-III scores, in children with cardiac lesions in the absence of underlying genetic comorbidities. Objectives To determine the relationship between cavum septum pellucidum (CSP) width and neurodevelopment in children born with sever cardiac defects. Design/Methods This was a historical cohort study of children born with cardiac anomalies in Manitoba (2009-2019). Eligible children with developmental pediatric follow-up between ages 18-24 months corrected age were identified using a clinical repository. Post-processing measurement of fetal CSP at mid-gestation using stored obstetrical ultrasounds was performed by two blinded and independent reviewers in a standardized fashion. Ultrasound reports were also reviewed to collate data about routine fetal biometry and imaging data then linked to demographics, birth information, surgical details and neurodevelopmental outcomes (Bayley-III scales). Linear regression models were used to evaluate the relationship between CSP width and Bayley-III scores; inferential statistics were used to compare outcomes between groups (biventricular versus single-ventricle repair). Results 78 of 111 eligible cases had stored ultrasound images and included in the analysis. Most children were delivered at term following vaginal delivery (71%), with normal birthweight and Apgars. Median CSP width was 3.8mm (SD 1.2). There was a range conotruncal cardiac anomalies and 47% required single-ventricle repair. There was no obvious relationship between CSP width and Bayley-III motor (p=0.932) or cognitive domains (p0.686), however there was a trend towards larger CSP and higher Bayley-III language scores (p=0.049). Conclusion The influence of the deoxygenated blood on the developing fetal brain in modifying outcomes for children with severe cardiac defects needs future study to improve postnatal development in this high-risk group.

Cavum septum pellucidum nomogram during the second trimester of pregnancy

This study aimed to determine cavum septum pellucidum (CSP) nomogram values between 15–28 weeks of gestation. Routine biometric measurements and CSP width were measured by transabdominal ultrasonography in 6042 structurally normal foetuses between 15–28 weeks of gestation. Distribution of CSP width by the week of pregnancy and percentile values were calculated. The mean week of gestation (GW) was 21 ± 1.7, and the mean biparietal diameter (BPD) was 50.2 ± 5.8 mm. The CSP width range was 1.6–7.7 mm at 15–28 weeks, and the mean CSP width was 4.1 ± 0.8 mm. CSP width was found to have a significant correlation between a gestational week (CSP = GW X 0.2705–1.6121; R = 0.62; p < .01) and BPD (CSP = BPD X 0.0859–0.273; R = 0.651; p 0.01). CSP width was found to differ significantly according to gestational weeks, and percentile distributions were calculated. Between 15 and 28 weeks of gestation, the 95th percentile values of CSP width were found to be 3.7–7 mm. Our study was determined that CSP width increased linearly between 15–28 weeks of gestation. For this reason, we think that it would be more appropriate to use CSP width percentile values in the examination of the foetus. Impact statement What is already known on this subject? The cavum septum pellucidum can be easily identified and evaluated by ultrasonography after 18 weeks of pregnancy. CSP can be associated with severe brain anomalies if it is not visualised or deformed. Moreover; large CSP may be associated with chromosomal abnormalities. What do the results of this study add? Our study showed that CSP width increased linearly between 15–28 weeks of gestation. CSP width was found to differ significantly according to gestational weeks, and between 15 and 28 weeks of gestation, the 95th percentile values of CSP width were found to be 3.7–7 mm. What are the implications of these findings for clinical practice and/or further research? We reported that it would be more appropriate to use CSP percentile values according to the gestational week in the definition of abnormal CSP.

Utility of Measuring Fetal Cavum Septum Pellucidum (CSP) Width During Routine Obstetrical Ultrasound for Improving Diagnosis of 22q11.2 Deletion Syndrome: A Case-Control Study.

ObjectiveTo evaluate the utility of measuring fetal cavum septum pellucidum (CSP) width during routine, mid-pregnancy ultrasound for improving diagnosis of 22q11.2 deletion syndrome amongst fetuses with and without conotruncal anomalies.Patients and MethodsThis was a retrospective case-control study (2005–2016). Fetuses and newborns with 22q11.2 deletion and/or conotruncal cardiac anomalies were identified using a regional, clinical database. A control group was assembled in a 2:1 ratio to create three groups for comparison: i) 22q11.2 deletion syndrome; ii) isolated conotruncal anomalies; and iii) controls. Eligibility was restricted to those with stored ultrasound images between 18–22 weeks’ gestation and a minimum biparietal diameter of 40 mm. Post-processing measurement of CSP width was performed in a standardized fashion by two blinded and independent study personnel. Descriptive and inferential statistics, regression modeling, and receiver operator curves (ROC) were used to compare outcomes between groups and evaluate sensitivity/specificity of CSP width as a marker of 22q11.2 deletion syndrome.ResultsTwenty-nine cases of 22q11.2 deletion and 64 cases of isolated conotruncal anomalies were matched to 186 healthy controls. Cases with 22q11.2 deletion syndrome had significantly larger CSP widths (5.36 mm; SD=1.2) compared to those with isolated conotruncal anomalies (3.75 mm; SD=1.11) and healthy controls (2.93 mm; SD=0.57; p<0.0001). There was no difference in CSP width amongst those with 22q11.2 deletion irrespective of the presence/absence of a conotruncal anomaly (p=0.362), or by type of conotruncal anomaly (p=0.211). Using a CSP width cutoff >4.3 mm, fetuses with 22q11.2 deletion can be accurately identified with good sensitivity (89.7%) and specificity (84%).ConclusionFetuses with 22q11.2 deletion syndrome have dilated CSPs when compared to those with isolated conotruncal anomalies or controls. Because CSP dilation can be evaluated during routine mid-pregnancy ultrasound using standard images of the fetal head, measurement could easily be incorporated to enhance prenatal diagnosis of this phenotypically diverse condition.

Prenatal Ultrasound Diagnosis of Biometric changes in the Brain of Growth Restricted Fetuses. A Systematic Review of Literature.

Fetal growth restriction (FGR) occurs when the fetus does not reach its intrauterine potential for growth and development as a result of compromise in placental function. It is a condition that affects 5 to 10% of pregnancies and is the second most common cause of perinatal morbidity and mortality. Children born with FGR are at risk of impaired neurological and cognitive development and cardiovascular or endocrine diseases in adulthood. The purpose of the present revision is to perform a literature search for evidence on the detection and assessment by ultrasound of brain injury linked to FGR during fetal life. Using a systematic approach and quantitative evaluation as study methodology, we reviewed ultrasound studies of the fetal brain structure of growth-restricted fetuses with objective quality measures. A total of eight studies were identified. High quality studies were identified for measurement of brain volumes; corpus callosum; brain fissure depth measurements, and cavum septi pellucidi width measurement. A low-quality study was available for transverse cerebellar diameter measurement in FGR. Further prospective randomized studies are needed to understand the changes that occur in the brain of fetuses with restricted growth, as well as their correlation with the changes in cognitive development observed.

Fetal intracranial structures: differences in size according to sex.

We aimed to compare gender difference on sizes of some structures in the brain of normal male and female fetuses between 20 and 22week gestations. A total of 300 female and 300 male singleton pregnancies with low risk were included in the study. Biparietal diameter, head circumference, transcerebellar diameter, cisterna magna, nuchal fold thickness, anterior and posterior horn of lateral ventricles, length and width ofcavum septum pellucidum were measured transabdominally. Mean±SD values were calculated and comparison of measurements were done between male andfemale fetuses. Kolmogorov-Smirnov and independent samples t-test were used for statistical analysis. A value of p<0.05 were accepted as statistically significant. We determined statistically significant difference in sizes of some structures of the brain of male and female fetuses. Mean±SD value of cavum septi pellucidi width was 3.38±0.61 and 3.85±0.96 in female and males, respectively (p<0.05). Male fetuses were also found to have larger anterior (1.92±0.30 vs. 1.58±0.26, p<0.0001) and posterior horn of lateral ventricles (6.00±0.87 vs. 5.53±1.17, p<0.05). Difference in sizes of some structures of the brain starts in fetal life. This finding may be important inevaluating the intracranial structures more precisely. These results may also give a contribution to the understanding physiological and pathologic differences between males and females.

Enlarged cavum septi pellucidi Z-scores in fetuses with trisomy 18

Objective We aim to establish a formula calculating the fetal cavum septi pellucidi (CSP) width Z-scores and compare CSP width between the normal fetus and 18-trisomy fetus. Methods In this retrospective study, 608 normal fetuses and 71 fetuses with the 18-trisomy syndrome were included. Z-scores were calculated after the acquisition of CSP images. Normal CSP width Z-scores formulae were constructed based on gestational age (GA) by performing a standard regression analysis followed by weighted regression of absolute residual values. Subsequently, the Mann–Whitney U test was used to compare the CSP width Z-scores between normal and 18-trisomy groups. Results Formulae calculating CSP width Z-scores were constructed. Normal fetal CSP width was significantly correlated with GA (R 2 = 0.50, p < .01). In 18-trisomy group, 69% (34/49) fetuses displayed enlarged fetal CSP width and CSP width Z-scores (p < .01). Conclusions The CSP width Z-scores formulae established in the current study can provide a quantitative basis for the prenatal diagnosis of 18-trisomy syndrome. Enlarged CSP width Z-score may serve as a novel prenatal diagnostic marker for the 18-trisomy syndrome.

New normal range of fetal cavum septum pellucidum in the second trimester of gestation

Fetal brain was retrospectively evaluated in 418 normal fetuses at 16–28 weeks of gestation. The multiplanar mode to obtain the axial cerebral plane and measured the width of the cavum septum pellucidum (CSP) and biparietal diameter (BD). All measurements of CSP were done from as the widest diameter across both borders in an inter-to inter fashion. The CSP width is increasing at second trimester of gestation. Normal range plotted on the reference range (mean, 5th and 95th percentiles) of fetal width CSP by measuring of its size may be useful for assessment of fetal brain development in the second trimester of gestation.

Quantitative study on the development of fetal ventricles and cisterna magna in second and third trimesters with MRI

Objective: To analyze the changes of growth and development of normal fetal ventricles and cisterna magna with gestational age(GA) and the correlation with fetal gender in the second and third trimester,and establish the MR prenatal diagnosis reference standards. Methods: A total of 633 fetuses (mean GA (27.0±4.1) weeks (18.9-40.6 weeks))without central nervous system abnormalities were retrospectively collected from the Obstetrics and Gynecology Hospital of Fudan University from June 2012 to August 2017. The lateral ventricle trigonometric width (LVTW), third ventricle width (TVW), fourth ventricle width (FVW), anterior-posterior diameter of the fourth ventricle(APDFV), cavum septum pellucidum width (CSPW) and cisterna magna width (CMW) were obtained in the standard measure planes on MR image.The correlation between the biometrics and GA and the correlation between the biometrics and fetal gender were analyzed respectively, and the normal reference values of the biometrics were calculated. Spearman correlation analysis, Pearson correlation analysis,linear regression analysis, independent samples t-test and paired samples t-test were used for statistic analysis. Results: (1)Fetal LLVTW,RLVTW,TVW,CSPW and CMW in second and third trimesters were correlated with GA at medium and low levels(the correlation coefficient r were 0.311, 0.277, 0.207, 0.226, 0.295, respectively, all P<0.01). FVW and APDFV were statistically correlated with GA, and the linear regression equations were as follows: y=0.022×GA-0.043 (adjusted R(2)=0.642); y=0.018×GA-0.159 (adjusted R(2)=0.690). (2)Fetal LLVTW,RLVTW,FVW,APDFV and CSPW were not correlated with fetal gender in second and third trimesters(r=-0.078,-0.057,-0.087,-0.004 and 0.024, P=0.124,0.258,0.085,0.931 and 0.618, all P>0.05). TVW and CMW were statistically correlated with fetal gender(r=-0.310, -0.180, P=0.000, 0.006, all P<0.05). (3) The mean values of LLVTW and RLVTW were (0.71±0.13) cm and (0.68±0.13) cm, respectively, and significant difference was found between them(t=3.180, P=0.002). The mean value of CSPW was (0.59±0.15) cm. And the mean values of male and female fetuses for TVW and CMW were (0.17±0.05) cm, (0.16±0.06) cm and (0.68±0.15) cm, (0.58±0.15) cm, respectively. The corresponding prenatal MRI diagnostic criteria were as follows: LLVTW 1.1 cm, RLVTW 1.0 cm, CSPW 1.0 cm, TVW 0.3 cm, CMW (male 1.1 cm, female 1.0 cm). Conclusions: The normal fetal ventricles and cisterna magna are increased with the GA in the second and third trimesters. TVW and CMW are related to fetal gender. The establishment of normal reference values of fetal ventricles and cisterna magna based on GA and fetal gender are conducive to enhance the accuracy of MRI prenatal diagnosis.

Ultrasound Measurements of Frontal Horns and the Cavum Septi Pellucidi in Healthy Fetuses in the Second and Third Trimesters of Pregnancy.

To assess the visualization rate and size of the frontal horns (FHs) and cavum septi pellucidi (CSP) in healthy fetuses throughout pregnancy. After Institutional Review Board approval, 522 consecutive uncomplicated singleton pregnancies between 15 and 39 gestational weeks were enrolled in the study. Ultrasound measurements of the anterior horn width (AHW), center from the horn distance (CFHD), distance from the FHs to the CSP, and CSP width were retrospectively performed using axial transventricular or transcerebellar planes. Available maternal body mass indices were recorded. At least 1 FH was seen in 78% of the cases. The mean AHW decreased over the second trimester and plateaued in the third trimester. The CFHD plateaued in the second trimester and increased in the third trimester. Downside FHs were generally larger than upside FHs. More FHs were measured in transventricular (69%) than transcerebellar (31%) planes. Frontal horns were seen with high, low, and no confidence in 57%, 21%, and 22% of cases, respectively. No-confidence rates were 17% in the second trimester and 42% in the third trimester. The CSP was not visualized in 4% of cases; 15 of 19 cases of a nonvisualized CSP were scanned between 18 and 37 weeks. Mean body mass indices ± SDs were 27.6 ± 6.7 kg/m2 for the patients in cases of a visualized CSP and 32.4 ± 9.1 kg/m2 for the patients in cases of a nonvisualized CSP. Normative data for the fetal FH and CSP width were established. Frontal horns are more frequently seen on transventricular views and are difficult to confidently assess in the late third trimester. This study challenges previously reported data that the CSP is seen in 100% of cases from 18 to 37 weeks.

Dilated cavum septi pellucidi as sole prenatal ultrasound defect: Case-base analysis of fetal outcomes

ObjectivesThis retrospective study was undertaken to examine fetuses with dilated cavum septi pellucidi (CSP) as an isolated finding and to identify factors impacting postnatal outcomes. Study DesignFully documented cases of dilated CSP as a sole prenatal defect were selected for study. Recorded data included serial sonographic examinations, fetal MRI studies, chromosomal testing, screening for infection, and postnatal follow-up. Fetal subjects were further stratified by gender, gestational age at diagnosis (<28 w or ≥28 w), CSP width at diagnosis (<10 mm or ≥10 mm), evolution at term (persistent vs non-persistent CSP), and postnatal MRI diagnosis (presence/absence of CSP cyst). Chi-square or Fisher’s exact test (as appropriate) was used to compare categorical variables and patient groups. ResultsA total of 48 fetuses met our inclusion criteria, none exhibiting chromosomal abnormalities. Six (12.5%) of these 48 were subsequently diagnosed with neurodevelopmental delays. However, such delays were unrelated to any categorical variable listed above (p > 0.05). ConclusionsDilated CSP as an isolated prenatal finding by ultrasound or MRI carries a low risk of chromosomal abnormalities but a high risk of neurodevelopmental delay. These perils should be adequately conveyed to the parents of such infants.

An investigation of the standardization of fetal cavum septi pellucidi measurements using three-dimensional volumes of the fetal head.

The purpose of this study was to measure the maximal width, middle width, and length of the cavum septi pellucidi (CSP) in normal fetuses, and compare these measurements obtained in the transthalamic (TT) plane with those obtained in the transventricular (TV) plane. A prospective study was conducted of normal singleton fetuses, ranging from 18 to 36 weeks in gestational age. In each case, a three-dimensional volume of the fetal head was obtained in the TT plane for further offline measurements, then the maximal width, middle width, and length of the CSP in both the TT and TV planes were measured. Intraobserver and interobserver reproducibility was assessed, and curve estimation was used to assess the possible relationship between these measurements of CSP and gestational age (GA). A total of 267 normal fetuses were studied. The CSP width and length in TT and TV planes as a function of GA were analyzed using a quadratic regression model. Intraobserver and interobserver agreement of the CSP measurements was excellent overall (ICCs >0.9), with intraobserver and interobserver differences of less than 4%. Measurements of CSP in the TT and TV planes are equally reproducible.

Relationship Between Cavum Septi Pellucidi Measurements and Fetal Hypoplastic Left Heart Syndrome or Dextro-Transposition of the Great Arteries.

The aim of this study was to compare the size and position of the cavum septi pellucidi (CSP) in fetuses with hypoplastic left heart syndrome (HLHS) or dextro-transposition of the great arteries (d-TGA) with healthy fetuses. The CSP length, CSP width, and frontal lobe length were measured in 185 healthy fetuses (404 scans), 11 fetuses with HLHS (16 scans), and 11 fetuses with d-TGA (12 scans) between January 2005 and April 2016. Each measurement was compared between healthy fetuses and those with HLHS or d-TGA, controlling for the biparietal diameter. Positive correlations were noted between biparietal diameter and CSP length, CSP width, and frontal lobe length (adjusted R2 = 0.811, 0.821, and 0.878, respectively). An increased CSP length was found in both fetuses with HLHS and those with d-TGA (P < .0001). The CSP width was only increased in fetuses with d-TGA (P = .0466). No difference in the frontal lobe length was noted. In fetuses with HLHS, the CSP is increased in length. In fetuses with d-TGA, the CSP is increased in both length and width.

Prenatal abnormal width of the cavum septum pellucidum – MRI features and neurodevelopmental outcome

Purpose: The purpose of this study is to describe the morphological characteristics of fetal MRIs and outcome of prenatally-detected abnormal width of the CSP (cavum septum pellucidum).Material and methods: A retrospective study of cases with abnormal width of the CSP demonstrated prenatally on MRI. Data collected included: prenatal history, MRI features, sonographic follow up, and neurodevelopmental outcome.Results: Most of the cases referred (34/39) had an abnormal CSP on MRI. Thirty cases had an abnormal width: 23 had narrow CSP and seven had wide CSP. Only three out of 12 cases that were referred with US diagnosis of absent CSP were confirmed by MRI, the rest had narrow CSP. Follow up was performed in 24 out of 30 cases with an abnormal CSP width; all had normal neurodevelopment.Conclusion: To the best of our knowledge, this is the first study to examine the outcome in narrow and wide CSPs detected prenatally. An abnormal width of the CSP prenatally, without an associated fetal abnormality such as aneuploidy, appears to have normal outcome. MRI should be offered when an absence of the CSP is suspected on US to rule out narrow CSP, which seems to be a benign finding.

Dilated cavum septi pellucidi in fetuses with microdeletion 22q11

The cavum septi pellucidi (CSP) is an easily recognizable landmark in the fetal brain. CSP disappears after birth to form the septum pellucidum. Children with microdeletion 22q11 (del. 22q11) were, however, reported to have a persistent dilated CSP. This study was designed to examine whether the CSP is dilated in fetuses with del.22q11. This was a case-control study where the CSP width was measured in normal fetuses from 16 to 34 weeks and in fetuses with del. 22q11. CSP width was correlated to the biparietal diameter (BPD). Reference curves were constructed, and z-scores calculated. Cavum septi pellucidi width in 260 normal fetuses showed a linear correlation with BPD. The study group consisted of 37 fetuses with del. 22q11. In 25/37 (67.5%) of fetuses with del. 22q11, the CSP was enlarged with a mean z-score of 2.64 (p < 0.0001). Fetuses with a BPD > 50 mm (>22 weeks of gestation) had a dilated CSP in 85.7% (24/28). The CSP is a structure routinely evaluated in screening ultrasound. A wide CSP is found in second trimester fetuses with del. 22q11. A dilated CSP may be an important sonographic marker for the presence of del. 22q11 along with conotruncal malformations and thymic hypoplasia. © 2016 John Wiley & Sons, Ltd.

Effect of assisted reproductive technology on fetal brain development assessed by prenatal ultrasonography.

The aim was to evaluate whether assisted reproductive technology (ART) affects the development of the fetal central nervous system (CNS). This study was carried out on women with singleton pregnancies, including 427 women who became pregnant by ART and 32,859 women with natural conceptions (NCs). The cavum septum pellucidum (CSP) width, transverse cerebellar diameter (TCD), cisterna magna (CM) depth, and lateral ventricle width were measured by ultrasound for 72 normal ART fetuses and 201 normal NC fetuses. The malformation rate of CNS was determined for both groups. In both groups, significant positive correlations with gestational age were found for CSP width (ART: r=0.7841, NC: r=0.7864; P<0.0001) and for TCD (ART: r=0.7698, NC: r=0.6926; P<0.0001). However, neither CM depth nor lateral ventricle width showed a significant correlation with gestational age. None of the measured parameters showed a statistically significant difference between the two groups. The CNS malformation detection rate was 1.2% (5/427) in ART fetuses and 0.9% (296/32,859) in NC fetuses. It did not reach statistical significance (P>0.05). The development and malformation rate of the fetal CNS is not significantly different between ART and NC fetuses, thus, ART does not affect the development of the fetal brain.