Reference intervals and reliability of cavum septi pellucidi volume measurements by three-dimensional ultrasound between 19 and 24 weeks’ gestation
-
Aslim Cinar
,
Serenat Eris Yalcin
Abstract
Objectives
A small or a large cavum septi pellucidi (CSP) during routine second trimester sonography may suggest abnormal cerebral development. Therefore, determination of CSP volume with three-dimensional (3D) ultrasound can be valuable. For this purpose, we sought to evaluate the reference ranges and measurement reliability of CSP volume by Virtual Organ Computer-aided AnaLysis (VOCAL).
Methods
VOCAL software was used to calculate the CSP volume from transabdominal multiplanar datasets of 99 structurally normal fetal ultrasound examinations between 19 and 24 weeks of gestation. Linear regression was utilized to determine reference intervals for CSP volumes as a function of gestational week (GW). Agreement among three evaluators with different proficiency levels (obstetrics and gynecology resident, perinatology fellow, and perinatologist) was assessed, using intraclass correlation coefficients (ICC) and 95% confidence intervals (CI).
Results
CSP volume and gestational age was positively correlated (r2=0.383, p=0.0001), represented by the following equation: 0.058–(1.016 x GW). Interobserver agreement between perinatologist and fellow was relatively high (ICC, 0.78; 95% CI, 0.70–0.85), whereas limited ultrasound experience (resident) was associated with fair agreement with non-novice observers (ICC for resident and perinatologist, 0.50; 95% CI, 0.29–0.65 and ICC for resident and fellow, 0.57; 95% CI, 0.38–0.71).
Conclusions
Reference ranges of CSP volumes using VOCAL from 19 0/6 through 24 6/7 weeks of gestation were established. A first-degree model to estimate CSP volume as a function of gestational age was also constructed. CSP volumetry seems reliable when evaluated by an examiner with particular 3D sonography experience.
Funding source: Süleyman Demirel University Scientific Research Projects Coordination Unit
Award Identifier / Grant number: TSG-2018-6917
Award Identifier / Grant number: 4867-TU1-17
-
Research funding: The research for this paper was financially supported by grants from Süleyman Demirel University Scientific Research Projects Coordination Unit (research project no, 4867-TU1-17 and TSG-2018-6917).
-
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: Authors state no conflict of interest.
-
Informed consent: Informed consent was obtained from all individuals included in this study.
-
Ethical approval: The current human study was reviewed and approved by Süleyman Demirel University Faculty of Medicine Clinical Research Ethics Committee (date, 21.12.2016 and no, 198/2016) and was performed in accordance with the ethical standards described in an appropriate version of the 1964 Declaration of Helsinki, as revised in 2013.
-
Article note: Part of data was published as a residency thesis (Aslim Cinar, Süleyman Demirel University) and presented as an abstract at the 25th European Congress of Obstetrics and Gynecology, 17–21 May 2017, Antalya, Turkey and at the 27th World Congress on Ultrasound in Obstetrics and Gynecology, 15–19 September 2017, Vienna, Austria.
References
1. Sherer, DM, Sokolovski, M, Dalloul, M, Santoso, P, Curcio, J, Abulafia, O. Prenatal diagnosis of dilated cavum septum pellucidum et vergae. Am J Perinatol 2004;21:247–51. https://doi.org/10.1055/s-2004-829869.Suche in Google Scholar PubMed
2. Ho, Y, Herrero, T, Aguinaldo, J, Hahn, ME, Klisser, K, Ghassemi, N, et al. Ultrasound measurements of frontal horns and the cavum septi pellucidi in healthy fetuses in the second and third trimesters of pregnancy. J Ultrasound Med 2020;39:127–37. https://doi.org/10.1002/jum.15086.Suche in Google Scholar PubMed
3. Winter, TC, Kennedy, AM, Byrne, J, Woodward, PJ. The cavum septi pellucidi: why is it important?. J Ultrasound Med 2010;29:427–444. https://doi.org/10.7863/jum.2010.29.3.427.Suche in Google Scholar PubMed
4. Nagaraj, UD, Calvo-Garcia, MA, Kline-Fath, BM. Abnormalities associated with the cavum septi pellucidi on fetal MRI: what radiologists need to know. AJR Am J Roentgenol 2018;210:989–97. https://doi.org/10.2214/ajr.17.19219.Suche in Google Scholar
5. Sundarakumar, DK, Farley, SA, Smith, CM, Maravilla, KR, Dighe, MK, Nixon, JN. Absent cavum septum pellucidum: a review with emphasis on associated commissural abnormalities. Pediatr Radiol 2015;45:950–64. https://doi.org/10.1007/s00247-015-3318-8.Suche in Google Scholar PubMed
6. Bronshtein, M, Weiner, Z. Prenatal diagnosis of dilated cava septi pellucidi et vergae: associated anomalies, differential diagnosis, and pregnancy outcome. Obstet Gynecol 1992;80:838–42.Suche in Google Scholar
7. Sahinoglu, Z, Uludogan, M, Delikara, MN. Prenatal sonographic diagnosis of dilated cavum vergae. J Clin Ultrasound 2002;30:378–83. https://doi.org/10.1002/jcu.10083.Suche in Google Scholar PubMed
8. Zhou, X, Lin, MF, Wu, LH, Huang, LH, Xie, HN. Enlarged cavum septi pellucidi Z-scores in fetuses with trisomy 18. J Matern Fetal Neonatal Med. https://doi.org/10.1080/14767058.2020.1742321. Published online: 14 April 2020.Suche in Google Scholar PubMed
9. Ho, YK, Turley, M, Marc-Aurele, KL, Jones MC, Housman E, Engelkemier D, et al. Enlarged cavum septi pellucidi and vergae in the fetus: a cause for concern. J Ultrasound Med 2017;36:1657–68. https://doi.org/10.7863/ultra.16.06081.Suche in Google Scholar PubMed
10. Abele, H, Babiy-Pachomow, O, Sonek, J, Hoopmann, M, Schaelike, M, Kagan, KO. The cavum septi pellucidi in euploid and aneuploid fetuses. Ultrasound Obstet Gynecol 2013;42:156–60. https://doi.org/10.1002/uog.12393.Suche in Google Scholar PubMed
11. Martins, WP, Ferriani, RA, Barra, DA, Dos Reis, RM, Bortolieiro, MA, Nastri, CO, et al. Reliability and validity of tissue volume measurement by three-dimensional ultrasound: an experimental model. Ultrasound Obstet Gynecol 2007;29:210–14. https://doi.org/10.1002/uog.3916.Suche in Google Scholar PubMed
12. Hata, T, Kuno, A, Dai, SY, Inubashiri, E, Hanaoka, U, Kanenishi, K, et al. Three-dimensional sonographic volume measurement of the fetal spleen. J Obstet Gynaecol Res 2007;33:600–5. https://doi.org/10.1111/j.1447-0756.2007.00618.x.Suche in Google Scholar PubMed
13. Yang, F, Leung, KY, Lee, YP, Chan, HY, Tang, MH. Fetal biometry by an inexperienced operator using two- and three-dimensional ultrasound. Ultrasound Obstet Gynecol 2010;35:566–71. https://doi.org/10.1002/uog.7600.Suche in Google Scholar PubMed
14. Mercé, LT, Barco, MJ, Bau, S. Three-dimensional volume sonographic study of fetal anatomy: intraobserver reproducibility and effect of examiner experience. J Ultrasound Med 2008;27:1053–63. https://doi.org/10.7863/jum.2008.27.7.1053.Suche in Google Scholar PubMed
15. Jou, HJ, Shyu, MK, Wu, SC, Chen, SM, Su, CH, Hsieh, FJ. Ultrasound measurement of the fetal cavum septi pellucidi. Ultrasound Obstet Gynecol 1998;12:419–421. https://doi.org/10.1046/j.1469-0705.1998.12060419.x.Suche in Google Scholar PubMed
16. Falco, P, Gabrielli, S, Visentin, A, Perolo, A, Pilu, G, Bovicelli, L. Transabdominal sonography of the cavum septum pellucidum in normal fetuses in the second and third trimesters of pregnancy. Ultrasound Obstet Gynecol 2000;16:549–53. https://doi.org/10.1046/j.1469-0705.2000.00244.x.Suche in Google Scholar PubMed
17. Zhao, D, Cai, A, Wang, B. An investigation of the standardization of fetal cavum septi pellucidi measurements using three-dimensional volumes of the fetal head. J Clin Ultrasound 2019;47:331–8. https://doi.org/10.1002/jcu.22727.Suche in Google Scholar PubMed
18. Monteagudo, A, Timor-Tritsch, IE. Normal sonographic development of the central nervous system from the second trimester onwards using 2D, 3D and transvaginal sonography. Prenat Diagn 2009;29:326–39. https://doi.org/10.1002/pd.2146.Suche in Google Scholar PubMed
19. Turan, OM, Turan, S, Buhimschi, IA, Funai, EF, Campbell, KH, Bahtiyar, OM, et al. Comparative analysis of 2-D versus 3-D ultrasound estimation of the fetal adrenal gland volume and prediction of preterm birth. Am J Perinatol 2012;29:673–80. https://doi.org/10.1055/s-0032-1314887.Suche in Google Scholar PubMed PubMed Central
20. Komoriyama, K, Ichizuka, K, Hasegawa, J, Matsuoka, R, Sekizawa, A, Okai, T. Establishment of fetal cranial and intracranial structure volume measurements using three-dimensional ultrasound imaging in a Japanese population. Showa Univ J Med Sci 2013;25:119–26. https://doi.org/10.15369/sujms.25.119.Suche in Google Scholar
21. Odeh, M, Bugoslavsky, S, Grinin, V, Ophir, E, Bornstein, J. Volume measurement of the cavum septum pellucidum: normal values between 20 and 40 weeks of gestation. Ultrasound Obstet Gynecol 2014;44:199–200. [Cited 16 May 2020] Available from URL https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.14047. https://doi.org/10.1002/uog.14047.Suche in Google Scholar
© 2020 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review
- Clinical evaluation of labor: an evidence- and experience-based approach
- Original Articles – Obstetrics
- How fever is defined in COVID-19 publications: a disturbing lack of precision
- Initial review of pregnancy and neonatal outcomes of pregnant women with COVID-19 infection
- Usefulness of COVID-19 screen-and-test approach in pregnant women: an experience from a country with low COVID-19 burden
- Clinical chorioamnionitis at term X: microbiology, clinical signs, placental pathology, and neonatal bacteremia – implications for clinical care
- Cytokine profiling: variation in immune modulation with preterm birth vs. uncomplicated term birth identifies pivotal signals in pathogenesis of preterm birth
- Hyperechoic amniotic membranes in patients with preterm premature rupture of membranes (p-PROM) and pregnancy outcome
- A novel technique for prediction of preterm birth: fetal nasal flow Doppler
- Pregnant women’s knowledge and behaviour to prevent cytomegalovirus infection: an observational study
- Reference intervals and reliability of cavum septi pellucidi volume measurements by three-dimensional ultrasound between 19 and 24 weeks’ gestation
- First-trimester presentation of ultrasound findings in trisomy 13 and validation of multiparameter ultrasound-based risk calculation models to detect trisomy 13 in the late first trimester
- Pre-operative tranexemic acid vs. etamsylate in reducing blood loss during elective cesarean section: randomized controlled trial
- External validation of a prediction model on vaginal birth after caesarean in a The Netherlands: a prospective cohort study
- The influence of race on cervical length in pregnant women in Brazil
- Original Articles – Fetus
- A 24-segment fractional shortening of the fetal heart using FetalHQ
- Original Articles – Neonates
- Antenatal corticosteroids and short-term neonatal outcomes in term and near-term infants of diabetic mothers. Analysis of the Qatar PEARL-peristat registry
- Acute respiratory effect of transpyloric feeding for respiratory exacerbation in preterm infants
- Quality improvement for reducing utilization drift in hypoxic-ischemic encephalopathy management
- Letter to the Editor
- Cross transmission of SARS-CoV-2 and obstetric ultrasound
- ‘Getting to zero’ cross transmission of SARS-CoV-2 in obstetric ultrasound during COVID-19 pandemic
Artikel in diesem Heft
- Frontmatter
- Review
- Clinical evaluation of labor: an evidence- and experience-based approach
- Original Articles – Obstetrics
- How fever is defined in COVID-19 publications: a disturbing lack of precision
- Initial review of pregnancy and neonatal outcomes of pregnant women with COVID-19 infection
- Usefulness of COVID-19 screen-and-test approach in pregnant women: an experience from a country with low COVID-19 burden
- Clinical chorioamnionitis at term X: microbiology, clinical signs, placental pathology, and neonatal bacteremia – implications for clinical care
- Cytokine profiling: variation in immune modulation with preterm birth vs. uncomplicated term birth identifies pivotal signals in pathogenesis of preterm birth
- Hyperechoic amniotic membranes in patients with preterm premature rupture of membranes (p-PROM) and pregnancy outcome
- A novel technique for prediction of preterm birth: fetal nasal flow Doppler
- Pregnant women’s knowledge and behaviour to prevent cytomegalovirus infection: an observational study
- Reference intervals and reliability of cavum septi pellucidi volume measurements by three-dimensional ultrasound between 19 and 24 weeks’ gestation
- First-trimester presentation of ultrasound findings in trisomy 13 and validation of multiparameter ultrasound-based risk calculation models to detect trisomy 13 in the late first trimester
- Pre-operative tranexemic acid vs. etamsylate in reducing blood loss during elective cesarean section: randomized controlled trial
- External validation of a prediction model on vaginal birth after caesarean in a The Netherlands: a prospective cohort study
- The influence of race on cervical length in pregnant women in Brazil
- Original Articles – Fetus
- A 24-segment fractional shortening of the fetal heart using FetalHQ
- Original Articles – Neonates
- Antenatal corticosteroids and short-term neonatal outcomes in term and near-term infants of diabetic mothers. Analysis of the Qatar PEARL-peristat registry
- Acute respiratory effect of transpyloric feeding for respiratory exacerbation in preterm infants
- Quality improvement for reducing utilization drift in hypoxic-ischemic encephalopathy management
- Letter to the Editor
- Cross transmission of SARS-CoV-2 and obstetric ultrasound
- ‘Getting to zero’ cross transmission of SARS-CoV-2 in obstetric ultrasound during COVID-19 pandemic
