Obliterated cavum septi pellucidi: Clinical significance and role of fetal magnetic resonance

Abstract Introduction The objective of this study was to describe a cohort of fetuses with an ultrasound prenatal diagnosis of obliterated cavum septi pellucidi (oCSP) with the aim to explore the rate of associated malformations, the progression during pregnancy and the role of fetal magnetic resona...

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Main Authors: Ilaria Fantasia, Claudia Ciardo, Gabriella Bracalente, Elisa Filippi, Flora Maria Murru, Anita Spezzacatene, Maura Bin, Olivia Mendez Quintero, Elisa Montaguti, Christoph Lees, Katherine Papanikolaou, Gianluigi Pilu, Federico Prefumo, Baskaran Thilaganathan, Tamara Stampalija
Format: Article
Language:English
Published: Wiley 2023-06-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14575
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author Ilaria Fantasia
Claudia Ciardo
Gabriella Bracalente
Elisa Filippi
Flora Maria Murru
Anita Spezzacatene
Maura Bin
Olivia Mendez Quintero
Elisa Montaguti
Christoph Lees
Katherine Papanikolaou
Gianluigi Pilu
Federico Prefumo
Baskaran Thilaganathan
Tamara Stampalija
author_facet Ilaria Fantasia
Claudia Ciardo
Gabriella Bracalente
Elisa Filippi
Flora Maria Murru
Anita Spezzacatene
Maura Bin
Olivia Mendez Quintero
Elisa Montaguti
Christoph Lees
Katherine Papanikolaou
Gianluigi Pilu
Federico Prefumo
Baskaran Thilaganathan
Tamara Stampalija
author_sort Ilaria Fantasia
collection DOAJ
description Abstract Introduction The objective of this study was to describe a cohort of fetuses with an ultrasound prenatal diagnosis of obliterated cavum septi pellucidi (oCSP) with the aim to explore the rate of associated malformations, the progression during pregnancy and the role of fetal magnetic resonance imaging (MRI). Material and methods This was a retrospective multicenter international study of fetuses diagnosed with oCSP in the second trimester with available fetal MRI and subsequent ultrasound and/or fetal MRI follow‐up in the third trimester. Where available, postnatal data were collected to obtain information on neurodevelopment. Results We identified 45 fetuses with oCSP at 20.5 weeks (interquartile range 20.1–21.1). oCSP was apparently isolated at ultrasound in 89% (40/45) and fetal MRI found additional findings in 5% (2/40) of cases, including polymicrogyria and microencephaly. In the remaining 38 fetuses, fetal MRI found a variable amount of fluid in CSP in 74% (28/38) and no fluid in 26% (10/38). Ultrasound follow‐up at or after 30 weeks confirmed the diagnosis of oCSP in 32% (12/38) while fluid was visible in 68% (26/38). At follow‐up MRI, performed in eight pregnancies, there were periventricular cysts and delayed sulcation with persistent oCSP in one case. Among the remaining cases with normal follow‐up ultrasound and fetal MRI findings, the postnatal outcome was normal in 89% of cases (33/37) and abnormal in 11% (4/37): two with isolated speech delay, and two with neurodevelopmental delay secondary to postnatal diagnosis of Noonan syndrome at 5 years in one case and microcephaly with delayed cortical maturation at 5 months in the other. Conclusions Apparently isolated oCSP at mid‐pregnancy is a transient finding with the visualization of the fluid later in pregnancy in up to 70% of cases. At referral, associated defects can be found in around 11% of cases at ultrasound and 8% at fetal MRI indicating the need for a detailed evaluation by expert physicians when oCSP is suspected.
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spelling doaj-art-324c6d3f00484c0da50c5e401ddb62dc2025-08-20T02:09:34ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-06-01102674475010.1111/aogs.14575Obliterated cavum septi pellucidi: Clinical significance and role of fetal magnetic resonanceIlaria Fantasia0Claudia Ciardo1Gabriella Bracalente2Elisa Filippi3Flora Maria Murru4Anita Spezzacatene5Maura Bin6Olivia Mendez Quintero7Elisa Montaguti8Christoph Lees9Katherine Papanikolaou10Gianluigi Pilu11Federico Prefumo12Baskaran Thilaganathan13Tamara Stampalija14Unit of Fetal Medicine, Institute for Maternal and Child Health IRCCS “Burlo Garofolo” Trieste ItalyDepartment of Gynecology and Obstetrics Ospedale Fracastoro San Bonifacio ItalyUOC Gynecology and Obstetrics Ospedale Cà Foncello Treviso Treviso ItalyUOC Gynecology and Obstetrics Ospedale Cà Foncello Treviso Treviso ItalyRadiology Service, Institute for Maternal and Child Health IRCCS “Burlo Garofolo” Trieste ItalyRadiology Service, Institute for Maternal and Child Health IRCCS “Burlo Garofolo” Trieste ItalyDivision of Child Neurology and Psychiatry, Institute for Maternal and Child Health IRCCS “Burlo Garofolo” Trieste ItalyFetal Medicine Unit Saint George's Hospital London UKObstetric Unit IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna ItalyCentre for Fetal Care, Queen Charlotte's & Chelsea Hospital Imperial College Healthcare NHS Trust London UKCentre for Fetal Care, Queen Charlotte's & Chelsea Hospital Imperial College Healthcare NHS Trust London UKObstetric Unit IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna ItalyObstetrics and Gynecology Unit IRCCS Istituto Giannina Gaslini Genoa ItalyFetal Medicine Unit Saint George's Hospital London UKUnit of Fetal Medicine, Institute for Maternal and Child Health IRCCS “Burlo Garofolo” Trieste ItalyAbstract Introduction The objective of this study was to describe a cohort of fetuses with an ultrasound prenatal diagnosis of obliterated cavum septi pellucidi (oCSP) with the aim to explore the rate of associated malformations, the progression during pregnancy and the role of fetal magnetic resonance imaging (MRI). Material and methods This was a retrospective multicenter international study of fetuses diagnosed with oCSP in the second trimester with available fetal MRI and subsequent ultrasound and/or fetal MRI follow‐up in the third trimester. Where available, postnatal data were collected to obtain information on neurodevelopment. Results We identified 45 fetuses with oCSP at 20.5 weeks (interquartile range 20.1–21.1). oCSP was apparently isolated at ultrasound in 89% (40/45) and fetal MRI found additional findings in 5% (2/40) of cases, including polymicrogyria and microencephaly. In the remaining 38 fetuses, fetal MRI found a variable amount of fluid in CSP in 74% (28/38) and no fluid in 26% (10/38). Ultrasound follow‐up at or after 30 weeks confirmed the diagnosis of oCSP in 32% (12/38) while fluid was visible in 68% (26/38). At follow‐up MRI, performed in eight pregnancies, there were periventricular cysts and delayed sulcation with persistent oCSP in one case. Among the remaining cases with normal follow‐up ultrasound and fetal MRI findings, the postnatal outcome was normal in 89% of cases (33/37) and abnormal in 11% (4/37): two with isolated speech delay, and two with neurodevelopmental delay secondary to postnatal diagnosis of Noonan syndrome at 5 years in one case and microcephaly with delayed cortical maturation at 5 months in the other. Conclusions Apparently isolated oCSP at mid‐pregnancy is a transient finding with the visualization of the fluid later in pregnancy in up to 70% of cases. At referral, associated defects can be found in around 11% of cases at ultrasound and 8% at fetal MRI indicating the need for a detailed evaluation by expert physicians when oCSP is suspected.https://doi.org/10.1111/aogs.14575cavum septi pellucidifetal brainfetal magnetic resonanceneurosonographypostnatal neurodevelopmental outcome
spellingShingle Ilaria Fantasia
Claudia Ciardo
Gabriella Bracalente
Elisa Filippi
Flora Maria Murru
Anita Spezzacatene
Maura Bin
Olivia Mendez Quintero
Elisa Montaguti
Christoph Lees
Katherine Papanikolaou
Gianluigi Pilu
Federico Prefumo
Baskaran Thilaganathan
Tamara Stampalija
Obliterated cavum septi pellucidi: Clinical significance and role of fetal magnetic resonance
Acta Obstetricia et Gynecologica Scandinavica
cavum septi pellucidi
fetal brain
fetal magnetic resonance
neurosonography
postnatal neurodevelopmental outcome
title Obliterated cavum septi pellucidi: Clinical significance and role of fetal magnetic resonance
title_full Obliterated cavum septi pellucidi: Clinical significance and role of fetal magnetic resonance
title_fullStr Obliterated cavum septi pellucidi: Clinical significance and role of fetal magnetic resonance
title_full_unstemmed Obliterated cavum septi pellucidi: Clinical significance and role of fetal magnetic resonance
title_short Obliterated cavum septi pellucidi: Clinical significance and role of fetal magnetic resonance
title_sort obliterated cavum septi pellucidi clinical significance and role of fetal magnetic resonance
topic cavum septi pellucidi
fetal brain
fetal magnetic resonance
neurosonography
postnatal neurodevelopmental outcome
url https://doi.org/10.1111/aogs.14575
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