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Background <p>Prenatal diagnosis of fetal central nervous system (CNS) anomalies remains challenging and is influenced by various factors, including imaging equipment quality, and access to advanced modalities such as fetal magnetic resonance imaging (MRI). In resource-limited settings, these constraints highlight the need for practical and accessible screening methods. This study aims to evaluate the predictive value of the fetal corpus callosum length-to-head circumference (CCL/HC) and corpus callosum length-to-occipitofrontal (CCL/OFD) diameter ratios in the detection of fetal central CNS abnormalities.</p> Materials and methods <p>This prospective cohort study included 243 singleton pregnancies undergoing routine mid-trimester ultrasound between November 2024 and May 2025. 15 fetuses with CNS anomalies confirmed by fetal MRI constituted the patient group. Diagnosed anomalies included schizencephaly, lissencephaly, vermian agenesis, cerebellar hypoplasia, hydrocephalus, pachygyria, septo-optic dysplasia, and corpus callosum (CC) malformations, particularly hypoplasia. After excluding 22 cases with non-CNS anomalies, maternal diseases, or intrauterine growth restriction, 206 fetuses comprised the control group. The CCL/HC and CCL/OFD ratios were then calculated for analysis and compared between groups.</p> Results <p>A total of 221 fetuses were analyzed; CNS anomalies were confirmed in 15 of them, while 206 served as the control group. In the anomaly group, the mean corpus callosum length (CCL) was significantly shorter compared to healthy fetuses (19.27 ± 3.03&#xa0;mm vs. 23.33 ± 3.50&#xa0;mm; <i>p</i> &lt; 0.001). Both the CCL/HC and CCL/OFD ratios were significantly lower in fetuses with CNS anomalies (<i>p</i> &lt; 0.001 for both). ROC analysis showed AUC values of 0.833 for CCL/HC and 0.935 for CCL/OFD; the cutoff values were 0.0953 and 0.2658, respectively, with both ratios demonstrating high specificity (99.5%) for anomaly detection. Additionally, both ratios exhibited a moderate positive correlation with gestational age in the control group and remained within the ± 2 standard deviation limits in 97% (CCL/HC) and 95.7% (CCL/OFD) of healthy fetuses.</p> Conclusion <p>Fetal CCL/OFD and CCL/HC ratios may offer a practical method for both assessing normal CC development and identifying potential CNS anomalies.</p>

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Rethinking fetal central nervous system anomalies: predicting central nervous system anomalies with corpus callosum to head circumference and occipitofrontal diameter ratios

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Ayşe Ceren Duymuş,
  • Nizamettin Bozbay,
  • Şeyma Kılıç,
  • Osman Yıldırım,
  • Gökçen Örgül,
  • Aybike Tazegül Pekin

摘要

Background

Prenatal diagnosis of fetal central nervous system (CNS) anomalies remains challenging and is influenced by various factors, including imaging equipment quality, and access to advanced modalities such as fetal magnetic resonance imaging (MRI). In resource-limited settings, these constraints highlight the need for practical and accessible screening methods. This study aims to evaluate the predictive value of the fetal corpus callosum length-to-head circumference (CCL/HC) and corpus callosum length-to-occipitofrontal (CCL/OFD) diameter ratios in the detection of fetal central CNS abnormalities.

Materials and methods

This prospective cohort study included 243 singleton pregnancies undergoing routine mid-trimester ultrasound between November 2024 and May 2025. 15 fetuses with CNS anomalies confirmed by fetal MRI constituted the patient group. Diagnosed anomalies included schizencephaly, lissencephaly, vermian agenesis, cerebellar hypoplasia, hydrocephalus, pachygyria, septo-optic dysplasia, and corpus callosum (CC) malformations, particularly hypoplasia. After excluding 22 cases with non-CNS anomalies, maternal diseases, or intrauterine growth restriction, 206 fetuses comprised the control group. The CCL/HC and CCL/OFD ratios were then calculated for analysis and compared between groups.

Results

A total of 221 fetuses were analyzed; CNS anomalies were confirmed in 15 of them, while 206 served as the control group. In the anomaly group, the mean corpus callosum length (CCL) was significantly shorter compared to healthy fetuses (19.27 ± 3.03 mm vs. 23.33 ± 3.50 mm; p < 0.001). Both the CCL/HC and CCL/OFD ratios were significantly lower in fetuses with CNS anomalies (p < 0.001 for both). ROC analysis showed AUC values of 0.833 for CCL/HC and 0.935 for CCL/OFD; the cutoff values were 0.0953 and 0.2658, respectively, with both ratios demonstrating high specificity (99.5%) for anomaly detection. Additionally, both ratios exhibited a moderate positive correlation with gestational age in the control group and remained within the ± 2 standard deviation limits in 97% (CCL/HC) and 95.7% (CCL/OFD) of healthy fetuses.

Conclusion

Fetal CCL/OFD and CCL/HC ratios may offer a practical method for both assessing normal CC development and identifying potential CNS anomalies.