RESUMEN
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.
Asunto(s)
Relevancia Clínica , Microcefalia , Femenino , Embarazo , Humanos , Ultrasonografía Prenatal/métodos , Imagen por Resonancia Magnética/métodos , Feto/anomalías , Estudios Retrospectivos , Espectroscopía de Resonancia MagnéticaRESUMEN
OBJECTIVE: The aim of this study was to report the rate of additional anomalies detected exclusively at prenatal magnetic resonance imaging (MRI) in fetuses with isolated severe ventriculomegaly undergoing neurosonography. METHOD: Multicenter, retrospective, cohort study involving 20 referral fetal medicine centers in Italy, United Kingdom, Spain and Denmark. Inclusion criteria were fetuses affected by isolated severe ventriculomegaly (≥15 mm), defined as ventriculomegaly with normal karyotype and no other additional central nervous system (CNS) and extra-CNS anomalies on ultrasound. In all cases, a multiplanar assessment of fetal brain as suggested by ISUOG guidelines on fetal neurosonography had been performed. The primary outcome was the rate of additional CNS anomalies detected exclusively at fetal MRI within two weeks from neurosonography. Subgroup analyses according to gestational age at MRI (Asunto(s)
Hidrocefalia
, Ultrasonografía Prenatal
, Estudios de Cohortes
, Femenino
, Feto
, Humanos
, Hidrocefalia/diagnóstico por imagen
, Imagen por Resonancia Magnética
, Embarazo
, Diagnóstico Prenatal
, Estudios Retrospectivos
RESUMEN
Aqueous two-phase systems (ATPS) represent a promising strategy for the recovery of CD133(+) stem cells. This particular type of stem cells has great potential for research and clinical applications. Traditional [polyethylene glycol (PEG), dextran (DEX), and ficoll] and novel (Ucon) polymer-polymer ATPS were exploited to study the partitioning behavior of CD133(+) stem cells and contaminants from human umbilical cord blood (HUCB). The aim of the study was to select conditions under which the product of interest and the contaminants concentrate in opposite phases. To accomplish this, three independent samples were tested: (1) enriched CD133(+) sample, (2) whole HUCB (contaminants), and (3) complex sample (CD133(+) stem cells and contaminants). The objective of this research was to evaluate the partition behavior of CD133(+) in ATPS in route to establish the basis for the development of a novel and scalable purification bioprocess. In conclusion, the partitioning behavior of CD133(+) stem cells and contaminants from complex samples was as follows: 59% of CD133(+) stem cells fractionated to the top phase when employing ficoll 400,000-DEX 70,000 or 100% to the bottom phase with Ucon-DEX 75,000 and PEG 8,000-DEX 500,000 ATPS. In average, 35% of the contaminants partitioned to the top phase of the ficoll 400,000-DEX 70,000 ATPS, 99% to the dextran rich phase of the Ucon-DEX 75,000 systems and 97% to the bottom phase of the PEG 8,000-DEX 500,000. Cell viability was at least 98% after ATPS recovery.