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Pediatr Radiol (2012) 42:886890 DOI 10.1007/s00247-011-2260-7
CASE REPORT
Thick corpus callosum: a clue to the diagnosis of fetal septopreoptic holoprosencephaly?
Mriam Koob & Anne-sophie Weingertner &
Bernard Gasser & Estanislao Oubel &
Jean-Louis Dietemann
Received: 11 April 2011 /Revised: 12 July 2011 /Accepted: 4 September 2011 /Published online: 18 October 2011 # Springer-Verlag 2011
Abstract We describe fetal septopreoptic holoprosencephaly (HPE) associated with a thick corpus callosum (CC) diagnosed with MRI in a fetus at 31 weeks gestation. Our report supports a recently published study connecting a thick fetal CC to other brain abnormalities. On diffusion tensor imaging (DTI), the body of the CC contained an abnormal longitudinal bundle, presumed to be a congenital heterotopic cingulum. Prenatal and postmortem brain MRI with DTI, CT, and pathological analyses are described and illustrated.
Keywords Corpus callosum . Fetus . Holoprosencephaly.
Diffusion tensor imaging
Introduction
Fetal corpus callosum agenesis is the most frequent brain malformation observed in utero by US and MRI. Conversely, a thick corpus callosum (CC) is very rarely reported in prenatal imaging [1]. Recently, nine cases of thick fetal CC have been reported, all associated with other brain abnormalities [2]. We describe a further case of a thick CC in a fetus at 31 weeks gestation. There was associated septopreoptic holoprosencephaly (HPE), a recently described milder form of lobar HPE [3]. Fetal and postmortem MRI with diffusion tensor imaging (DTI), CT, and neuropatho-logical analysis were performed. DTI showed that an abnormal longitudinal bundle presumed to be a heterotopic congenital cingulum [2, 4], was responsible for the thickening of the body of the CC.
Case report
The male fetus was of nonconsanguineous Caucasian parents. The 26-year-old mother was a wheelchair user due to unknown neurodegenerative disease. In the first trimester, nuchal thickening (4 mm) was detected on US. Fetal karyotype was normal. At 31 weeks gestation, US showed a left labiomaxillary cleft, dextrogastria, and poor visualization of the anterior part of the CC. Fetal brain and abdominal MRI were performed on a 1.5-Tesla Siemens Avanto MRI Scanner (Siemens, Erlangen, Germany) with a combined 6-channel phase-array body and spine coil positioned over the lower pelvic area. Fetal sedation was obtained with Flunitrazepam (1 mg) given orally to the mother 30 min before the scan. Brain MRI included...