[The ethics of fetal myelomeningocele surgery]
Jouannic, J-M; Guilbaud, L; Maurice, P; Maisonneuve, E; de Saint Denis, T; du Peuty, C; Zerah, M
In: Gynecol Obstet Fertil Senol, vol. 50, no. 2, pp. 189–193, 2022, ISSN: 2468-7189.
@article{pmid34656790,
title = {[The ethics of fetal myelomeningocele surgery]},
author = {J-M Jouannic and L Guilbaud and P Maurice and E Maisonneuve and T de Saint Denis and C du Peuty and M Zerah},
doi = {10.1016/j.gofs.2021.10.006},
issn = {2468-7189},
year = {2022},
date = {2022-02-01},
journal = {Gynecol Obstet Fertil Senol},
volume = {50},
number = {2},
pages = {189--193},
abstract = {Fetal myelomeningocele surgery was introduced in France in 2014. Developments in prenatal diagnosis of neural tube defects have accompanied the development of prenatal diagnosis. This fetal surgery represents one of the three possible care paths for pregnant women faced with this prenatal diagnosis. The ethical issues of this fetal surgery are discussed and in particular regarding prenatal counselling and patient autonomy of choice.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Fetal myelomeningocele surgery was introduced in France in 2014. Developments in prenatal diagnosis of neural tube defects have accompanied the development of prenatal diagnosis. This fetal surgery represents one of the three possible care paths for pregnant women faced with this prenatal diagnosis. The ethical issues of this fetal surgery are discussed and in particular regarding prenatal counselling and patient autonomy of choice.
Guilbaud, Lucie; Dugas, Anaïs; Weber, Mathilde; Deflers, Carole; Lallemant, Pauline; Lilin, Thomas; Adam, Clovis; Cras, Audrey; Mebarki, Miryam; Zérah, Michel; Faivre, Lionel; Larghero, Jérôme; Jouannic, Jean-Marie
In: Curr Res Transl Med, vol. 70, no. 1, pp. 103314, 2022, ISSN: 2452-3186.
@article{pmid34731725,
title = {In utero treatment of myelomeningocele with allogenic umbilical cord-derived mesenchymal stromal cells in an ovine model},
author = {Lucie Guilbaud and Anaïs Dugas and Mathilde Weber and Carole Deflers and Pauline Lallemant and Thomas Lilin and Clovis Adam and Audrey Cras and Miryam Mebarki and Michel Zérah and Lionel Faivre and Jérôme Larghero and Jean-Marie Jouannic},
doi = {10.1016/j.retram.2021.103314},
issn = {2452-3186},
year = {2022},
date = {2022-01-01},
journal = {Curr Res Transl Med},
volume = {70},
number = {1},
pages = {103314},
abstract = {PURPOSE OF THE STUDY: The purpose of our study was to investigate the effects of ovine umbilical cord-derived mesenchymal stromal cells (UC-MSCs) seeded in a fibrin patch as an adjuvant therapy for fetal myelomeningocele repair in the ovine model.nnMATERIALS AND METHODS: MMC defects were surgically created at 75 days of gestation and repaired 15 days later with UC-MSCs patch or an acellular patch. At birth, motor function, tail movements, and voiding abilities were recorded. Histological and immunohistochemical analysis included study of MMC defect's healing, spinal cord, UC-MSCs survival, and screening for tumors.nnRESULTS: Six lambs were born alive in each group. There was no difference between the two groups on the median sheep locomotor rating score but all lambs in the control group had a score between lower than 3 compared to 50% in UC-MSCs group. There were more lambs with tail movements and voiding ability in UC-MSCs group (83% vs 0% and 50% vs 0%, respectively). gray matter area and large neurons density were higher in UC-MSCs group (2.5 vs 0.8 mm and 19.3 vs 1.6 neurons/mm of gray matter, respectively). Fibrosis thickness at the myelomeningocele scar level was reduced in UC-MSCs group (1269 µm vs 2624 µm). No tumors were observed.nnCONCLUSION: Fetal repair of myelomeningocele using allogenic UC-MSCs patch provides a moderate improvement in neurological functions, gray matter and neuronal preservation and prevented from fibrosis development at the myelomeningocele scar level.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE OF THE STUDY: The purpose of our study was to investigate the effects of ovine umbilical cord-derived mesenchymal stromal cells (UC-MSCs) seeded in a fibrin patch as an adjuvant therapy for fetal myelomeningocele repair in the ovine model.nnMATERIALS AND METHODS: MMC defects were surgically created at 75 days of gestation and repaired 15 days later with UC-MSCs patch or an acellular patch. At birth, motor function, tail movements, and voiding abilities were recorded. Histological and immunohistochemical analysis included study of MMC defect’s healing, spinal cord, UC-MSCs survival, and screening for tumors.nnRESULTS: Six lambs were born alive in each group. There was no difference between the two groups on the median sheep locomotor rating score but all lambs in the control group had a score between lower than 3 compared to 50% in UC-MSCs group. There were more lambs with tail movements and voiding ability in UC-MSCs group (83% vs 0% and 50% vs 0%, respectively). gray matter area and large neurons density were higher in UC-MSCs group (2.5 vs 0.8 mm and 19.3 vs 1.6 neurons/mm of gray matter, respectively). Fibrosis thickness at the myelomeningocele scar level was reduced in UC-MSCs group (1269 µm vs 2624 µm). No tumors were observed.nnCONCLUSION: Fetal repair of myelomeningocele using allogenic UC-MSCs patch provides a moderate improvement in neurological functions, gray matter and neuronal preservation and prevented from fibrosis development at the myelomeningocele scar level.
Langlais, T; Vergari, C; Xavier, F; Hawsawi, M Al; Gajny, L; Vialle, R; Skalli, W; Pietton, R
In: Med Eng Phys, vol. 99, pp. 103735, 2022, ISSN: 1873-4030.
@article{pmid35058028,
title = {3D quasi-automatic spine length assessment using low dose biplanar radiography after surgical correction in thoracic idiopathic scoliosis},
author = {T Langlais and C Vergari and F Xavier and M Al Hawsawi and L Gajny and R Vialle and W Skalli and R Pietton},
doi = {10.1016/j.medengphy.2021.103735},
issn = {1873-4030},
year = {2022},
date = {2022-01-01},
journal = {Med Eng Phys},
volume = {99},
pages = {103735},
abstract = {OBJECTIVE: Surgical correction of thoracic scoliosis leads to a height improvement. Our objectives were to assess how the linear and developed spinal column lengths relate to the frontal and sagittal parameters after a surgical correction of thoracic idiopathic scoliosis, and whether the measurement of these lengths is reliable using quasi-automatic 3D reconstruction methods with biplanar X-rays.nnMETHODS: Consecutive children with thoracic idiopathic scoliosis who underwent spinal fusion surgery and biplanar pre and postoperative X-rays in free-standing position were included prospectively. Quasi-automatic computed 3D reconstructions of the spine were done using a previously validated technique and allowed the automatic computation of geometrical spinopelvic parameters including OD-pelvis, linear, and developed T1-T12 and T1-L5 lengths.nnRESULTS: Thirty patients with scoliosis were included, and 240 reconstructions were performed (2 operators x2 repetitions x30 patients pre and postoperative). The main thoracic Cobb angle, T1-T12, T1-L5 linear and developed distance, OD-pelvis were significantly improved (p < 0.001). The gain of the main thoracic Cobb angle (31.6°;SD = 9°) was correlated to the gain of the linear distance T1-T12 (15.3 mm;SD=7.3 mm)(rho = 0.76;p < 0.0001) and T1-L5 (24.7 mm;SD = 8 mm)(rho = 0.64;p < 0.0001). The postoperative change of developed length between T1-L5 represented 41% of the gain in linear distance between the same vertebrae. Similarly, the gain of T1-T12 developed length was 50% of linear T1-T12 height gain. Both differences were significant (p = 0.01). Absolute bias using Bland & Altman plots was lower than 1 mm for linear distance (0.1%) and lower than 2 mm (0.3%) for developed distance.nnCONCLUSION: The gain in spinal length is correlated to the thoracic Cobb angle correction in the surgical treatment of idiopathic thoracic scoliosis. The new significant finding is that the developed spinal height gain represented approximately a little less than 50% of the linear spinal height gain and these parameters were reliable from a 3D quasi-automatic reconstruction of biplanar X-ray.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: Surgical correction of thoracic scoliosis leads to a height improvement. Our objectives were to assess how the linear and developed spinal column lengths relate to the frontal and sagittal parameters after a surgical correction of thoracic idiopathic scoliosis, and whether the measurement of these lengths is reliable using quasi-automatic 3D reconstruction methods with biplanar X-rays.nnMETHODS: Consecutive children with thoracic idiopathic scoliosis who underwent spinal fusion surgery and biplanar pre and postoperative X-rays in free-standing position were included prospectively. Quasi-automatic computed 3D reconstructions of the spine were done using a previously validated technique and allowed the automatic computation of geometrical spinopelvic parameters including OD-pelvis, linear, and developed T1-T12 and T1-L5 lengths.nnRESULTS: Thirty patients with scoliosis were included, and 240 reconstructions were performed (2 operators x2 repetitions x30 patients pre and postoperative). The main thoracic Cobb angle, T1-T12, T1-L5 linear and developed distance, OD-pelvis were significantly improved (p < 0.001). The gain of the main thoracic Cobb angle (31.6°;SD = 9°) was correlated to the gain of the linear distance T1-T12 (15.3 mm;SD=7.3 mm)(rho = 0.76;p < 0.0001) and T1-L5 (24.7 mm;SD = 8 mm)(rho = 0.64;p < 0.0001). The postoperative change of developed length between T1-L5 represented 41% of the gain in linear distance between the same vertebrae. Similarly, the gain of T1-T12 developed length was 50% of linear T1-T12 height gain. Both differences were significant (p = 0.01). Absolute bias using Bland & Altman plots was lower than 1 mm for linear distance (0.1%) and lower than 2 mm (0.3%) for developed distance.nnCONCLUSION: The gain in spinal length is correlated to the thoracic Cobb angle correction in the surgical treatment of idiopathic thoracic scoliosis. The new significant finding is that the developed spinal height gain represented approximately a little less than 50% of the linear spinal height gain and these parameters were reliable from a 3D quasi-automatic reconstruction of biplanar X-ray.
Pietton, Raphaël; Bouloussa, Houssam; Langlais, Tristan; Taytard, Jessica; Beydon, Nicole; Skalli, Wafa; Vergari, Claudio; Vialle, Raphaël
In: Bone Joint J, vol. 104-B, no. 1, pp. 112–119, 2022, ISSN: 2049-4408.
@article{pmid34969276,
title = {Estimating pulmonary function after surgery for adolescent idiopathic scoliosis using biplanar radiographs of the chest with 3D reconstruction},
author = {Raphaël Pietton and Houssam Bouloussa and Tristan Langlais and Jessica Taytard and Nicole Beydon and Wafa Skalli and Claudio Vergari and Raphaël Vialle},
doi = {10.1302/0301-620X.104B1.BJJ-2021-0337.R2},
issn = {2049-4408},
year = {2022},
date = {2022-01-01},
journal = {Bone Joint J},
volume = {104-B},
number = {1},
pages = {112--119},
abstract = {AIMS: This study addressed two questions: first, does surgical correction of an idiopathic scoliosis increase the volume of the rib cage, and second, is it possible to evaluate the change in lung function after corrective surgery for adolescent idiopathic scoliosis (AIS) using biplanar radiographs of the ribcage with 3D reconstruction?nnMETHODS: A total of 45 patients with a thoracic AIS which needed surgical correction and fusion were included in a prospective study. All patients underwent pulmonary function testing (PFT) and low-dose biplanar radiographs both preoperatively and one year after surgery. The following measurements were recorded: forced vital capacity (FVC), slow vital capacity (SVC), and total lung capacity (TLC). Rib cage volume (RCV), maximum rib hump, main thoracic curve Cobb angle (MCCA), medial-lateral and anteroposterior diameter, and T4-T12 kyphosis were calculated from 3D reconstructions of the biplanar radiographs.nnRESULTS: All spinal and thoracic measurements improved significantly after surgery (p < 0.001). RCV increased from 4.9 l (SD 1) preoperatively to 5.3 l (SD 0.9) (p < 0.001) while TLC increased from 4.1 l (SD 0.9) preoperatively to 4.3 l (SD 0.8) (p < 0.001). RCV was correlated with all functional indexes before and after correction of the deformity. Improvement in RCV was weakly correlated with correction of the mean thoracic Cobb angle (p = 0.006). The difference in TLC was significantly correlated with changes in RCV (p = 0.041). It was possible to predict postoperative TLC from the postoperative RCV.nnCONCLUSION: 3D rib cage assessment from biplanar radiographs could be a minimally invasive method of estimating pulmonary function before and after spinal fusion in patients with an AIS. The 3D RCV reflects virtual chest capacity and hence pulmonary function in this group of patients. Cite this article: 2022;104-B(1):112-119.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
AIMS: This study addressed two questions: first, does surgical correction of an idiopathic scoliosis increase the volume of the rib cage, and second, is it possible to evaluate the change in lung function after corrective surgery for adolescent idiopathic scoliosis (AIS) using biplanar radiographs of the ribcage with 3D reconstruction?nnMETHODS: A total of 45 patients with a thoracic AIS which needed surgical correction and fusion were included in a prospective study. All patients underwent pulmonary function testing (PFT) and low-dose biplanar radiographs both preoperatively and one year after surgery. The following measurements were recorded: forced vital capacity (FVC), slow vital capacity (SVC), and total lung capacity (TLC). Rib cage volume (RCV), maximum rib hump, main thoracic curve Cobb angle (MCCA), medial-lateral and anteroposterior diameter, and T4-T12 kyphosis were calculated from 3D reconstructions of the biplanar radiographs.nnRESULTS: All spinal and thoracic measurements improved significantly after surgery (p < 0.001). RCV increased from 4.9 l (SD 1) preoperatively to 5.3 l (SD 0.9) (p < 0.001) while TLC increased from 4.1 l (SD 0.9) preoperatively to 4.3 l (SD 0.8) (p < 0.001). RCV was correlated with all functional indexes before and after correction of the deformity. Improvement in RCV was weakly correlated with correction of the mean thoracic Cobb angle (p = 0.006). The difference in TLC was significantly correlated with changes in RCV (p = 0.041). It was possible to predict postoperative TLC from the postoperative RCV.nnCONCLUSION: 3D rib cage assessment from biplanar radiographs could be a minimally invasive method of estimating pulmonary function before and after spinal fusion in patients with an AIS. The 3D RCV reflects virtual chest capacity and hence pulmonary function in this group of patients. Cite this article: 2022;104-B(1):112-119.
Open fetal surgery for myelomeningocele repair in France
Guilbaud, Lucie; Maurice, Paul; Lallemant, Pauline; Saint-Denis, Timothée De; Maisonneuve, Emeline; Dhombres, Ferdinand; Friszer, Stéphanie; Rocco, Federico Di; Garel, Catherine; Moutard, Marie-Laure; Lachtar, Mohamed-Ali; Rigouzzo, Agnès; Forin, Véronique; Zérah, Michel; Jouannic, Jean-Marie
In: J Gynecol Obstet Hum Reprod, vol. 50, no. 9, pp. 102155, 2021, ISSN: 2468-7847.
@article{pmid33915336,
title = {Open fetal surgery for myelomeningocele repair in France},
author = {Lucie Guilbaud and Paul Maurice and Pauline Lallemant and Timothée De Saint-Denis and Emeline Maisonneuve and Ferdinand Dhombres and Stéphanie Friszer and Federico Di Rocco and Catherine Garel and Marie-Laure Moutard and Mohamed-Ali Lachtar and Agnès Rigouzzo and Véronique Forin and Michel Zérah and Jean-Marie Jouannic},
doi = {10.1016/j.jogoh.2021.102155},
issn = {2468-7847},
year = {2021},
date = {2021-11-01},
journal = {J Gynecol Obstet Hum Reprod},
volume = {50},
number = {9},
pages = {102155},
abstract = {INTRODUCTION: Open fetal myelomeningocele (MMC) surgery is currently the standard of care option for prenatal MMC repair. We described the population referred to our center and reviewed outcome after open fetal MMC repair.nnMATERIAL AND METHODS: All patients referred to our center for MMC were reviewed from July 2014 to June 2020. For all the patients who underwent fetal MMC repair, surgical details, maternal characteristics and data from the neonatal to the three-years-old evaluations were collected.nnRESULTS: Among the 126 patients referred to our center, 49.2% were eligible and 27.4% (n = 17) of them underwent fetal MMC repair. Average gestational age at fetal surgery was 24 weeks. There was no case of fetal complication and the only maternal complication was one case of transfusion. We recorded 70% of premature rupture of membranes and 47% of premature labor. Average gestational age at delivery was 34 weeks and no patient delivered before 30 weeks. There was no case of uterine scar dehiscence or maternal complication during cesarean section. After birth, 59% of the children had a hindbrain herniation reversal. At 1-year-old, 42% were assigned a functional level of one or more better than expected according to the prenatal anatomic level and 25% required a ventriculoperitoneal shunt. At 3-year-old, all the children attended school and 75% were able to walk with orthotics or independently.nnCONCLUSION: Open fetal surgery enables anatomical repair of the MMC lesion, a potential benefit on cerebral anomalies and motor function, with a low rate of perinatal and maternal complications.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Open fetal myelomeningocele (MMC) surgery is currently the standard of care option for prenatal MMC repair. We described the population referred to our center and reviewed outcome after open fetal MMC repair.nnMATERIAL AND METHODS: All patients referred to our center for MMC were reviewed from July 2014 to June 2020. For all the patients who underwent fetal MMC repair, surgical details, maternal characteristics and data from the neonatal to the three-years-old evaluations were collected.nnRESULTS: Among the 126 patients referred to our center, 49.2% were eligible and 27.4% (n = 17) of them underwent fetal MMC repair. Average gestational age at fetal surgery was 24 weeks. There was no case of fetal complication and the only maternal complication was one case of transfusion. We recorded 70% of premature rupture of membranes and 47% of premature labor. Average gestational age at delivery was 34 weeks and no patient delivered before 30 weeks. There was no case of uterine scar dehiscence or maternal complication during cesarean section. After birth, 59% of the children had a hindbrain herniation reversal. At 1-year-old, 42% were assigned a functional level of one or more better than expected according to the prenatal anatomic level and 25% required a ventriculoperitoneal shunt. At 3-year-old, all the children attended school and 75% were able to walk with orthotics or independently.nnCONCLUSION: Open fetal surgery enables anatomical repair of the MMC lesion, a potential benefit on cerebral anomalies and motor function, with a low rate of perinatal and maternal complications.
Papaioannou, Georgia; Klein, Willemijn; Cassart, Marie; Garel, Catherine
In: Pediatr Radiol, vol. 51, no. 11, pp. 2105–2114, 2021, ISSN: 1432-1998.
@article{pmid34137935,
title = {Indications for magnetic resonance imaging of the fetal central nervous system: recommendations from the European Society of Paediatric Radiology Fetal Task Force},
author = {Georgia Papaioannou and Willemijn Klein and Marie Cassart and Catherine Garel},
doi = {10.1007/s00247-021-05104-w},
issn = {1432-1998},
year = {2021},
date = {2021-10-01},
journal = {Pediatr Radiol},
volume = {51},
number = {11},
pages = {2105--2114},
abstract = {Fetal central nervous system MRI is a well-established method to complement a high-quality fetal ultrasound and to clarify sonographically detected abnormalities in complex pregnancies. However, there is still worldwide heterogeneity and confusion regarding the indications of fetal central nervous system MRI, which has roots in differences among countries regarding the performance of ultrasound examinations and legislation on pregnancy termination. The purpose of this article is to clarify the indications for fetal central nervous system MRI by focusing on the ultrasound findings that guide further investigation with MRI and highlight the strengths and the weaknesses of each modality on imaging the fetal central nervous system.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Fetal central nervous system MRI is a well-established method to complement a high-quality fetal ultrasound and to clarify sonographically detected abnormalities in complex pregnancies. However, there is still worldwide heterogeneity and confusion regarding the indications of fetal central nervous system MRI, which has roots in differences among countries regarding the performance of ultrasound examinations and legislation on pregnancy termination. The purpose of this article is to clarify the indications for fetal central nervous system MRI by focusing on the ultrasound findings that guide further investigation with MRI and highlight the strengths and the weaknesses of each modality on imaging the fetal central nervous system.
Langlais, Tristan; Vergari, Claudio; Rougereau, Grégoire; Gajny, Laurent; Assi, Ayman; Ghanem, Ismat; Dubousset, Jean; Vialle, Raphaël; Pietton, Raphaël; Skalli, Wafa
In: Med Eng Phys, vol. 94, pp. 33–40, 2021, ISSN: 1873-4030.
@article{pmid34303499,
title = {Balance, barycentremetry and external shape analysis in idiopathic scoliosis: What can the physician expect from it?},
author = {Tristan Langlais and Claudio Vergari and Grégoire Rougereau and Laurent Gajny and Ayman Assi and Ismat Ghanem and Jean Dubousset and Raphaël Vialle and Raphaël Pietton and Wafa Skalli},
doi = {10.1016/j.medengphy.2021.06.004},
issn = {1873-4030},
year = {2021},
date = {2021-08-01},
journal = {Med Eng Phys},
volume = {94},
pages = {33--40},
abstract = {OBJECTIVE: Our objective was to establish a corridor of normality for the external shape 3D parameters and then to assess these variables in adolescent idiopathic scoliosis (AIS).nnMETHODS: Adolescent with mild and severe AIS were included prospectively, as well as a control group of asymptomatic subjects. A quasi-automatic 3D reconstruction of the spine and manual 3D reconstruction of the external envelope was performed from biplanar radiography. The center of mass position, the axial intersegmental moment resulting at the apex and junctional vertebrae, and the coronal trunk balance were automatically computed. A normality corridor of asymptomatic subjects was calculated as the range [5-95 percentiles] for external shape parameters at each vertebral level.nnRESULTS: Forty-one asymptomatic subjects (19 females; 22 males; 21 yo, SD=4) and sixty AIS (56 females; 4 males; 13 years old, SD=1.9; 30 mild and 30 severe; 34 thoracic curves and 26 thoraco-lumbar or lumbar curves) were included. All parameters based on the external shape showed differences between AIS and controls, as well as between mild and severe scoliosis. For instance, the intersegmental moment applied to the upper junctional vertebra was above the 95 percentile of controls in 70% of AIS patient. The percentage of severe patients showing parameters higher than the normality corridor was significantly higher than mild patients (p<0.0001).nnCONCLUSIONS: The analysis of center of mass, vertebral intersegmental moment and coronal trunk balance parameters appear to be relevant in characterizing the 3D deformity of adolescent idiopathic scoliosis. The upper junctional intersegmental moment seems to be able to distinguish the different stages of curvature severity.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: Our objective was to establish a corridor of normality for the external shape 3D parameters and then to assess these variables in adolescent idiopathic scoliosis (AIS).nnMETHODS: Adolescent with mild and severe AIS were included prospectively, as well as a control group of asymptomatic subjects. A quasi-automatic 3D reconstruction of the spine and manual 3D reconstruction of the external envelope was performed from biplanar radiography. The center of mass position, the axial intersegmental moment resulting at the apex and junctional vertebrae, and the coronal trunk balance were automatically computed. A normality corridor of asymptomatic subjects was calculated as the range [5-95 percentiles] for external shape parameters at each vertebral level.nnRESULTS: Forty-one asymptomatic subjects (19 females; 22 males; 21 yo, SD=4) and sixty AIS (56 females; 4 males; 13 years old, SD=1.9; 30 mild and 30 severe; 34 thoracic curves and 26 thoraco-lumbar or lumbar curves) were included. All parameters based on the external shape showed differences between AIS and controls, as well as between mild and severe scoliosis. For instance, the intersegmental moment applied to the upper junctional vertebra was above the 95 percentile of controls in 70% of AIS patient. The percentage of severe patients showing parameters higher than the normality corridor was significantly higher than mild patients (p<0.0001).nnCONCLUSIONS: The analysis of center of mass, vertebral intersegmental moment and coronal trunk balance parameters appear to be relevant in characterizing the 3D deformity of adolescent idiopathic scoliosis. The upper junctional intersegmental moment seems to be able to distinguish the different stages of curvature severity.
Perre, Saskia Vande; Guilbaud, Lucie; de Saint-Denis, Timothée; Maurice, Paul; Lallemant-Dudek, Pauline; Maisonneuve, Emeline; Dhombres, Ferdinand; Blondiaux, Eléonore; le Pointe, Hubert Ducou; Zerah, Michel; Jouannic, Jean-Marie; Garel, Catherine
In: Fetal Diagn Ther, vol. 48, no. 9, pp. 690–700, 2021, ISSN: 1421-9964.
@article{pmid34814137,
title = {The Myelic Limited Dorsal Malformation: Prenatal Ultrasonographic Characteristics of an Intermediate Form of Dysraphism},
author = {Saskia Vande Perre and Lucie Guilbaud and Timothée de Saint-Denis and Paul Maurice and Pauline Lallemant-Dudek and Emeline Maisonneuve and Ferdinand Dhombres and Eléonore Blondiaux and Hubert Ducou le Pointe and Michel Zerah and Jean-Marie Jouannic and Catherine Garel},
doi = {10.1159/000519060},
issn = {1421-9964},
year = {2021},
date = {2021-01-01},
journal = {Fetal Diagn Ther},
volume = {48},
number = {9},
pages = {690--700},
abstract = {OBJECTIVES: The aim of the study was to report a subtype of dysraphism designated as myelic limited dorsal malformation (MyeLDM) and to describe its characteristics at prenatal ultrasound (US).nnMETHODS: It was a retrospective study from 2014 to 2020 based on second-line US evaluation of patients referred to our institution for myelomeningocele (MMC). Magnetic resonance imaging and acetylcholine esterase evaluation in the amniotic fluid were also offered. Major and minor criteria for open and closed dysraphism were defined and recorded for each patient. Patients were included as MyeLDM when both criteria of closed and open dysraphism were observed in the same fetus. Correlations were obtained with the postpartum data.nnRESULTS: Twenty patients fulfilled the inclusion criteria, some of them being very close to MMC, others very close to limited dorsal myeloschisis (LDM), and others lying in between. There were 13 live-born neonates and 7 terminations of pregnancy. Correlations between prenatal and postpartum data were overall very good.nnCONCLUSION: Our series describe the ultrasonographic characteristics of an intermediate type of dysraphism and suggest that there is a continuum between MMC and LDM with numerous possibilities of hybrid forms (MyeLDM) sharing characteristics of both open and closed dysraphisms.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: The aim of the study was to report a subtype of dysraphism designated as myelic limited dorsal malformation (MyeLDM) and to describe its characteristics at prenatal ultrasound (US).nnMETHODS: It was a retrospective study from 2014 to 2020 based on second-line US evaluation of patients referred to our institution for myelomeningocele (MMC). Magnetic resonance imaging and acetylcholine esterase evaluation in the amniotic fluid were also offered. Major and minor criteria for open and closed dysraphism were defined and recorded for each patient. Patients were included as MyeLDM when both criteria of closed and open dysraphism were observed in the same fetus. Correlations were obtained with the postpartum data.nnRESULTS: Twenty patients fulfilled the inclusion criteria, some of them being very close to MMC, others very close to limited dorsal myeloschisis (LDM), and others lying in between. There were 13 live-born neonates and 7 terminations of pregnancy. Correlations between prenatal and postpartum data were overall very good.nnCONCLUSION: Our series describe the ultrasonographic characteristics of an intermediate type of dysraphism and suggest that there is a continuum between MMC and LDM with numerous possibilities of hybrid forms (MyeLDM) sharing characteristics of both open and closed dysraphisms.
[The paradoxes of spina bifida in the prenatal period]
Guilbaud, L; Zerah, M; Jouannic, J-M; Quarello, E
2021, ISSN: 2468-7189.
@misc{pmid33989830,
title = {[The paradoxes of spina bifida in the prenatal period]},
author = {L Guilbaud and M Zerah and J-M Jouannic and E Quarello},
doi = {10.1016/j.gofs.2021.05.002},
issn = {2468-7189},
year = {2021},
date = {2021-01-01},
journal = {Gynecol Obstet Fertil Senol},
volume = {49},
number = {7-8},
pages = {569--572},
keywords = {},
pubstate = {published},
tppubtype = {misc}
}
Pietton, Raphaël; David, Mercedes; Hisaund, Alisa; Langlais, Tristan; Skalli, Wafa; Vialle, Raphaël; Vergari, Claudio
In: Ultrasound Med Biol, vol. 47, no. 1, pp. 51–57, 2021, ISSN: 1879-291X.
@article{pmid33077337,
title = {Biomechanical Evaluation of Intercostal Muscles in Healthy Children and Adolescent Idiopathic Scoliosis: A Preliminary Study},
author = {Raphaël Pietton and Mercedes David and Alisa Hisaund and Tristan Langlais and Wafa Skalli and Raphaël Vialle and Claudio Vergari},
doi = {10.1016/j.ultrasmedbio.2020.09.011},
issn = {1879-291X},
year = {2021},
date = {2021-01-01},
journal = {Ultrasound Med Biol},
volume = {47},
number = {1},
pages = {51--57},
abstract = {Spine deformity during adolescent idiopathic scoliosis can induce a rib-cage deformity. This bone deformity can have direct consequences on the chest-wall muscles, including intercostal muscles, leading to respiratory impairments in individuals with severe cases. The aim of this study was to determine whether shear-wave elastography can be used to measure intercostal-muscle shear-wave speed (SWS) in healthy children and those with adolescent idiopathic scoliosis (AIS). Nineteen healthy participants and 16 with AIS took part. SWS measurements were taken by three operators, twice each. Average SWS was 2.3 ± 0.4 m/s, and inter-operator reproducibility was 0.2 m/s. SWS was significantly higher during apnea than in normal breathing (p < 0.01) in both groups. No significant difference was observed between groups in apnea or in normal breathing. Characterization of the intercostal muscles by ultrasound elastography is therefore feasible and reliable for children and adolescents with and without scoliosis.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Spine deformity during adolescent idiopathic scoliosis can induce a rib-cage deformity. This bone deformity can have direct consequences on the chest-wall muscles, including intercostal muscles, leading to respiratory impairments in individuals with severe cases. The aim of this study was to determine whether shear-wave elastography can be used to measure intercostal-muscle shear-wave speed (SWS) in healthy children and those with adolescent idiopathic scoliosis (AIS). Nineteen healthy participants and 16 with AIS took part. SWS measurements were taken by three operators, twice each. Average SWS was 2.3 ± 0.4 m/s, and inter-operator reproducibility was 0.2 m/s. SWS was significantly higher during apnea than in normal breathing (p < 0.01) in both groups. No significant difference was observed between groups in apnea or in normal breathing. Characterization of the intercostal muscles by ultrasound elastography is therefore feasible and reliable for children and adolescents with and without scoliosis.