{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T15:25:27Z","timestamp":1781191527228,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T00:00:00Z","timestamp":1684108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To develop novel fetal reference ranges for the characterization of the normal appearance of the Sylvian fissures (SF) along gestation and to apply them to fetuses with cortical abnormalities affecting the SF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cross\u2010sectional study, we used three\u2010dimensional sonographic multiplanar reformatting (3D\u2010MPR) to examine the fetal SF. Normal development was assessed in the second and third trimesters. SF parameters were evaluated in predefined axial and coronal planes: insular height and length, SF depth, and the extent of the coverage of the insula by the frontal and temporal lobes. Intra\u2010observer variability and inter\u2010rater reliability for the studied parameters were evaluated. The new reference charts were applied to 19 fetuses with cortical abnormalities involving the SF who had appropriate sonographic volumes for 3D\u2010MPR analysis. Their diagnoses were confirmed by autopsy, fetal or postnatal MRI, genetic findings related to cortical malformations, or an abnormal cortical imaging pattern with similar MRI findings in an affected sibling. We applied the two previously published references for the evaluation of fetal SF development to these cases and compared the ability of the references to correctly detect SF abnormalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 189 fetuses of low\u2010risk singleton pregnancies between 24 and 34 gestational weeks. The insular length or height increased with gestational age in the axial and coronal planes with adjusted <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.621, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001 and <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.384, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001, respectively. The SF depth also increased with gestational age in the axial and coronal planes with adjusted <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.695, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001 and <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.219, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.008, respectively. The extent of the coverage of the insula by the frontal and temporal lobes in the coronal plane increased with gestational age (adjusted <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.627, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001 and <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.589, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001, respectively). The interclass correlation coefficients of the intra\u2010 and inter\u2010rater reliability of the studied parameters ranged between 0.71 and 0.97. The cortical anomalies in the 19 fetuses were polymicrogyria (7), simplified gyral pattern (3), dysgyria (3), lissencephaly (2), cortical malformation related to tubulinopathy (1), brain atrophy (1), cortical dysplasia (1), and cobblestone malformation (1). Three of the fetuses had multiple cortical anomalies. In 17 of 19 (89%) cases, at least one of our 6 SF parameters was found to be out of the normal range. In the coronal plane, SF height and depth were measured below 2SD in 9 (47%) and 4 (21%) cases, respectively. In the axial plane, SF length and depth were out of the normal ranges in six (31.5%) and four (21%), correspondingly. In the coronal plane, the opercular coverage by the frontal and temporal lobes was below 2 SD in 10 (52%) and 11 (57%), respectively. The scoring of the SF operculization by Quarello et\u00a0al. was abnormal in 8 cases (42%). The measurement of the SF angle according to Poon et\u00a0al. was abnormal in 14 cases (74%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The fetal SF is a complex developing structure that can be reliably characterized by sonographic parameters. One abnormal parameter is sufficient to raise the suspicion of SF malformation. Our new SF parameters might facilitate the detection of prenatal cortical abnormalities affecting the SF.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6359","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T14:42:04Z","timestamp":1682692924000},"page":"1066-1078","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Diagnosis of fetal cortical abnormalities by new reference charts for assessment of sylvian fissure biometry"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4699-1941","authenticated-orcid":false,"given":"Einav Kadour","family":"Peero","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Bnai\u2010Zion Medical Center  Haifa Israel"},{"name":"Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Kugelman","sequence":"additional","affiliation":[{"name":"Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology  Haifa Israel"},{"name":"Department of Obstetrics and Gynecology Carmel Medical Center  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7827-1922","authenticated-orcid":false,"given":"Liat","family":"Gindes","sequence":"additional","affiliation":[{"name":"Fetal Neurology Clinic Obstetrics\u2010Gynecology Ultrasound Unit Department of Obstetrics and Gynecology Wolfson Medical Center  Holon Israel"},{"name":"Sackler School of Medicine Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avi","family":"Shariv","sequence":"additional","affiliation":[{"name":"Sackler School of Medicine Tel\u2010Aviv University  Tel\u2010Aviv Israel"},{"name":"Pediatric Neurology Unit Wolfson Medical Center  Holon Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorit","family":"Lev","sequence":"additional","affiliation":[{"name":"Fetal Neurology Clinic Obstetrics\u2010Gynecology Ultrasound Unit Department of Obstetrics and Gynecology Wolfson Medical Center  Holon Israel"},{"name":"Sackler School of Medicine Tel\u2010Aviv University  Tel\u2010Aviv Israel"},{"name":"Genetics Institute Wolfson Medical Center  Holon Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mordechai","family":"Tamarkin","sequence":"additional","affiliation":[{"name":"Fetal Neurology Clinic Obstetrics\u2010Gynecology Ultrasound Unit Department of Obstetrics and Gynecology Wolfson Medical Center  Holon Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Haddad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Bnai\u2010Zion Medical Center  Haifa 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