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Serial Prenatal Imaging of Ganglionic Eminence Evolution: A PDHA1-Variant Case Demonstrating Metabolic Brain Injury
Tian Tian1,2, Huizhu Chen2,3, Hong Luo1,2
1Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Insights
Serial ultrasounds reveal early brain abnormalities in pyruvate dehydrogenase complex deficiency (PDCD). These ganglionic eminence (GE) changes can guide prenatal diagnosis of this lethal genetic disorder.
Area of Science:
- Neuroimaging
- Prenatal Diagnosis
- Genetic Disorders
Background:
- Pyruvate dehydrogenase complex deficiency (PDCD) is a severe metabolic disorder.
- Early prenatal diagnosis of PDCD is crucial for management and counseling.
- Characteristic brain anomalies in PDCD are often diagnosed later in gestation.
Abstract:
This report documents the first serial sonographic progression of ganglionic eminence (GE) anomalies in pyruvate dehydrogenase complex deficiency (PDCD) from 12 to 28 weeks. Ultrasound revealed bilateral anterior hypoechoic foci (12 weeks), progressing to solid-cystic GE cavitations (22 weeks) and periventricular germinolysis-type pseudocysts (28 weeks). MRI confirmed concurrent callosal dysgenesis and cerebellar hypoplasia. A pathogenic PDHA1 variant (c.581A>G, p.Y194C) provided definitive molecular diagnosis after exclusion of common etiologies. This continuum serves as an early PDCD imaging indicator, guiding prenatal diagnosis of this lethal disorder.
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