Supplementary Material for: Imaging factors affecting prenatal counselling in orofacial clefts

Introduction: we aim to correlate pre-and postnatal data regarding the cleft type and surgical prognostic factors associated to orofacial clefts. Methods: retrospective study concerning all cases of orofacial cleft evaluated prenatally (US+/-MRI) between 2015 and 2020 with available postnatal outcome. We compared prenatal imaging (cleft type and surgical prognostic factors) with postnatal findings. Results: 48 fetuses were included. Median gestational age at first US/MRI examination: 29WG+2D and 31WG+6D respectively. The prenatal diagnosis was in accordance with postnatal findings with regard to the cleft type in 88% of the cases (n=42/48) for US and/or MRI, 84% (n=38/45) for US only and 90% (n=37/41) for MRI only. The nasal septum deviation and nostril collapse were underestimated by prenatal US in 48% (n=12/25) and 44% (n=11/25) of cases respectively (Cohen’s kappa of 0.22 and 0.32 respectively). Pre-and postnatal examinations were in accordance in 75% of cases (n=8) regarding evaluation of anteroposterior maxillary shift in case of unilateral alveolar cleft and in 90% and 80% of cases (n=10) regarding the degree of protrusion/deviation of the premaxillary protrusion in case of bilateral cleft respectively. Conclusion: Prenatal imaging can accurately assess the type of orofacial cleft and evaluate maxillary shift and deviation of the premaxilla. It underestimates the nose deformity.

引言：本研究旨在针对口面裂（orofacial clefts）的裂型及手术预后因素，开展产前与产后数据的关联分析。方法：本研究为回顾性研究，纳入2015至2020年间所有经产前评估（超声（US）+/-磁共振成像（MRI））且具备完整产后结局数据的口面裂病例。研究团队将产前影像学检查所获的裂型与手术预后因素指标，与产后检查结果进行对比分析。结果：本研究共纳入48例胎儿。首次超声与磁共振成像检查的中位孕龄分别为孕29周+2天与孕31周+6天。产前影像学（超声和/或磁共振成像）对裂型的诊断与产后结果的符合率为88%（42/48）；仅行超声检查者的符合率为84%（38/45）；仅行磁共振成像检查者的符合率为90%（37/41）。产前超声分别低估了48%（12/25）的鼻中隔偏曲病例与44%（11/25）的鼻孔塌陷病例，对应的科恩kappa值（Cohen’s kappa）分别为0.22与0.32。针对单侧牙槽裂病例的上颌骨前后向移位评估，产前与产后检查的符合率为75%（n=8）；针对双侧口面裂病例的前颌骨前突程度/偏斜度评估，符合率分别为90%与80%（n=10）。结论：产前影像学可准确评估口面裂的类型，并可评价上颌骨移位及前颌骨偏斜情况，但会低估鼻部畸形的严重程度。