The value of in-utero magnetic resonance imaging in ultrasound diagnosed foetal isolated cerebral venticulomegaly

Section of Academic Radiology, Royal Hallamshire Hospital, University of Sheffield, UK.
Clinical Radiology (Impact Factor: 1.76). 03/2007; 62(2):140-4. DOI: 10.1016/j.crad.2006.06.016
Source: PubMed


To assess whether magnetic resonance imaging (MRI) is a useful adjunct to ultrasound (US) when imaging cases of foetal isolated cerebral ventriculomegaly. To assess whether, in such cases, ventricular morphology is a useful indicator for the underlying pathology, as has recently been suggested.
A retrospective analysis was undertaken of 30 cases of isolated ventriculomegaly diagnosed using US and referred for in utero MRI. The gestational age of each case was noted and the MRI report. Both ventricles were measured and each case was categorized according to severity and morphology. The MRI report was compared to the final diagnosis.
Of the 30 cases evaluated 18 had mild ventriculomegaly (<15 mm; gestational age range 20-31 weeks, mean 22.8, median 22) and 12 had severe ventriculomegaly (>15 mm; gestational age range 21-37 weeks, mean 28, median 28.5). Additional abnormalities were found in 50% of cases overall (44% mild, 58% severe) using MRI.
Using MRI additional abnormalities were identified in 50% of the foetuses. The morphology of the cases did not suggest underlying pathology in this group. In utero MRI is a useful adjunct to US in cases of foetal cerebral ventriculomegaly referred after initial diagnosis using US.

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    • "The value of in utero MRI in cases of ultrasound diagnosed fetal isolated VM is addressed by a number of recent studies (Malinger et al., 2004; Valsky et al., 2004; Ouahba et al., 2006; Salomon et al., 2006; Benacerraf et al., 2007; Glenn and Barkovich, 2006a; Glenn and Barkovich, 2006b; Morris et al., 2007). The percentage of additional abnormalities diagnosed by MRI ranges from 5% (Salomon et al., 2006) to 50% (Morris et al., 2007). Such large differences among studies could be due to the variable standards of ultrasound or MRI, but could also be explained by the type of malformations observed; in fact, it seems that MRI is superior to ultrasound in detecting parenchymal damage, migrational abnormalities, infarctions , germinal matrix hemorrhage and intraventricular hemorrhage, but not other malformations for which a dedicated neurosonographic examination could be superior (Malinger et al., 2004). "
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    ABSTRACT: Fetal cerebral ventriculomegaly (VM) is diagnosed when the width of one or both ventricles, measured at the level of the glomus of the choroid plexus (atrium), is > or = 10 mm. VM can result from different processes: abnormal turnover of the cerebrospinal fluid (CSF), neuronal migration disorders, and destructive processes. In a high percentage of cases, it is associated with structural malformations of the central nervous system (CNS), but also of other organs and systems. The rate of associated malformations is higher (> or =60%) in severe VM (>15 mm) and lower (10-50%) in cases of borderline VM (10-15 mm). When malformations are not present, aneuploidies are found in 3-15% of borderline VM; the percentage is lower in severe VM. The neurodevelopmental outcome of isolated VM is normal in > 90% of cases if the measurement of ventricular width is between 10 and 12 mm; it is less favorable when the measurement is > 12 mm.
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    C Garel ·

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