The value of in-utero magnetic resonance imaging in ultrasound diagnosed foetal isolated cerebral ventriculomegaly.
ABSTRACT 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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ABSTRACT: Dilatation of the fetal cerebral ventricles (ventriculomegaly) is a generic sonographic sign common to several pathological entities carrying different prognoses. The main causes of fetal ventriculomegaly are aqueductal stenosis, Chiari II malformation, Dandy-Walker complex and agenesis of the corpus callosum. Ventriculomegaly is easily recognized by ultrasound by measuring the atrial width. This simple measure allows the recognition of mild forms of ventricular dilatation and is used as a screening method for ventriculomegaly. However, although the diagnosis of ventriculomegaly is easy, the prenatal identification of the cause of ventricular dilatation is a more difficult task. To this end, the evaluation of the posterior fossa in association with the visualization of the corpus callosum is a useful landmark. Research into the cause of ventriculomegaly is clinically useful, since the prognosis mainly depends on the etiology and on the presence of associated anomalies. In this article the role of prenatal sonography in recognizing the cause of ventriculomegaly and the prognostic value of the prenatal sonographic findings are discussed.Journal of Perinatal Medicine 02/2004; 32(1):5-12. · 1.95 Impact Factor
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ABSTRACT: The normal fetal lateral ventricular diameter remains stable at 10 mm over gestation. Mild ventriculomegaly, defined as a lateral ventricular diameter of >or=10 mm but <or=15 mm or a choroid-lateral ventricular separation >or=3 mm but <or=8 mm occurs bilaterally in 0.15-0.7% of fetuses and unilaterally in 0.07% of pregnancies. This finding is associated with an increased risk of fetal chromosomal abnormalities, congenital anomalies and infections, syndromes, perinatal death, and childhood developmental delays. Prenatal evaluation includes targeted sonographic examination for central nervous system and extra-central nervous system abnormalities, and diagnostic amniocentesis for chromosomal analysis and infectious disease studies. Individualized patient counseling is based on these test results. Optimal postnatal care involves appropriate pediatric neurologic and developmental specialists.Obstetrical and Gynecological Survey 06/2003; 58(6):407-14. · 2.51 Impact Factor
Article: Obstetric MR imaging.[show abstract] [hide abstract]
ABSTRACT: The surge in the development of fast magnetic resonance (MR) techniques has revolutionized our ability to image the pregnant patient and the fetus. Fast MR imaging techniques provide excellent resolution for imaging the maternal and fetal anatomies without the need for sedation. This article addresses the use of fast MR imaging techniques in the evaluation of the pregnant patient for adnexal masses, pelvimetry, hydroureteronephrosis of pregnancy, and placenta accreta. In addition, fetal anomalies for which MR imaging has proved useful, such as ventriculomegaly, arachnoid cysts, and abdominal masses, are described.Radiology 07/1999; 211(3):609-17. · 6.34 Impact Factor