RT Journal Article
SR Electronic
T1 A Prospective Study of Fetuses with Isolated Ventriculomegaly Investigated by Antenatal Sonography and In Utero MR Imaging
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 106
OP 111
DO 10.3174/ajnr.A1767
VO 31
IS 1
A1 P.D. Griffiths
A1 M.J. Reeves
A1 J.E. Morris
A1 G. Mason
A1 S.A. Russell
A1 M.N.J. Paley
A1 E.H. Whitby
YR 2010
UL http://www.ajnr.org/content/31/1/106.abstract
AB BACKGROUND AND PURPOSE: Fetal ventriculomegaly (VM) is important because of its high prevalence and high risk of association with other brain abnormalities. The purpose of this article was to investigate the hypotheses that including in utero MR imaging (iuMR) in the diagnostic pathway for fetuses with isolated VM on antenatal imaging will show other brain abnormalities in a high proportion of cases and that these will have a significant effect on clinical management. MATERIALS AND METHODS: One hundred forty-seven pregnant women were recruited prospectively from 8 fetomaternal centers in Britain. All of the fetuses had VM diagnosed on sonography but no other abnormality. iuMR was performed, and the results of the examinations were compared with those of sonography. Two fetomaternal experts made independent assessments of the effects of any new diagnoses on clinical management. RESULTS: Categoric assessments of ventricular size were the same in approximately 90% of fetuses. Other abnormalities were shown in 17% of fetuses. The most frequent additional brain abnormality shown on iuMR was agenesis of the corpus callosum. Severe VM was associated with an approximately 10-fold increase in the risk of another brain abnormality being present when compared with fetuses with mild VM. The most profound effects on clinical management, however, were found in cases of mild VM. CONCLUSIONS: This work supports our hypotheses by showing a high detection rate of other brain pathology when iuMR was used to supplement antenatal sonography (17%). In a high proportion of cases, the detection of the extra pathology would have led to significant changes in clinical management.