Falip Céline, Blanc Nathalie, Maes Emmanuelle, Zaccaria Isabelle, Oury Jean François, Sebag Guy, Garel Catherine
Department of Paediatric Imaging, Hôpital Robert Debré, Paris, France.
Pediatr Radiol. 2007 Oct;37(10):981-9. doi: 10.1007/s00247-007-0582-2. Epub 2007 Aug 28.
Postnatal imaging and clinical outcome of fetuses with isolated mild ventriculomegaly (IMV) have never been systematically analysed.
To evaluate the postnatal clinical outcomes of a large cohort of fetuses with IMV and to correlate them with pre- and postnatal imaging.
We report a prospective study of 101 fetuses with IMV (10-15 mm ventriculomegaly with otherwise normal US, MRI, karyotype and TORCH screening). IMV was divided into minor (10-11.9 mm) and moderate (12-15 mm) ventriculomegaly. Ventriculomegaly was considered uni- or bilateral, stable, progressive, regressive or resolved according to the prenatal US follow-up. Clinical follow-up was performed by a neuropaediatrician. Postnatal imaging included cranial US (n = 71) and MRI (n = 76).
The outcome of minor and moderate IMV was excellent in 94% and 85% of infants, respectively. It was not different between uni- and bilateral IMV, and between stable, regressive and resolved IMV, and was independent of gestational age at diagnosis and gender. Fixed neurological abnormalities were observed in nine infants. Postnatal MRI showed white-matter abnormalities in 14 infants, including 6 of the 9 infants with a poor outcome.
The prognosis was slightly better in minor IMV than in moderate IMV. Postnatal MRI showed white-matter abnormalities in two-thirds of the infants with a poor outcome.
孤立性轻度脑室扩大(IMV)胎儿的产后影像学表现及临床结局从未得到系统分析。
评估一大群IMV胎儿的产后临床结局,并将其与产前和产后影像学表现相关联。
我们报告了一项对101例IMV胎儿的前瞻性研究(脑室扩大10 - 15mm,超声、磁共振成像、核型及TORCH筛查其他方面均正常)。IMV分为轻度(10 - 11.9mm)和中度(12 - 15mm)脑室扩大。根据产前超声随访,脑室扩大被视为单侧或双侧、稳定、进展、消退或已缓解。由神经儿科医生进行临床随访。产后影像学检查包括头颅超声(n = 71)和磁共振成像(n = 76)。
轻度和中度IMV婴儿的结局分别有94%和85%良好。单侧和双侧IMV之间,以及稳定、消退和已缓解的IMV之间结局无差异,且与诊断时的孕周和性别无关。9例婴儿出现固定的神经功能异常。产后磁共振成像显示14例婴儿有白质异常,其中9例结局不良的婴儿中有6例。
轻度IMV的预后略优于中度IMV。产后磁共振成像显示三分之二结局不良的婴儿有白质异常。