Winkler Alice, Tölle Sandra, Natalucci Giancarlo, Plecko Barbara, Wisser Josef
Clinic of Obstetrics, University Hospital Zürich, Zürich, Switzerland.
Fetal Diagn Ther. 2018;44(3):210-220. doi: 10.1159/000480500. Epub 2017 Sep 27.
In order to provide aid for prenatal counseling in fetal isolated ventriculomegaly (IVM) on ultrasound, we recorded the latest long-term clinical and imaging outcomes of children with a mean age of 7.2 years (range 2.1-14.6).
In 72 fetuses with IVM, diagnosed between 1999 and 2011, the measurement quality of atrial diameter was reviewed in the axial plane. We assessed the association of characteristics of IVM with outcome parameters in the cohort and in subgroups. Prognostic values of significant associations were reported by receiver operating characteristic curve analysis.
Cerebral anomalies were diagnosed postnatally in 42% and genetic disorders in 12% of 45 live births. Significant associations of outcome parameters were found between the degree of IVM and genetic disorders (p = 0.017) with an area under the curve (AUC) of 0.866, and between progression of IVM and motor impairment (p = 0.024) with an AUC of 0.789. No significant correlation was found with the other assessed outcome parameters. Furthermore, our subgroup analysis clearly showed that, if cerebral or genetic anomalies are not found postnatally, a favorable outcome may be expected.
Diameter and progression in IVM are not significantly associated with most outcome parameters. Cerebral anomalies and genetic disorders may contribute to an unfavorable outcome.
为超声诊断胎儿孤立性脑室扩张（IVM）的产前咨询提供帮助，我们记录了平均年龄7.2岁（范围2.1 - 14.6岁）儿童的最新长期临床和影像学结局。
对1999年至2011年间诊断出的72例IVM胎儿，在轴位平面回顾心房直径的测量质量。我们评估了该队列及亚组中IVM特征与结局参数之间的关联。通过受试者工作特征曲线分析报告显著关联的预后价值。
45例活产儿中，42%在出生后被诊断出脑异常，12%被诊断出遗传疾病。在IVM程度与遗传疾病之间发现结局参数有显著关联（p = 0.017），曲线下面积（AUC）为0.866；在IVM进展与运动障碍之间也有显著关联（p = 0.024），AUC为0.789。与其他评估的结局参数未发现显著相关性。此外，我们的亚组分析清楚地表明，如果出生后未发现脑或遗传异常，则可能预期有良好结局。
IVM的直径和进展与大多数结局参数无显著关联。脑异常和遗传疾病可能导致不良结局。
