Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecologia, Obstetricia i Neonatologia, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Spain.
Departamento de Obstetrícia e Ginecologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
Prenat Diagn. 2018 Apr;38(5):365-375. doi: 10.1002/pd.5240.
To perform a comprehensive assessment of cortical development in fetuses with isolated nonsevere ventriculomegaly (INSVM) by neurosonography.
We prospectively included 40 fetuses with INSVM and 40 controls. INSVM was defined as atrial width between 10.0 and 14.9 mm without associated malformation, infection, or chromosomal abnormality. Cortical development was assessed by neurosonography at 26 and 30 weeks of gestation measuring depth of selected sulci and applying a maturation scale from 0 (no appearance) to 5 (maximally developed) of main sulci and areas.
INSVM showed underdeveloped calcarine and parieto-occipital sulci. In addition, significant delayed maturation pattern was also observed in regions distant to ventricular system including Insula depth (controls 30.8 mm [SD 1.7] vs INSVM 31.7 mm [1.8]; P = .04), Sylvian fissure grading (>2 at 26 weeks: controls 87.5% vs INSVM 50%, P = .01), mesial area grading (>2 at 30 weeks: controls 95% vs INSVM 62.5%; P = .03), and cingulate sulcus grading (>2 at 30 weeks: controls 100% vs INSVM 80.5%; P = .01).
Fetuses with INSVM showed underdeveloped cortical maturation including also regions, where effect of ventricular dilatation is unlikely. These results suggest that in a proportion of fetuses with INSVM, ventricular dilation might be related with altered cortical architecture.
通过神经超声对单纯性非重度脑室扩张（INSVM）胎儿的皮质发育进行全面评估。
我们前瞻性纳入了 40 例 INSVM 胎儿和 40 例对照。INSVM 定义为心房宽度在 10.0 至 14.9 毫米之间，无相关畸形、感染或染色体异常。通过神经超声在 26 和 30 周时评估皮质发育，测量选定脑沟的深度，并应用从 0（无出现）到 5（发育完全）的成熟量表对主要脑沟和区域进行评分。
INSVM 显示出发育不全的枕叶和顶枕叶脑沟。此外，还观察到脑室系统以外的区域明显延迟成熟模式，包括脑岛深度（对照组 30.8 毫米[SD 1.7]比 INSVM 31.7 毫米[1.8]；P=0.04）、外侧裂分级（26 周时>2：对照组 87.5%比 INSVM 50%，P=0.01）、内侧区域分级（30 周时>2：对照组 95%比 INSVM 62.5%；P=0.03）和扣带回脑沟分级（30 周时>2：对照组 100%比 INSVM 80.5%；P=0.01）。
INSVM 胎儿皮质发育不成熟，包括脑室扩张不太可能影响的区域。这些结果表明，在一部分 INSVM 胎儿中，脑室扩张可能与皮质结构改变有关。
