Peng Y X, Huang L P, Li J, Yu Y H, Chen C H, Chen S J, Chang Q X
Department of Obestetrics and Gynecology, Nanfang Hospital Affiliated to Southern Medicial University, Guangzhou 510515, China.
Zhonghua Fu Chan Ke Za Zhi. 2018 May 25;53(5):294-298. doi: 10.3760/cma.j.issn.0529-567x.2018.05.002.
To evaluate the clinical outcome of fetus diagnosed as mild and moderate isolated ventriculomegaly (IVM) and its correlation with imaging follow-up. Totally, 161 cases of single pregnancy whose fetus was diagnosed as mild or moderate IVM by ultrasound were administrated. Data of prenatal ultrasound examination, pregnancy outcomes, and the postnatal MRI results were collected. New borns' growth and development, language expression, movement coordination, auditory and visual function were followed up to evaluate the neurodevelopment. (1) Before birth: 80.1% (129/161) of IVM disappeared before the delivery, 16.1% (26/161) remained stable, and 3.7% (6/161) continued to deteriorate. (2) Postnatal MRI: 8 cases (9.6%, 8/83) were diagnosed IVM, of which 3 cases were found additional abnormalities (1 case was the corpus callosum dysplasia and 2 cases were leukodystrophy) . The additional abnormal detection rate was 3/8. (3) Postnatal assessments: There were 7 cases (8.9%, 7/79) neunatal behavioral neurological assessment (NBNA) , 6 cases (7.6%, 6/79) Bayley scales of infant development (BSID) -psychomotor developmental index (PDI) and 3 cases (3.8%, 3/79) BSID-mental development index (MDI) whose scores were low. There was no significant difference of the NBNA and BSID scores between mild and moderate IVM (NBNA: χ(2)=2.042, 0.210; BSID-PDI: χ(2)=-1.359, 0.174; BSID-MDI: χ(2)=-1.205, 0.228) . Follow-up of 9 cases (11.4%, 9/79) with low BSID score, 6 of them were found to be stable in the medial ventricle of the uterus, and the size of the lateral ventricle was normal after birth by ultrasound and MRI. The majority of IVM fetuses have good prognosis, but there is also a risk of neurodevelopmental dysplasia. The postnatal follow-up should be paid attention to, and MRI should be performed as the postnatal imaging evaluation.
评估诊断为轻度和中度孤立性脑室扩大（IVM）胎儿的临床结局及其与影像学随访的相关性。共纳入161例单胎妊娠孕妇，其胎儿经超声诊断为轻度或中度IVM。收集产前超声检查数据、妊娠结局及产后MRI结果。对新生儿的生长发育、语言表达、运动协调、听觉和视觉功能进行随访以评估神经发育情况。（1）出生前：80.1%（129/161）的IVM在分娩前消失，16.1%（26/161）保持稳定，3.7%（6/161）继续恶化。（2）产后MRI：8例（9.6%，8/83）诊断为IVM，其中3例发现合并其他异常（1例胼胝体发育不良，2例脑白质营养不良）。合并异常检出率为3/8。（3）产后评估：7例（8.9%，7/79）新生儿行为神经评定（NBNA）、6例（7.6%，6/79）贝利婴幼儿发育量表（BSID）-心理运动发育指数（PDI）和3例（3.8%，3/79）BSID-智力发育指数（MDI）评分较低。轻度和中度IVM之间的NBNA和BSID评分无显著差异（NBNA：χ(2)=2.042，P=0.210；BSID-PDI：χ(2)= -1.359，P=0.174；BSID-MDI：χ(2)= -1.205，P=0.228）。对9例（11.4%，9/79）BSID评分低的患儿进行随访，其中6例经超声和MRI检查发现子宫内脑室中度稳定，出生后侧脑室大小正常。大多数IVM胎儿预后良好，但也存在神经发育异常的风险。应重视产后随访，并进行MRI作为产后影像学评估。
