Başkent University, Adana Application and Research Hospital, Gazipasa Mah., Baraj Cd., Seyhan, Adana, Turkey.
Başkent University, Adana Application and Research Hospital, Gazipasa Mah., Baraj Cd., Seyhan, Adana, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2019 Sep;240:52-56. doi: 10.1016/j.ejogrb.2019.06.009. Epub 2019 Jun 12.
Ventriculomegaly is one of the most common anomalies encountered at obstetric ultrasound and it necessitates follow up. Fetal magnetic resonance imaging (MRI) can be used to confirm the ultrasound diagnose or to detect additional anomalies. Aim of this study is to assess follow up and management of fetal ventriculomegaly shown by ultrasound, and to evaluate additional diagnostic contribution of MRI.
This study was conducted retrospectively including 89 patients who had fetal MRI subsequent to ultrasound diagnose of ventriculomegaly in between 2011-2017. Medical records of patients were investigated and accompanying anomalies, congenital infection, chromosomal examination, degree and progression of ventriculomegaly, neonatal imaging and diagnose, and neurodevelopmental findings on follow up were evaluated. Patients were classified in two groups as isolated and nonisolated ventriculomegaly, and subgroups mild, moderate, severe were formed according to their findings. SPSS 23.0 programme was used for statistical analysis.
Ultrasound and following MRI was performed in a range of 18-35 gestational weeks, diagnoses were isolated ventriculomegaly for 56 patients and nonisolated ventriculomegaly for 33 patients. Progression and neurodevelopmental delay was higher in severe nonisolated ventriculomegaly group. There was not significant contribution of MRI in the follow up of isolated ventriculomegaly (p < 0.001), and diagnostic imaging findings declined in neonatal period with proceeding normal neurodevelopment in 92.7% of patients followed with diagnosis of isolated ventriculomegaly.
When isolated ventriculomegaly is detected, ultrasound performed by an experienced team is mostly sufficient. MRI can be used in suspicious cases or when ventriculomegaly progresses.
脑室扩大是产前超声检查中最常见的异常之一，需要进行随访。胎儿磁共振成像（MRI）可用于确认超声诊断或检测其他异常。本研究旨在评估超声显示的胎儿脑室扩大的随访和管理，并评估 MRI 的额外诊断价值。
本研究为回顾性研究，纳入 2011 年至 2017 年间因超声诊断脑室扩大而随后进行胎儿 MRI 的 89 例患者。调查患者的病历，并评估伴随的异常、先天性感染、染色体检查、脑室扩大的程度和进展、新生儿影像学诊断以及随访时的神经发育情况。患者分为孤立性和非孤立性脑室扩大两组，并根据其发现分为轻度、中度和重度亚组。使用 SPSS 23.0 程序进行统计分析。
超声和随后的 MRI 在妊娠 18-35 周进行，诊断为 56 例孤立性脑室扩大和 33 例非孤立性脑室扩大。重度非孤立性脑室扩大组的进展和神经发育迟缓发生率更高。MRI 在孤立性脑室扩大的随访中没有显著贡献（p<0.001），并且在进行正常神经发育诊断后，92.7%的孤立性脑室扩大患者的新生儿期诊断影像学发现下降。
当发现孤立性脑室扩大时，由经验丰富的团队进行的超声检查通常就足够了。MRI 可用于可疑病例或脑室扩大进展时。
