Academic Unit of Radiology, The University of Sheffield, Sheffield, UK.
Neuroradiology, Sheffield Childrens Hospital NHS Foundation Trust, Sheffield, UK.
Arch Dis Child Fetal Neonatal Ed. 2022 Jul;107(4):431-436. doi: 10.1136/archdischild-2021-321984. Epub 2021 Nov 29.
Fetal ventriculomegaly is the the most common intracranial abnormality detected antenatally. When ventriculomegaly is mild and the only, isolated, abnormality detected (isolated mild ventriculomegaly (IMVM)) the prognosis is generally considered to be good. We aim to determine if there are features on in utero MRI (iuMRI) that can identify fetuses with IMVM who have lower risks of abnormal neurodevelopment outcome.
We studied cases recruited into the MRI to enhance the diagnosis of fetal developmental brain abnormalities in utero (MERIDIAN) study, specifically those with: confirmed IMVM, 3D volume imaging of the fetal brain and neurodevelopmental outcomes at 3 years. We explored the influence of sex of the fetus, laterality of the ventriculomegaly and intracranial compartmental volumes in relation to neurodevelopmental outcome.
Forty-two fetuses met the criteria (33 male and 9 female). There was no obvious correlation between fetal sex and the risk of poor neurodevelopmental outcome. Unilateral IMVM was present in 23 fetuses and bilateral IMVM in 19 fetuses. All fetuses with unilateral IMVM had normal neurodevelopmental outcomes, while only 12/19 with bilateral IMVM had normal neurodevelopmental outcomes. There was no obvious correlation between measure of intracranial volumes and risk of abnormal developmental outcomes.
The most important finding is the very high chance of a good neurodevelopmental outcome observed in fetuses with unilateral IMVM, which is a potentially important finding for antenatal counselling. There does not appear to be a link between the volume of the ventricular system or brain volume and the risk of poor neurodevelopmental outcome.
胎儿脑室扩张是产前最常见的颅内异常。当脑室扩张程度较轻且为唯一、孤立的异常（孤立性轻度脑室扩张（IMVM））时，一般认为预后良好。我们旨在确定宫内 MRI（iuMRI）上是否存在可识别 IMVM 胎儿且神经发育结局异常风险较低的特征。
我们研究了招募入 MRI 以增强产前胎儿发育性脑异常诊断（MERIDIAN）研究的病例，特别是那些具有：明确的 IMVM、胎儿脑的 3D 容积成像以及 3 岁时的神经发育结局。我们探讨了胎儿性别、脑室扩张的侧别以及颅内腔室容积与神经发育结局的关系。
42 例胎儿符合标准（33 例男性和 9 例女性）。胎儿性别与神经发育不良结局的风险之间没有明显的相关性。23 例胎儿为单侧 IMVM，19 例胎儿为双侧 IMVM。所有单侧 IMVM 胎儿的神经发育结局均正常，而双侧 IMVM 中仅有 12/19 例的神经发育结局正常。颅内容积的测量值与发育不良结局的风险之间没有明显的相关性。
最重要的发现是单侧 IMVM 胎儿具有良好神经发育结局的可能性非常高，这是产前咨询的一个潜在重要发现。脑室系统或脑容积与神经发育不良结局风险之间似乎没有联系。
