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胎儿神经超声检查发现的孤立性脑室扩大中,脉络丛生长是否发生改变?

Is choroid plexus growth altered in isolated ventriculomegaly on fetal neuro-ultrasound?

作者信息

Hu Wei-Xi, Zhan Xin, Lu Dan, Li Zhi-Qiang

机构信息

Department of Ultrasound in Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.

Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.

出版信息

Eur Radiol. 2025 Jan;35(1):463-473. doi: 10.1007/s00330-024-10966-3. Epub 2024 Jul 17.

Abstract

OBJECTIVES

Reveal developmental alterations in choroid plexus volume (CPV) among fetuses with isolated ventriculomegaly (VM) through neuro-ultrasound.

METHODS

This prospective study aimed to assess the development of fetal CPV in normal fetuses and those with isolated VM through neuro-ultrasound. The fetuses of isolated VM were categorized into mild, moderate, and severe groups, and subsequently, the lateral ventricle evolution was monitored. The developmental alterations in CPV among fetuses with isolated VM were determined by comparing the CPV z-scores with those of normal fetuses. Receiver operating characteristics curve analysis was used to assess the predictive value of altered CPV in lateral ventricle evolution.

RESULTS

A total of 218 normal fetuses and 114 isolated VM fetuses from 22 weeks to 35 weeks of gestation were included. The CPV decreased as the isolated VM was getting worse. Both fetuses with isolated moderate ventriculomegaly and those with isolated severe ventriculomegaly exhibited reduced CPV compared to normal fetuses. The CPV in fetuses with isolated mild ventriculomegaly (IMVM) varied, with some showing a larger CPV compared to normal fetuses, while others exhibited a smaller CPV. The larger CPV in cases of IMVM may serve as a predictive factor for either regression or stability of the lateral ventricle, while reduced CPV in cases of isolated VM may indicate worsening of the lateral ventricle.

CONCLUSION

The growth volume of fetal CP exhibited alterations in fetuses with isolated VM, and these changes were found to be correlated with the evolution of the lateral ventricle.

CLINICAL RELEVANCE STATEMENT

Neuro-ultrasound revealed varying degrees of alterations in the volume development of the choroid plexus within the fetus with isolated VM. The findings can help predict lateral ventricle prognosis, greatly contributing to prenatal diagnosis strategies for fetuses with isolated VM.

KEY POINTS

The volume of choroid plexus growth is altered in fetuses with isolated VM. The altered CPV in isolated VM was associated with lateral ventricle evolution. The findings are useful for prenatal counseling and managing fetuses with isolated VM.

摘要

目的

通过神经超声揭示孤立性脑室扩大(VM)胎儿脉络丛体积(CPV)的发育变化。

方法

本前瞻性研究旨在通过神经超声评估正常胎儿及孤立性VM胎儿的胎儿CPV发育情况。将孤立性VM胎儿分为轻度、中度和重度组,随后监测侧脑室的演变。通过比较孤立性VM胎儿与正常胎儿的CPV z评分,确定孤立性VM胎儿CPV的发育变化。采用受试者工作特征曲线分析评估CPV改变对侧脑室演变的预测价值。

结果

纳入了218例妊娠22周~35周的正常胎儿和114例孤立性VM胎儿。随着孤立性VM病情加重,CPV降低。与正常胎儿相比,孤立性中度脑室扩大胎儿和孤立性重度脑室扩大胎儿的CPV均降低。孤立性轻度脑室扩大(IMVM)胎儿的CPV有所不同,一些胎儿的CPV比正常胎儿大,而另一些则较小。IMVM病例中较大的CPV可能是侧脑室消退或稳定的预测因素,而孤立性VM病例中CPV降低可能表明侧脑室病情恶化。

结论

孤立性VM胎儿的胎儿CP生长体积出现改变,且这些变化与侧脑室的演变相关。

临床相关性声明

神经超声显示,孤立性VM胎儿脉络丛体积发育存在不同程度的改变。这些发现有助于预测侧脑室预后,对孤立性VM胎儿的产前诊断策略有很大帮助。

关键点

孤立性VM胎儿脉络丛生长体积发生改变。孤立性VM中CPV改变与侧脑室演变相关。这些发现有助于对孤立性VM胎儿进行产前咨询和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7f0/11632053/2d2dab7b9a2b/330_2024_10966_Fig1_HTML.jpg

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