Yu Lei, Xiao Xue, Zhan Jun, Han Liujie
( 610041) Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
() ( 610041) Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2024 Sep 20;55(5):1133-1137. doi: 10.12182/20240960107.
Fetal ventriculomegaly is a central nervous system disorder commonly seen in prenatal imaging, and the prognosis ranges from normal health to severe dysfunction. Currently, fetal predictive markers associated with postpartum individual neurodevelopmental function are still not available, which increases the difficulty of prenatal diagnosis and clinical management. Constant advancements in magnetic resonance imaging (MRI) technology have brought better accuracy and reliability of MRI applied in the diagnosis, prognosis assessment, and etiology investigation of ventriculomegaly. MRI plays a critical role in prognostic management and prenatal consultation. Nevertheless, due to the potential safety hazards and economic and technical constraints of MRI, it is not the first choice for prenatal imaging diagnosis. Moreover, there are different opinions regarding the measurement results and grading criteria of ultrasound and MRI. At present, it is accepted that three-dimensional volume may provide reliable information for prognosis. However, accurate segmentation and measurement of brain structure remain serious challenges, and no consensus on the MRI measurement of lateral ventricle volume has been reached. In this paper, based on the latest research reports from China and around the world, we reviewed the progress in applying MRI in the prenatal diagnosis and treatment of ventriculomegaly. This review offers a theoretical foundation for further exploration of the role of lateral ventricle volume measurement in disease diagnosis and management. We suggest that researchers combine two-dimensional width with three-dimensional volume in the future to identify the optimal cutoff value for prognostic prediction of fetal ventriculomegaly.
胎儿脑室扩大是产前影像学中常见的中枢神经系统疾病,其预后范围从健康正常到严重功能障碍。目前,仍没有与产后个体神经发育功能相关的胎儿预测标志物,这增加了产前诊断和临床管理的难度。磁共振成像(MRI)技术的不断进步,提高了MRI在脑室扩大诊断、预后评估及病因调查中的准确性和可靠性。MRI在预后管理和产前咨询中起着关键作用。然而,由于MRI存在潜在安全隐患以及经济和技术限制,它并非产前影像诊断的首选。此外,关于超声和MRI的测量结果及分级标准存在不同观点。目前,人们公认三维容积可能为预后提供可靠信息。然而,脑结构的精确分割和测量仍然是严峻挑战,并且关于侧脑室容积的MRI测量尚未达成共识。本文基于中国和世界各地的最新研究报告,综述了MRI在脑室扩大产前诊断和治疗中的应用进展。本综述为进一步探索侧脑室容积测量在疾病诊断和管理中的作用提供了理论基础。我们建议研究人员未来将二维宽度与三维容积相结合,以确定胎儿脑室扩大预后预测的最佳临界值。