Halevy Jorden, Doitch Amdurski Hadar, Gafner Michal, Fried Shalev, Ziv-Baran Tomer, Katorza Eldad
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Derech Sheba 2, Ramat Gan 5262000, Israel.
Department of Pediatrics, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 6423906, Israel.
Diagnostics (Basel). 2025 Aug 3;15(15):1945. doi: 10.3390/diagnostics15151945.
: The increasing use of fetal MRI has increased the diagnosis of posterior fossa malformations, yet the long-term neurodevelopmental outcomes of affected fetuses remain unclear. This study aims to examine the long-term neurodevelopmental outcomes of fetuses with structural posterior fossa malformation diagnosed on fetal MRI. : A historical cohort study was conducted at a single tertiary referral center, including fetuses diagnosed with structural posterior fossa malformations and apparently healthy fetuses who underwent fetal brain MRI between 2011 and 2019. Maternal, pregnancy, and newborn characteristics were compared between groups, alongside long-term neurodevelopmental outcomes using the Vineland Adaptive Behavior Scales II (VABS-II) questionnaire. This included an extensive assessment of malformation types, additional structural, genetic, or neurodevelopmental anomalies, and outcomes. : A total of 126 fetuses met the inclusion criteria, of which 70 were apparently healthy fetuses, and 56 had structural posterior fossa malformations. Among the latter, 18 pregnancies were terminated, 4 resulted in neonatal death, and 11 were lost to follow-up. No significant differences were found in the overall neurodevelopmental outcomes between fetuses with structural posterior fossa malformation (93.4 ± 19.0) and apparently healthy fetuses (99.8 ± 13.8). Motor skills scores were lower among fetuses with structural posterior fossa malformations (87.7 ± 16.5 vs. 99.3 ± 17.2, = 0.01) but remained within the normal range. : Fetuses with structural posterior fossa malformations may exhibit normal long-term neurodevelopmental outcomes if no additional anomalies are detected during thorough prenatal screening that includes proper sonographic, biochemical and genetic screening, as well as fetal MRI. Further research with larger cohorts and longer-term assessments is recommended to validate these findings and support clinical decision-making.
胎儿磁共振成像（MRI）的使用日益增加，后颅窝畸形的诊断率也随之上升，但受影响胎儿的长期神经发育结局仍不明确。本研究旨在探讨经胎儿MRI诊断为结构性后颅窝畸形的胎儿的长期神经发育结局。：在一家单一的三级转诊中心进行了一项历史性队列研究，纳入2011年至2019年间经胎儿脑MRI诊断为结构性后颅窝畸形的胎儿以及明显健康的胎儿。比较两组之间的母亲、妊娠和新生儿特征，同时使用文兰适应行为量表第二版（VABS-II）问卷评估长期神经发育结局。这包括对畸形类型、其他结构、遗传或神经发育异常以及结局进行广泛评估。：共有126例胎儿符合纳入标准，其中70例为明显健康的胎儿，56例有结构性后颅窝畸形。在后者中，18例妊娠终止，4例导致新生儿死亡，11例失访。结构性后颅窝畸形胎儿（93.4±19.0）与明显健康胎儿（99.8±13.8）的总体神经发育结局无显著差异。结构性后颅窝畸形胎儿的运动技能得分较低（87.7±16.5对99.3±17.2，P = 0.01），但仍在正常范围内。：如果在包括适当的超声、生化和基因筛查以及胎儿MRI在内的全面产前筛查中未检测到其他异常，结构性后颅窝畸形胎儿可能表现出正常的长期神经发育结局。建议进行更大样本量和更长期评估的进一步研究，以验证这些发现并支持临床决策。
