Mild cerebral ventriculomegaly on prenatal ultrasound. As previously described, multiple genetic disorders table may contribute to fetal ventriculomegaly. Fetal cerebral ventriculomegaly is present if the atrial diameter is. An abnormal karyotype has been reported to be the causative factor in approximately 27 per cent of cases goldstein et al. The role of magnetic resonance imaging in the diagnostic work. Some of the symptoms that can indicate the problem of ventriculomegaly are the abnormal head growth. Perinatal management and outcome of fetal ventriculomegaly. Ventriculomegaly symptoms, prognosis, causes, treatment.
But it has the potential to develop into hydrocephalus, which puts pressure on. Fetal cerebral ventriculomegaly is a relatively common finding on second trimester obstetric ultrasound examination. Ventriculomegaly, also known as hydrocephalus, is a condition in which the csffilled structures within the brain become larger than normal. Cesarean section if the fetal head circumference is. The 18 23 weeks scan the fetal medicine foundation. Of the 60 fetuses with severe ventriculomegaly, only 10 16% were alive and normally developed at the age of at least 2 years. It is often associated with hydrocephalus, a condition of excessive intracranial cerebrospinal fluid, but can also be related to a decrease in the amount of normal brain tissue. Moderate carries a significant risk of a chromosome anomaly 14%.
Ventriculomegaly ultrasonography of the prenatal brain, 3e. Possible conflicting classifications caused by their measurement in different sectional planes by sonography and mr imaging are frequently raised. Aim to assess the aetiology and neurological outcomes of ventriculomegaly at a university hospital from 20092012. Some have estimated the incidence of ventriculomegaly identified on sonography to be about 1%. Mild cerebral ventriculomegaly on prenatal ultrasound next. Fetal cerebral ventriculomegaly fetal and maternal medicine. Fetal cerebral ventriculomegaly fetal and maternal. Sometimes ventriculomegaly is associated with developmental problems of the fetal spine called neural tube defects or spina bifida. Claus 1 1 department of radiology, university hospitals leuven, leuven, belgium. Fetal ventriculomegaly is aetiologically heterogeneous roume et al. Fetal ventriculomegaly vm refers to the enlargement of the cerebral ventricles in utero. Ventriculomegaly is an excess of fluid in the lateral ventricles within the developing cerebrum.
P05 disorders of newborn related to slow fetal gr p05. Exclusion of fetal ventriculomegaly with a single measurement. Ventriculomegaly is a brain condition that mainly occurs in the fetus when the lateral ventricles become dilated. Down syndrome and fetal ventriculomegaly cerebral ventriculomegaly is commonly detected in fetuses by ultrasonography cardoza et al. Other fetal developmental abnormalities of the brain, such as agenesis of the corpus callosum, brainstem abnormalities, and cortical migration anoma. Mild ventriculomegaly, defined as a lateral ventricular diameter of. Mild ventriculomegaly is different from the more severe form of ventriculomegaly, hydrocephalus or water on the brain. Dysmorphic ventriculomegaly is a form of complex ventriculomegaly best exemplified by agenesis of the corpus callosum with its characteristic ventricular morphology, that is, retention of the teardropshaped fetal configuration posteriorly colpocephaly and a steerhorn configuration anteriorly see chapter 2. It is not uncommon for lateral ventricles to be slightly larger in boys. Fetal ventriculomegaly is a congenital finding that affects the brain. Methods 35 women with ventriculomegaly were identified on anomalyfetal medicine scans between 20 to 30 weeks of gestation.
Isolated mild ventriculomegaly can be a normal variant associated with normal offspring outcome, but ventriculomegaly can also be caused by a variety of disorders that result in neurologic, motor, andor cognitive impairment. Using the current sonographic cutoff criteria see radiographic features below, the estimated prevalence may be at 0. The normal fetal lateral ventricular diameter remains stable at 10 mm over gestation. Fvm is diagnosed when either or both lateral ventricular dilatation equals or exceeds 10 mm at the. Ventriculomegaly is the most frequent fetal brain anomaly, with a prevalence of around 1 per live births, 1,2 or even 22 per according to some authors. Fetal ventriculomegaly ventricle width 10 mm is an important finding in itself and it is also associated with other central nervous system abnormalities. Halfway through my pregnancy with megan, she was diagnosed with fetal ventriculomegaly. The indication for fetal magnetic resonance imaging mri remains a subject of debate, partly because of questions concerning its diagnostic accuracy compared to ultrasound, partly because of practical factors such as accessibility, high costs and available expertise. It is associated with the postnatal diagnosis of hydrocephalus. Severe carries a significant risk 17% the finding of any ventriculomegaly is sufficient to warrant the offer of karyotyping to all women of any age. Lasso is more free to choose the most relevant features from any cortical.
Prenatally, the diaphragm is imaged by ultrasonography as an echofree space between the. The vp shunt procedure will be performed by a pediatric neurosurgeon. Therefore the majority of fetuses with ventriculomegaly do not. Fetal ventriculomegaly refers to the presence of dilated cerebral ventricles in utero. Ultrasound scans every 4 weeks to monitor the evolution of ventriculomegaly. Mild fetal ventriculomegaly 11 mm with enlargement of the posterior horn of the. Because of the anatomic detailed seen with advanced imaging, vm is often further characterized by fetal magnetic resonance imaging mri. Fetal cerebral ventriculomegaly vm is diagnosed when the width of one or both ventricles, measured at the level of the glomus of the choroid plexus atrium, is or 10 mm. Pdf early, sensitive and specific prenatal diagnosis of malformations of the fetal brain and correct identification of the various. Dedicated to the mission of bringing free or lowcost educational materials and information to the global ultrasound community.
Outcome of prenatallydetected fetal ventriculomegaly. The fetal mri obtained at 24 weeks gestation demonstrated a phenotypically male fetus with severely dilated lateral. Ventriculomegaly is a term that describes the actual image of the enlarged spaces as it appears on a prenatal ultrasound. Counseling in isolated mild fetal ventriculomegaly isuog. Ventriculomegaly can be diagnosed at the earlier stage. By itself, the condition is not necessarily a problem. Fetal lateral ventriculomegaly is a relatively common finding.
Ventriculomegaly is frequently associated with a large number of intra and extracranial chromosomal as well as nonchromosomal anomalies. Fetal brain, mri, ventriculomegaly, cortical folding, statistical analysis, lasso. Hydrocephalus is the main concern associated with ventriculomegaly. Hydrocephalus occurs when csf builds up within the ventricles of the brain, causing. Abstract objective ventriculomegaly is the most common fetal brain anomaly identified during prenatal anatomy ultrasound. Down syndrome and fetal ventriculomegaly, prenatal. Pdf ventriculomegaly is an increase in cerebral ventricular dimensions. Ouahba j, luton d, vuillard e, garel c, gressens p, blanc n, elmaleh m, evrard p, oury j. For measuring the lateral ventricle it is recommended to use an axial view of the brain and to place the clipers at the level of the parietooccipital fissure that is usually well demonstrated from 20 weeks. Mild ventriculomegaly in the fetus, natural history, associated findings and outcome of isolated mild ventriculomegaly. Neurodevelopmental outcomes may correlate with severity of ventricle enlargement. Are there any medical complications associated with ventriculomegaly. Enlargement of the ventricular system, the fluidfilled spaces in the brain, can be caused by the overproduction of csf, inadequate brain development or destruction of brain tissue.
Mild cerebral ventriculomegaly on prenatal ultrasound next steps and clinical implications learning objectives and cmedisclosure information this activity is intended for healthcare providers delivering care to women and their families. Cortical folding alterations in fetuses with isolated nonsevere. Intrauterine hydrocephalus and ventriculomegaly are conditions which are readily diagnosed. Fetal brain anomalies associated with ventriculomegaly or. The objective of our study was to evaluate the agreement between ultrasonography and mr imaging in the measurement of the. Pdf brain malformations and fetal ventriculomegaly.
The reported incidence of hydrocephalus at birth is 0. Advances in fetal diagnostic techniques have opened many areas to prenatal anatomical scrutiny. Nov 09, 2017 by dr tahir a siddiqui consultant sonologist gujranwala. As a result, the large ventricles can inhibit the proper development of the brain. Thirtysix cases of prenatal diagnosed mild to moderate ventriculomegaly, from 20052011. Milder ventriculomegaly by providing uptodate evidencebased answers to theand moderate ventriculomegaly have been used to more common questions regarding the diagnosis of isolated mild fetal dicate measurements of 1012 mm and 15 mm,respectively12. Ventricles measuring between 10 to15 mm are called mild ventriculomegaly. Mild fetal cerebral ventriculomegaly or borderline ventriculomegaly is defined as an axial. Mild ventriculomegaly means that one or both of the babys lateral ventricles are slightly larger than usual. It is usually diagnosed at a routine fetal anomaly scan at 1822 weeks gestation. Management of the condition and counselling of parents are difficult, as the cause, absolute risk, and degree of resulting handicap cannot be determined with confidence. Her pregnancy to date had been uncomplicated without notable fevers, illnesses, or need for medications aside from prenatal vitamins. Alasali, md, hydrocephalus, weeks moshe bronshtein. Even when the analysis was limited to cases of isolated ventriculomegaly, the rate of normal neurodevelopmental outcome was 62.
In ten patients 50%, isolated fetal ventriculomegaly or ventriculomegaly asociated with spina bifida was diagnosed antenatally, and the perinatal management consisted of frequent ultrasound examinations, weekly fetal biophysical profiles, and delivery by cesarean. Ventriculomegaly ultrasonography of the prenatal brain. The contents of the brain consist primarily of brain tissue, blood and cerebrospinal fluid csf. Introduction ventriculomegaly is the most frequent fetal brain anomaly. Hydrocephalus with multiple fetal anomalies othman a.
Karyotypes were available for 6 of these 8 malformed fetuses and chromosomal aberrations were found in 3 trisomy 18, 45xo, triploidy. Cesarean section if the fetal head circumference is 40 cm. The mean diameter of the lateral ventricle has been reported to range from 5. Mild fetal cerebral ventriculomegaly or borderline ventriculomegaly is defined as an axial diameter 10 mm across the atrium of the posterior or anterior horn of lateral ventricles at any gestation. Ventriculomegaly simply means enlargement of the lateral cerebral ventricles.
For more information, see the main article fetal ventriculomegaly. Its a condition that occurs in about 1 in 1,000 births. The objective of our study was to evaluate the agreement between ultrasonography and mr imaging in the. Fetal ventriculomegaly due to isolated brain malformations. The most common definition uses a width of the atrium of the lateral ventricle of greater than 10 mm. Mild fetal cerebral ventriculomegaly fetal diagn ther 2005. Isolated ventriculomegaly and risk of chromosome anomaly borderline probably caries a risk of % but data is still limited. When this measurement is between 10 and 15 mm, the ventriculomegaly may be described as mild to moderate. Fetal cerebral ventriculomegaly is defined as an atrial diameter of. Apr 01, 2015 fetal cerebral ventriculomegaly is diagnosed in utero when the atrial width of at least one lateral ventricle is greater than 10 mm. If the posterior horn atrium measures more than 15 mm, it is known as hydrocephaly. A vp shunt is the surgical implantation of a small plastic catheter that drains the cerebrospinal fluid into a part of the body that can easily absorb the fluid such as the abdomen or peritoneum membrane that forms the lining of the abdominal cavity.
The ventricles in her brain were slightly larger than normal. When this measurement is between 10 and 15 mm, the ventriculomegaly may be described as. A 23yearold g1p0 woman was referred for fetal mri after her 20week anatomic fetal ultrasound demonstrated cerebral ventriculomegaly. Ventriculomegaly detected on 20week anatomic fetal. Ventriculomegaly international society of ultrasound in. The infants with the minor problem of ventriculomegaly dont have symptoms at first but as the ventriculomegaly progresses with the age it can show signs and the symptoms. Fetal ventriculomegaly fvm is a frequently detected anomaly in the second and third trimester ultrasound scanning. Fetal cerebral ventriculomegaly is diagnosed in utero when the atrial width of at least one lateral ventricle is greater than 10 mm. Therefore it is useful to divide fetal ventriculomegaly into isolated ventriculomegaly. The role of magnetic resonance imaging in the diagnostic workup of fetal ventriculomegaly l.
Important in itself, it is also associated with other cns anomalies. Dedicated to the mission of bringing free or lowcost educational materials and information to the global. In ten patients 50%, isolated fetal ventriculomegaly or ventriculomegaly asociated with spina bifida was diagnosed antenatally, and the perinatal management consisted of frequent ultrasound examinations, weekly fetal biophysical profiles, and delivery by. The incidence of ventriculomegaly diagnosed antenatally by ultrasound atrium 1015mm, varies from 1. The role of magnetic resonance imaging in the diagnostic. Accurate measurement of the lateral ventricles is of paramount importance in prenatal diagnosis. Mild cerebral ventriculomegaly on prenatal ultrasound next steps and clinical implications. Fetal ventriculomegaly radiology reference article. Eight fetuses were delivered and had congenital malformations. Fetal intervention has been undertaken in humans in order to minimize the craniofacial disfigurement and to maximize the growth potential of the brain. Vm is clinically diagnosed on ultrasound and is defined as an atrial diameter greater than 10 mm.