1. Role of prenatal magnetic resonance imaging in fetuses with isolated mild or moderate ventriculomegaly in the era of neurosonography: international multicenter study
- Author
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Di Mascio, D, Khalil, A, Thilaganathan, B, Rizzo, G, Buca, D, Liberati, M, Celentano, C, Melchiorre, K, Caulo, M, Pilu, G, Salsi, G, Toni, F, Stampalija, T, Fantasia, I, Luise, G, Gregori, M, Volpe, P, Olivieri, C, Giancotti, A, D'Ambrosio, V, Brunelli, R, Panici, PB, Manganaro, L, Antonelli, A, Ercolani, G, Pasquini, L, Masini, G, Di Maurizio, M, Lees, C, Bracalente, G, Morales-Rosello, J, Loscalzo, G, Saccone, G, Carbone, L, Sarno, L, Maruotti, GM, Zullo, F, Ghi, T, Frusca, T, Dall'Asta, A, Volpe, N, Ormitti, F, Buongiorno, S, De Santis, M, D'Oria, L, Lanzone, A, Prefumo, F, Pinelli, L, Bertucci, E, Sileo, FG, Flacco, ME, Manzoli, L, Giangiordano, I, Mastricci, L, Meccariello, G, Vasciaveo, L, Nappi, L, Familiari, A, Scambia, G, Berghella, V, D'Antonio, F, and ENSO Working Grp
- Subjects
prenatal diagnosis ,fetal ultrasound ,fetal magnetic resonance imaging ,central nervous system ,ventriculomegaly ,MRI ,neurosonography - Abstract
Objectives To assess the role of fetal magnetic resonance imaging (MRI) in detecting associated anomalies in fetuses presenting with mild or moderate isolated ventriculomegaly (VM) undergoing multiplanar ultrasound evaluation of the fetal brain. Methods This was a multicenter, retrospective, cohort study involving 15 referral fetal medicine centers in Italy, the UK and Spain. Inclusion criteria were fetuses affected by isolated mild (ventricular atrial diameter, 10.0-11.9 mm) or moderate (ventricular atrial diameter, 12.0-14.9 mm) VM on ultrasound, defined as VM with normal karyotype and no other additional central nervous system (CNS) or extra-CNS anomalies on ultrasound, undergoing detailed assessment of the fetal brain using a multiplanar approach as suggested by the International Society of Ultrasound in Obstetrics and Gynecology guidelines for the fetal neurosonogram, followed by fetal MRI. The primary outcome of the study was to report the incidence of additional CNS anomalies detected exclusively on prenatal MRI and missed on ultrasound, while the secondary aim was to estimate the incidence of additional anomalies detected exclusively after birth and missed on prenatal imaging (ultrasound and MRI). Subgroup analysis according to gestational age at MRI (< 24 vs >= 24 weeks), laterality of VM (unilateral vs bilateral) and severity of dilatation (mild vs moderate VM) were also performed. Results Five hundred and fifty-six fetuses with a prenatal diagnosis of isolated mild or moderate VM on ultrasound were included in the analysis. Additional structural anomalies were detected on prenatal MRI and missed on ultrasound in 5.4% (95% CI, 3.8-7.6%) of cases. When considering the type of anomaly, supratentorial intracranial hemorrhage was detected on MRI in 26.7% of fetuses, while polymicrogyria and lissencephaly were detected in 20.0% and 13.3% of cases, respectively. Hypoplasia of the corpus callosum was detected on MRI in 6.7% of cases, while dysgenesis was detected in 3.3%. Fetuses with an associated anomaly detected only on MRI were more likely to have moderate than mild VM (60.0% vs 17.7%; P
- Published
- 2020