Morphological evaluation of lateral ventricles of fetuses with ventriculomegaly by three-dimensional ultrasonography and magnetic resonance imaging: correlation with etiology

• Published in: Archives of gynecology and obstetrics 2011-08, Vol.284 (2), p.331-336
• Main Authors: Haratz, Karina Krajden, Nardozza, Luciano Marcondes Machado, de Oliveira, Patrícia Soares, Rolo, Liliam Cristine, Milani, Hérbene José Figuinha, de Sá Barreto, Enoch Quinderé, Araujo Júnior, Edward, Ajzen, Sérgio Aron, Moron, Antonio Fernandes
• Format: Article
• Language: English
• Subjects: Aicardi Syndrome - complications; Arnold-Chiari Malformation - complications; Chromosomes, Human, Pair 18; Cross-Sectional Studies; Cytomegalovirus Infections - complications; Endocrinology; Etiology; Fetal Diseases - diagnostic imaging; Fetal Diseases - etiology; Fetuses; Gynecology; Human Genetics; Humans; Hydrocephalus - diagnostic imaging; Hydrocephalus - etiology; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Lateral Ventricles - diagnostic imaging; Magnetic Resonance Imaging; Materno-fetal Medicine; Medicine; Medicine & Public Health; Morphology; NMR; Nuclear magnetic resonance; Obstetrics/Perinatology/Midwifery; Trisomy; Ultrasonography
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-010-1666-z

Purpose To evaluate morphology of lateral ventricles of ventriculomegaly/hydrocephaly fetuses using 3D-sonography by virtual organ computer-aided analysis (VOCAL) technique and magnetic resonance imaging (MRI) and verify morphologic patterns related to etiology. Methods Seventeen fetuses presenting with ventricular enlargement (atria > 10 mm) were evaluated. 3D datasets were acquired from a coronal reference plane and post-processed by the rotational imaging using VOCAL 30 o . MRI study was analyzed in the three plans in all sequences. Morphologic aspects such as global shape, anterior, posterior and inferior horn characteristics, wall irregularities and deformities were analyzed and related to etiology factor. Results Twenty-nine percent of the cases were secondary to Arnold–Chiari syndrome and presented with global dilation of the three-horns. Cases related to aqueduct stenosis presented with ependymal rupture and wall irregularities in advanced cases. Corpus callosum agenesis cases presented with small ventricular volumes, thin shape, normal or slightly enlarged anterior and inferior horns with dilation restricted to posterior horn. Cases related to trisomy 18 and cytomegalovirus presented irregular ventricular walls associated with anomalous ventricular shapes, suggesting parenchymal destruction. Conclusion Ventricular morphology evaluation gives important information on etiology of ventricular enlargement, supporting prognosis prediction and decision making process of the affected fetuses and their families.