Pediatric Radiology

, Volume 37, Issue 10, pp 981–989

Postnatal clinical and imaging follow-up of infants with prenatal isolated mild ventriculomegaly: a series of 101 cases

  • Céline Falip
  • Nathalie Blanc
  • Emmanuelle Maes
  • Isabelle Zaccaria
  • Jean François Oury
  • Guy Sebag
  • Catherine Garel
Original Article
  • 422 Downloads

Abstract

Background

Postnatal imaging and clinical outcome of fetuses with isolated mild ventriculomegaly (IMV) have never been systematically analysed.

Objective

To evaluate the postnatal clinical outcomes of a large cohort of fetuses with IMV and to correlate them with pre- and postnatal imaging.

Materials and methods

We report a prospective study of 101 fetuses with IMV (10–15 mm ventriculomegaly with otherwise normal US, MRI, karyotype and TORCH screening). IMV was divided into minor (10–11.9 mm) and moderate (12–15 mm) ventriculomegaly. Ventriculomegaly was considered uni- or bilateral, stable, progressive, regressive or resolved according to the prenatal US follow-up. Clinical follow-up was performed by a neuropaediatrician. Postnatal imaging included cranial US (n = 71) and MRI (n = 76).

Results

The outcome of minor and moderate IMV was excellent in 94% and 85% of infants, respectively. It was not different between uni- and bilateral IMV, and between stable, regressive and resolved IMV, and was independent of gestational age at diagnosis and gender. Fixed neurological abnormalities were observed in nine infants. Postnatal MRI showed white-matter abnormalities in 14 infants, including 6 of the 9 infants with a poor outcome.

Conclusion

The prognosis was slightly better in minor IMV than in moderate IMV. Postnatal MRI showed white-matter abnormalities in two-thirds of the infants with a poor outcome.

Keywords

Ventriculomegaly Fetus MRI Brain White matter 

References

  1. 1.
    Ouahba J, Luton D, Vuillard E et al (2006) Prenatal isolated mild ventriculomegaly: outcome in 167 cases. BJOG 113:1072–1079PubMedCrossRefGoogle Scholar
  2. 2.
    Garel C, Alberti C (2006) Coronal measurement of the fetal lateral ventricles: comparison between ultrasonography and magnetic resonance imaging. Ultrasound Obstet Gynecol 27:23–27PubMedCrossRefGoogle Scholar
  3. 3.
    Cardoza JD, Goldstein RB, Filly RA (1988) Exclusion of fetal ventriculomegaly with a single measurement: the width of the lateral ventricular atrium. Radiology 169:711–714PubMedGoogle Scholar
  4. 4.
    Garel C (2004) Ventricular dilatation. In: Garel C (ed) MRI of the fetal brain. Springer, Berlin Heidelberg New York, pp 201–216Google Scholar
  5. 5.
    D’Addario V (2004) The role of ultrasonography in recognizing the cause of fetal cerebral ventriculomegaly. J Perinat Med 32:5–12PubMedCrossRefGoogle Scholar
  6. 6.
    Kelly EN, Allen VM, Seaward G et al (2001) Mild ventriculomegaly in the fetus, natural history, associated findings and outcome of isolated mild ventriculomegaly: a literature review. Prenat Diagn 21:697–700PubMedCrossRefGoogle Scholar
  7. 7.
    Bromley B, Frigoletto FD Jr, Benacerraf BR (1991) Mild fetal lateral cerebral ventriculomegaly: clinical course and outcome. Am J Obstet Gynecol 164:863–867PubMedGoogle Scholar
  8. 8.
    Durfee SM, Kim FM, Benson CB (2001) Postnatal outcome of fetuses with the prenatal diagnosis of asymmetric hydrocephalus. J Ultrasound Med 20:263–268PubMedGoogle Scholar
  9. 9.
    Gaglioti P, Danelon D, Bontempo S et al (2005) Fetal cerebral ventriculomegaly: outcome in 176 cases. Ultrasound Obstet Gynecol 25:372–377PubMedCrossRefGoogle Scholar
  10. 10.
    Goldstein RB, La Pidus AS, Filly RA et al (1990) Mild lateral cerebral ventricular dilatation in utero: clinical significance and prognosis. Radiology 176:237–242PubMedGoogle Scholar
  11. 11.
    Nadel AS, Benacerraf BR (1995) Lateral ventricular atrium: larger in male than female fetuses. Int J Gynaecol Obstet 51:123–126PubMedCrossRefGoogle Scholar
  12. 12.
    Vergani P, Locatelli A, Strobelt N et al (1998) Clinical outcome of mild fetal ventriculomegaly. Am J Obstet Gynecol 178:218–222PubMedCrossRefGoogle Scholar
  13. 13.
    Patel MD, Filly AL, Hersh DR et al (1994) Isolated mild fetal cerebral ventriculomegaly: clinical course and outcome. Radiology 192:759–764PubMedGoogle Scholar
  14. 14.
    Wilhelm C, Keck C, Hess S et al (1998) Ventriculomegaly diagnosed by prenatal ultrasound and mental development of the children. Fetal Diagn Ther 13:162–166PubMedCrossRefGoogle Scholar
  15. 15.
    Mercier A, Eurin D, Mercier PY et al (2001) Isolated mild fetal cerebral ventriculomegaly: a retrospective analysis of 26 cases. Prenat Diagn 21:589–595PubMedCrossRefGoogle Scholar
  16. 16.
    Alagappan R, Browning PD, Laorr A et al (1994) Distal lateral ventricular atrium: reevaluation of normal range. Radiology 193:405–408PubMedGoogle Scholar
  17. 17.
    Pilu G, Falco P, Gabrielli S et al (1999) The clinical significance of fetal isolated cerebral borderline ventriculomegaly: report of 31 cases and review of the literature. Ultrasound Obstet Gynecol 14:320–326PubMedCrossRefGoogle Scholar
  18. 18.
    Signorelli M, Tiberti A, Valseriati D et al (2004) Width of the fetal lateral ventricular atrium between 10 and 12 mm: a simple variation of the norm? Ultrasound Obstet Gynecol 23:14–18PubMedCrossRefGoogle Scholar
  19. 19.
    Lipitz S, Yagel S, Malinger G et al (1998) Outcome of fetuses with isolated borderline unilateral ventriculomegaly diagnosed at mid-gestation. Ultrasound Obstet Gynecol 12:23–26PubMedCrossRefGoogle Scholar
  20. 20.
    Kinzler WL, Smulian JC, McLean DA et al (2001) Outcome of prenatally diagnosed mild unilateral cerebral ventriculomegaly. J Ultrasound Med 20:257–262PubMedGoogle Scholar
  21. 21.
    Senat MV, Bernard JP, Schwarzler P et al (1999) Prenatal diagnosis and follow-up of 14 cases of unilateral ventriculomegaly. Ultrasound Obstet Gynecol 14:327–332PubMedCrossRefGoogle Scholar
  22. 22.
    Arora A, Bannister CM, Russell S et al (1998) Outcome and clinical course of prenatally diagnosed cerebral ventriculomegaly. Eur J Pediatr Surg 8 [Suppl 1]:63–64PubMedGoogle Scholar
  23. 23.
    Robson S, McCormack K, Rankin J (1998) Prenatally detected mild/moderate cerebral ventriculomegaly: associated anomalies and outcome. Northern Congenital Abnormality Survey Steering Group. Eur J Pediatr Surg 8 [Suppl 1]:70–71PubMedGoogle Scholar
  24. 24.
    Bloom SL, Bloom DD, DellaNebbia C et al (1997) The developmental outcome of children with antenatal mild isolated ventriculomegaly. Obstet Gynecol 90:93–97PubMedCrossRefGoogle Scholar
  25. 25.
    Breeze AC, Dey PK, Lees CC et al (2005) Obstetric and neonatal outcomes in apparently isolated mild fetal ventriculomegaly. J Perinat Med 33:236–240PubMedCrossRefGoogle Scholar
  26. 26.
    Valat AS, Dehouck MB, Dufour P et al (1998) Fetal cerebral ventriculomegaly. Etiology and outcome, report of 141 cases. J Gynecol Obstet Biol Reprod (Paris) 27:782–789Google Scholar
  27. 27.
    Gilmore JH, van Tol JJ, Lewis Streicher H et al (2001) Outcome in children with fetal mild ventriculomegaly: a case series. Schizophr Res 48:219–226PubMedCrossRefGoogle Scholar
  28. 28.
    Daily DK, Ardinger HH, Holmes GE (2000) Identification and evaluation of mental retardation. Am Fam Physician 61:1059–1067PubMedGoogle Scholar
  29. 29.
    Moeschler JB, Shevell M (2006) Clinical genetic evaluation of the child with mental retardation or developmental delays. Pediatrics 117:2304–2316PubMedCrossRefGoogle Scholar
  30. 30.
    Nelson MD Jr, Tavare CJ, Petrus L et al (2003) Changes in the size of the lateral ventricles in the normal-term newborn following vaginal delivery. Pediatr Radiol 33:831–835PubMedCrossRefGoogle Scholar
  31. 31.
    Pierre-Kahn A, Hanlo P, Sonigo P et al (2000) The contribution of prenatal diagnosis to the understanding of malformative intracranial cysts: state of the art. Childs Nerv Syst 16:619–626PubMedGoogle Scholar
  32. 32.
    Rutherford M, Srinivasan L, Dyet L et al (2006) Magnetic resonance imaging in perinatal brain injury: clinical presentation, lesions and outcome. Pediatr Radiol 36:582–592PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Céline Falip
    • 1
  • Nathalie Blanc
    • 2
  • Emmanuelle Maes
    • 2
  • Isabelle Zaccaria
    • 3
  • Jean François Oury
    • 4
  • Guy Sebag
    • 1
  • Catherine Garel
    • 5
  1. 1.Department of Paediatric ImagingHôpital Robert DebréParisFrance
  2. 2.Department of Pediatric Neurology and Metabolic DiseasesHôpital Robert DebréParisFrance
  3. 3.AP-HP, Unit of clinical epidemiology INSERMHôpital Robert DebréParisFrance
  4. 4.Department of Obstetrics and GynaecologyHôpital Robert DebréParisFrance
  5. 5.Department of RadiologyHôpital d’Enfants Armand-TrousseauParis Cedex 12France

Personalised recommendations