Purpose or Case Report: The purpose of this research was to analyze our institution’s large database of fetal magnetic resonance (MR) for cases of ventriculomegaly in order to understand trends in pre and postnatal MR.
Methods & Materials: In this retrospective study, 316 individual fetal MR exams from the past 10 years at our institution were reviewed. Of those, 86 patients had fetal MRs with findings of either ventriculomegaly or an ordering indication of ventriculomegaly. Our inclusion criteria of a diagnosis of ventriculomegaly (lateral ventricle measured at the trigone on coronal imaging of over 10mm) on fetal MR with a corresponding postnatal MR for that patient yielded 21 patients. Information extracted included degree of ventriculomegaly, and cause as determined by imaging. Correlation was performed via chart review to understand each patient's clinical outcome. Poor outcome was defined as permanent neurological deficits including seizures and developmental delay. The majority of the clinical outcome information was collected from the first few years of life.
Results: Of the 21 patients with ventriculomegaly with pre and postnatal MR imaging, the cause for ventriculomegaly was determined by prenatal imaging in 10 patients, by postnatal imaging in 4, while in 7 patients, a definite cause was not determined by the combination of prenatal and post-natal imaging. On prenatal imaging 7 fetuses had mild ventriculomegaly (10-12mm), 6 fetuses had moderate ventriculomegaly (>12-15mm) and 6 fetuses had severe ventriculomegaly (>15mm). Of the patients with mild ventriculomegaly, 5/7 had a normal neurological outcome while 2/7 have thus far had a poor neurological outcome. Of the patients with moderate ventriculomegaly, all 6, and similarly of the severe ventriculomegaly, 4/5 have thus far had a poor neurological outcome, with one patient not having enough clinical information thus far to determine outcome.
Conclusions: Our study demonstrates the utility of fetal MR in characterizing ventriculomegaly, with 48% (10/21) of patients receiving an etiology for the ventriculomegaly based on fetal MR findings. Our study also confirms previously reported studies that fetuses with mild ventriculomegaly more often have a normal neurological outcome (71%, 5/7) when compared to those with moderate to severe ventriculomegaly.