Clinical value of prenatal MRI for diagnosis of isolated ventriculomegaly and prediction of early postnatal developmental outcomes

Zhi, Li; Lv, Yi-Dan; He, Pingya; Luo, Zhiqin; Pan, Liming; Du, Ying; Fang, Rong; Liu, Yuqin; Li, Lan; Zhu, Ling

doi:10.1002/pd.5399

Cited by 8 publications

(8 citation statements)

References 17 publications

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“…Compared with ultrasonography, MRI has unique advantages of a large visual field, multiple parameters, and high resolution of soft tissue; it is also not restricted by fetal position or maternal figure and can better visualize the details of the normal anatomy and abnormal lesions of the fetal chest; therefore, it has been adopted as an important supplement to obstetrical ultrasonography (10,16). Fetal MRI examination is usually performed based on True FISP/B-FFE and HASTE/SSFSE sequences, which, with the fast scanning speed, can shorten the imaging time and greatly reduce the number of artifacts in fetuses and pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Prospective analysis of the prognostic value of prenatal MRI measurement of cystic volume ratio in fetal congenital cystic adenomatoid malformation

Li¹,

Li²,

Luo³

et al. 2022

Ann Palliat Med

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Background: The cystic volume ratio (CVR) has been used to predict the prognosis of fetal lung disease, but most of them are reported on ultrasound. The purpose of this study was to investigate the prognostic value of prenatal magnetic resonance imaging (MRI) measurement of CVR in fetal congenital cystic adenomatoid malformation (CCAM). Methods: To collect follow-up data on postnatally confirmed CCAM fetuses. According to the size of CVR, they were divided into a CVR ≥1.26 group and a CVR <1.26 group. The lesions were divided into macrocystic (diameter ≥5 mm) and microcystic (diameter <5 mm) types according to the size of cysts in the lesions. The collected contents also included the location of the lesions, prenatal symptoms, postpartum clinical prognosis, and pregnancy outcomes. Results: In all, 51 cases were collected. Of these, 11 were placed into the CVR ≥1.26 group, and 40 were placed into the CVR <1.26 group; meanwhile 34 were classified as macrocystic lesions and 17 as microcystic lesions; 7 cases involved a terminated pregnancy. In the CVR ≥1.26 group, 81.82% (9/11) and 36.36% (4/11) had displacement of large vessels/heart and increased amniotic fluid, respectively; meanwhile, in the CVR <1.26 group, these phenomena occurred in 35.00% (14/40) and 2.50% (1/40) of cases (P=0.006, 0.010). Additionally, 83.33% (5/6) of live infants in the CVR ≥1.26 group had dyspnea, a significantly higher proportion than the 21.05% (8/38) in the CVR <1.26 group (P=0.011). Moreover, 45.45% (5/11) of the cases in the CVR ≥1.26 group were terminated pregnancies, a significantly higher proportion than the 5.26% (2/38) in the CVR <1.26 group (P=0.001). Finally, the CVR of macrocystic lesions was 0.55 (0.34-1.31), which was significantly greater than the 0.34 (0.17-0.57) of microcystic lesions (P=0.022). Logistical regression analysis identified that CVR is an independent factor associated with the postpartum prognosis of CCAM. Conclusions: Prenatal symptoms and postpartum prognosis were worse than CVR <1.26 when fetal CVR ≥1.26 measured by prenatal MRI; and the measurement of CVR of CCAM through prenatal MRI has considerable practical value in prenatal consultation, evaluation, and postpartum treatment.

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Section: Discussionmentioning

confidence: 99%

Prospective analysis of the prognostic value of prenatal MRI measurement of cystic volume ratio in fetal congenital cystic adenomatoid malformation

Li¹,

Li²,

Luo³

et al. 2022

Ann Palliat Med

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“…• Counselling for myelomeningocele should involve a multidisciplinary team with knowledge of all long-term outcomes. 12mm, [22][23][24]26 and our view is that the term 'moderate ventriculomegaly' can cause unnecessary anxiety and should be abandoned. Unilateral ventriculomegaly (one ventricle is >10mm and ≥2mm difference between the size of the lateral ventricles) and asymmetrical ventriculomegaly (both lateral ventricles >10mm, but ≥2mm difference between sides) have similar outcomes to bilateral ventriculomegaly.…”

Section: Ventriculomegaly Measuring <15mmmentioning

confidence: 95%

“…Of the surviving infants, developmental outcome was typical in 42.4%, mild/moderate atypical outcomes in 18% to 30% (defined as developmental scores 1-2SD below the mean), and severely atypical in 30% to 40%. 22,36 The rates of ventriculoperitoneal shunt insertion (VPS) were 21.4% to 29.5%. 26,37 Larger and progressive ventriculomegaly are the most likely to require neurosurgical intervention and usually have an adverse developmental outcome.…”

Section: Ventriculomegaly Measuring >15mmmentioning

confidence: 99%

“…A meta‐analysis of outcomes of 110 fetuses with iVM >15mm showed the pooled proportion of stillbirth or perinatal death was 12.1%. Of the surviving infants, developmental outcome was typical in 42.4%, mild/moderate atypical outcomes in 18% to 30% (defined as developmental scores 1–2SD below the mean), and severely atypical in 30% to 40% 22,36 . The rates of ventriculoperitoneal shunt insertion (VPS) were 21.4% to 29.5% 26,37 .…”

Section: Ventriculomegalymentioning

confidence: 99%

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Antenatal counselling for prospective parents whose fetus has a neurological anomaly: part 2, risks of adverse outcome in common anomalies

Hart

Vasudevan

Griffiths

et al. 2021

Develop Med Child Neuro

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After diagnosis of a fetal neurological anomaly, prospective parents want to know the best and worst‐case scenarios and an estimation of the risk to their infant of having an atypical developmental outcome. The literature on developmental outcomes for fetal neurological anomalies is poor: studies are characterized by retrospective design, small sample size, often no standardized assessment of development, and differing definitions of anomalies. This review provides an aide‐memoir on the risks of adverse neurodevelopmental outcome for ventriculomegaly, cortical anomalies, microcephaly, macrocephaly, agenesis of the corpus callosum, posterior fossa anomalies, and myelomeningocele, to assist healthcare professionals in counselling. The data in this review should be used alongside recommendations on counselling and service design described in part 1 to provide antenatal counselling.

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“…Until recently, there have been only scattered studies, limited to mostly studies of cases of isolated ventriculomegaly (VM) and posterior fossa abnormalities, which have assessed the role of feMRI in predicting postnatal outcome. [5][6][7][8] The Magnetic Resonance Imaging to Enhance the Diagnosis of Fetal Developmental Brain Abnormalities in Utero (MERIDIAN) study is a large multicenter prospective study that assessed the utility of feMRI in diagnosing fetal brain abnormalities. 9 One component of this study, published in 2019, assessed the prognostic accuracy of feMRI versus ultrasound in predicting postnatal neurodevelopment.…”

mentioning

confidence: 99%

Prognostic Accuracy of Fetal MRI in Predicting Postnatal Neurodevelopmental Outcome

Wilson¹,

Muir²,

Reddy

et al. 2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The superior diagnostic accuracy of fetal MR imaging in detecting fetal brain abnormalities has been previously demonstrated; however, the ability of fetal MR imaging to prognosticate postnatal outcome is not well-studied. We performed a retrospective analysis to determine the prognostic accuracy of fetal MR imaging in predicting postnatal neurodevelopmental outcome. MATERIALS AND METHODS:We identified all fetal MR imaging performed at the Children's Hospital of Eastern Ontario during a 10-year period and assessed agreement between prenatal prognosis and postnatal outcome. Prenatal prognosis was determined by a pediatric neurologist who reviewed the fetal MR imaging report and categorized each pregnancy as having a favorable, indeterminate, or poor prognosis. Assessment of postnatal neurodevelopmental outcome was made solely on the basis of the child's Gross Motor Function Classification System score and whether the child developed epilepsy. Postnatal outcome was categorized as favorable, intermediate, or poor. We also assessed the diagnostic accuracy of fetal MR imaging by comparing prenatal and postnatal imaging diagnoses. RESULTS:We reviewed 145 fetal MR images: 114 were included in the assessment of diagnostic accuracy, and 104 were included in the assessment of prognostic accuracy. There was 93.0% agreement between prenatal and postnatal imaging diagnoses. Prognosis was favorable in 44.2%, indeterminate in 50.0%, and poor in 5.8% of pregnancies. There was 93.5% agreement between a favorable prenatal prognosis and a favorable postnatal outcome. CONCLUSIONS:A favorable prenatal prognosis is highly predictive of a favorable postnatal outcome. Further studies are required to better understand the role of fetal MR imaging in prognosticating postnatal development, particularly in pregnancies with indeterminate and poor prognoses.

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Clinical value of prenatal MRI for diagnosis of isolated ventriculomegaly and prediction of early postnatal developmental outcomes

Cited by 8 publications

References 17 publications

Prospective analysis of the prognostic value of prenatal MRI measurement of cystic volume ratio in fetal congenital cystic adenomatoid malformation

Prospective analysis of the prognostic value of prenatal MRI measurement of cystic volume ratio in fetal congenital cystic adenomatoid malformation

Antenatal counselling for prospective parents whose fetus has a neurological anomaly: part 2, risks of adverse outcome in common anomalies

Prognostic Accuracy of Fetal MRI in Predicting Postnatal Neurodevelopmental Outcome

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