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Role of prenatal magnetic resonance imaging in fetuses with isolated severe ventriculomegaly at neurosonography: A multicenter study

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  • Daniele Di Mascio
  • Asma Khalil
  • Gianluigi Pilu
  • Giuseppe Rizzo
  • Massimo Caulo
  • Marco Liberati
  • Antonella Giancotti
  • Christoph Lees
  • Paolo Volpe
  • Danilo Buca
  • Ludovica Oronzi
  • Alice D'Amico
  • Sara Tinari
  • Tamara Stampalija
  • Ilaria Fantasia
  • Lucia Pasquini
  • Giulia Masini
  • Roberto Brunelli
  • Valentina D'Ambrosio
  • Ludovico Muzii
  • Lucia Manganaro
  • Amanda Antonelli
  • Giada Ercolani
  • Sandra Ciulla
  • Gabriele Saccone
  • Giuseppe Maria Maruotti
  • Luigi Carbone
  • Fulvio Zullo
  • Claudiana Olivieri
  • Tullio Ghi
  • Tiziana Frusca
  • Andrea Dall'Asta
  • Silvia Visentin
  • Erich Cosmi
  • Francesco Forlani
  • Alberto Galindo
  • Cecilia Villalain
  • Ignacio Herraiz
  • Filomena Giulia Sileo
  • Olivia Mendez Quintero
  • Ginevra Salsi
  • Gabriella Bracalente
  • José Morales-Roselló
  • Gabriela Loscalzo
  • Marcella Pellegrino
  • Marco De Santis
  • Antonio Lanzone
  • Cecilia Parazzini
  • Mariano Lanna
  • Olav Bennike Bjørn Petersen (Medlem af forfattergruppering)
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OBJECTIVE: The aim of this study was to report the rate of additional anomalies detected exclusively at prenatal magnetic resonance imaging (MRI) in fetuses with isolated severe ventriculomegaly undergoing neurosonography.

METHOD: Multicenter, retrospective, cohort study involving 20 referral fetal medicine centers in Italy, United Kingdom, Spain and Denmark. Inclusion criteria were fetuses affected by isolated severe ventriculomegaly (≥15 mm), defined as ventriculomegaly with normal karyotype and no other additional central nervous system (CNS) and extra-CNS anomalies on ultrasound. In all cases, a multiplanar assessment of fetal brain as suggested by ISUOG guidelines on fetal neurosonography had been performed. The primary outcome was the rate of additional CNS anomalies detected exclusively at fetal MRI within two weeks from neurosonography. Subgroup analyses according to gestational age at MRI (<vs ≥ 24 weeks of gestation) and the laterality of ventriculomegaly (unilateral vs bilateral) were also performed. Univariate and multivariate logistic regression analysis was used to analyze the data.

RESULTS: 187 fetuses with a prenatal diagnosis of isolated severe ventriculomegaly on neurosonography were included in the analysis. Additional structural anomalies were detected exclusively at prenatal MRI in 18.1% of cases. When considering the type of anomaly, malformations of cortical development were detected on MRI in 32.4% cases, while midline or acquired (hypoxemic/hemorrhagic) lesions were detected in 26.5% and 14.7% of cases, respectively. There was no difference in the rate of additional anomalies when stratifying the analysis according to either gestational age at MRI or laterality of the lesion. At multivariate logistic regression analysis, the presence of additional anomalies only found at MRI was significantly higher in bilateral compared versus unilateral ventriculomegaly (OR: 4.37, 95% CI 1.21-15.76; p = 0.04), while neither maternal body mass index, age, severity of ventricular dilatation, interval between ultrasound and MRI, nor gestational age at MRI were associated with the likelihood of detecting associated anomalies at MRI.

CONCLUSION: The rate of associated anomalies detected exclusively at prenatal MRI in fetuses with isolated severe ventriculomegaly is lower than previously reported, but higher compared to isolated mild and moderate ventriculomegaly. Fetal MRI should be considered as a part of the prenatal assessment of fetuses presenting with isolated severe ventriculomegaly at neurosonography.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Vol/bind267
Sider (fra-til)105-110
Antal sider6
ISSN0301-2115
DOI
StatusUdgivet - dec. 2021

Bibliografisk note

Funding Information:
This study was promoted and endorsed by the European NeuroSOnography (ENSO) working group.

Publisher Copyright:
© 2021 Elsevier B.V.

ID: 74000033