Document Detail


Magnetic resonance volumetric assessments of brains in fetuses with ventriculomegaly correlated to outcomes.
MedLine Citation:
PMID:  21527607     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to correlate 2-dimensional magnetic resonance (MR) measurements of lateral ventricular width and 3-dimensional measurements of lateral ventricular and supratentorial parenchymal volumes to postnatal outcomes in fetuses with ventriculomegaly.
METHODS: A total of 307 fetuses (mean gestational age, 26.0 weeks; range, 15.7-39.4 weeks) had MR volumetry after referral for ventriculomegaly. Fetuses were grouped into those with (n = 114) and without (n = 193) other central nervous system (CNS) anomalies. Pregnancy and postnatal neurodevelopmental outcomes up to 3 years of age were obtained. A subgroup analysis was performed excluding fetuses with other CNS anomalies. Logistic regression analysis was performed to assess which measurement was most predictive of outcomes.
RESULTS: There were 50 terminations, 2 stillbirths, and 255 live births. Seventy-five cases were lost to follow-up. Among 180 live-born neonates with follow-up, 140 had abnormal and 40 had normal outcomes. Atrial diameter (P < .0001), frontal horn diameter (P < .0001), and ventricular volume (P = .04) were predictive of live birth, with 92% specificity at 60% sensitivity. Among fetuses without other CNS anomalies, 180 of 193 pregnancies (93%) resulted in live deliveries, with atrial diameter (P < .0001), frontal horn diameter (P = .003), and ventricular volume (P = .008) associated with live birth and atrial diameter having the highest specificity (>99% at 60% sensitivity). Parenchymal volume was not associated with normal or abnormal outcomes (either live birth versus death or normal versus abnormal neurodevelopmental outcome). Among live-born neonates, no age-adjusted threshold for any of the measurements reliably distinguished between normal and abnormal neurodevelopmental outcomes.
CONCLUSIONS: Ventricular volume and diameter, but not parenchymal volume, correlate with live birth in fetuses with ventriculomegaly. However, once live born, neither 2- nor 3-dimensional measurements can distinguish a fetus that will have a normal outcome.
Authors:
Danielle B Pier; Deborah Levine; Miliam L Kataoka; Judy A Estroff; Xiang Q Werdich; Janice Ware; Marjorie Beeghly; Tina Y Poussaint; Adre Duplessis; Yi Li; Henry A Feldman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  30     ISSN:  1550-9613     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-29     Completed Date:  2011-09-26     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  595-603     Citation Subset:  IM    
Affiliation:
Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.
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MeSH Terms
Descriptor/Qualifier:
Boston / epidemiology
Brain / embryology,  pathology*
Female
Humans
Hydrocephalus / embryology,  epidemiology*,  pathology*
Imaging, Three-Dimensional / methods*
Magnetic Resonance Imaging / methods*
Outcome Assessment (Health Care)
Pregnancy
Prenatal Diagnosis / statistics & numerical data*
Prevalence
Reproducibility of Results
Risk Assessment / methods
Risk Factors
Sensitivity and Specificity
Statistics as Topic
Grant Support
ID/Acronym/Agency:
R01 EB001998/EB/NIBIB NIH HHS
Comments/Corrections

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