ABSTRACT
OBJECTIVES: To compare cortical maturation between fetuses with isolated mild ventriculomegaly (IMV) and healthy fetuses, and to explore its potential prognostic value in IMV. METHODS: This prospective study quantified cortical maturation by ultrasound in 24 fetuses with IMV and 46 healthy fetuses. Depth and grading the developmental pattern of the parieto-occipital fissure (POF), calcarine fissure (CF) and sylvian fissure, and grading the Sylvian fissure operculization at 23-25, 27-28 and 31-32 weeks gestation were determined. RESULTS: At 23-25 and 27-28 gestational weeks, POF and CF mean depths were statistically lower in the IMV group. The POF and CF depth distribution had a normal distribution in the control group but displayed a bimodal distribution in the IMV group. IMV with progression of ventricular dilatation showed mean depth of CF lower than IMV in which ventriculomegaly regressed or remained stable. The sensitivity, specificity, positive predictive value and negative predictive value of a CF depth below the fifth percentile to predict progression of ventricular dilatation were, at 28 weeks, 100%, 88%, 67% and 100%, respectively. CONCLUSIONS: Cortical fissure assessment by ultrasound allowed the differentiation of a subgroup of IMV fetuses with a higher risk of progression of ventricular dilatation.
Subject(s)
Cerebral Cortex/embryology , Hydrocephalus/diagnostic imaging , Adult , Case-Control Studies , Cerebral Cortex/diagnostic imaging , Female , Fetal Development , Humans , Hydrocephalus/complications , Infant, Newborn , Magnetic Resonance Imaging , Male , Pregnancy , Pregnancy Outcome , Prospective Studies , Ultrasonography, PrenatalABSTRACT
OBJECTIVES: To determine the accuracy of measuring the corpus callosum (CC) length in reconstructed mid-sagittal views obtained by 3D multiplanar manipulations or volume contrast imaging in the C-plane (VCI-C) in comparison to measurements obtained by direct mid-sagittal view. METHODS: Forty-six normal fetuses were examined by 2D and 3D ultrasound between 23 and 32 weeks of gestation. Direct mid-sagittal views were obtained by either the transabdominal or/and the transvaginal approach. 3D reconstructed mid-sagittal views were obtained by either 3D multiplanar manipulations or VCI-C. The CC length was measured in direct mid-sagittal views and in 3D reconstructed mid-sagittal views. RESULTS: One hundred and thirty ultrasound examinations were performed. In 118 cases (91%) it was possible to obtain both a direct and a 3D reconstructed mid-sagittal view. Measurements of the CC length in direct mid-sagittal views correlated significantly with the measurements in reconstructed mid-sagittal views when the region underneath the comma-shaped echogenic structure was measured, but correlated poorly when this echogenic structure was included. CONCLUSIONS: Reconstructed mid-sagittal views obtained by 3D multiplanar manipulations or by VCI-C are valid approaches for measuring CC length. In these views the CC should be measured as the region underneath the comma-shaped echogenic structure.
