Danielle Pier, Presenter: Nothing to Disclose

Henry A. Feldman PhD, Abstract Co-Author: Nothing to Disclose

Judy Ann Estroff MD, Abstract Co-Author: Nothing to Disclose

Caroline Diana Robson MBChB, Abstract Co-Author: Consultant, Amirsys, Inc

Tejas S. Mehta MD, Abstract Co-Author: Nothing to Disclose

Deborah Levine MD, Abstract Co-Author: Consultant, SafeMed Inc, San Diego, CA

Carol Elizabeth Barnewolt MD, Abstract Co-Author: Nothing to Disclose

Richard L. Robertson MD, Abstract Co-Author: Nothing to Disclose

Tina Young Poussaint MD, Abstract Co-Author: Nothing to Disclose

Janice Ware MD, Abstract Co-Author: Nothing to Disclose

Omar Kwaja MD, Abstract Co-Author: Nothing to Disclose

Adre Duplessis MD, Abstract Co-Author: Nothing to Disclose

Janet Soul MD, Abstract Co-Author: Nothing to Disclose

Marjorie Beeghly, Abstract Co-Author: Nothing to Disclose

Rakhee Kisan Sansgiri MBBS, DMRD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

To determine whether fetal MR imaging, in comparison to ultrasound (US) alone, adds clinically useful information among fetuses diagnosed with ventriculomegaly (VM) with respect to postnatal outcome.

318 fetuses were prospectively enrolled after a diagnosis of fetal VM by US (lateral ventricles at atria measuring ≥ 10 mm), and underwent fetal MRI. 2D measurements of the ventricle at the level of the atria and frontal horns, 3D volumetry of supratentorial parenchyma and lateral ventricles, sulcation pattern, parenchymal thickness, cerebellar diameter, and presence of other CNS anomalies were assessed. Initial outcome determination was live birth versus termination/demise. Subsequent outcome was obtained up to age 2, with an abnormal result being defined as an abnormal neurologic finding or 2 standard deviations below the mean on standardized psychometric tests. Analysis of variance and receiver-operating characteristic curve analysis (adjusted for gestational age) were performed to assess which factors were predictive of outcome.

MR showed additional anomalies not seen by US in 72/318 (23%) cases. In 14/171 (8%) cases of isolated VM on US, the diagnosis was changed to VM with associated anomalies on MR. The presence of associated CNS anomalies was predictive of live birth: 43/117 (37%) of these cases were either terminated or did not survive. Other variables associated with outcome were gestational age at diagnosis, cerebellar diameter, ventricular frontal horn diameter, frontal horn:atrial ratio, lateral ventricular volume, and parenchymal thickness in the frontal, parietal, and temporal lobes. Using ROC analysis, however, none of these parameters performed better than atrial diameter (see table). Similar results were obtained in fetuses with isolated VM. The only group in which ventricular volume predicted better than atrial diameter was those with isolated mild VM (atrial diameter 10-12 mm).

MR adds information regarding associated CNS findings in fetuses with VM. These MR indices generally do not add to the prediction of outcome compared to atrial diameter. Further studies are needed to explore if there are combinations of MR indices that are best predictive of outcome.

MR adds useful information in fetuses with VM, however additional indices to predict outcome perform no better than atrial diameter except for ventricular volume in cases of mild isolated VM.

Pier, D, Feldman, H, Estroff, J, Robson, C, Mehta, T, Levine, D, Barnewolt, C, Robertson, R, Poussaint, T, Ware, J, Kwaja, O, Duplessis, A, Soul, J, Beeghly, M, Sansgiri, R, et al, 0, MR Indices of Fetal Ventriculomegaly Correlated to Postnatal Outcome.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8003559.html