Fourth ventricle index: sonographic marker for severe fetal vermian dysgenesis/agenesis

Haratz, K.K.; Shulevitz, S. Leshem; Leibovitz, Z.; Lev, Dina; Shalev, Josef; Tomarkin, M.; Malinger, G.; Lerman‐Sagie, Tally; Gindes, L.

doi:10.1002/uog.19034

Cited by 10 publications

(13 citation statements)

References 23 publications

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“…Es ist jedoch verse diameter should always be greater than the AP diameter (ratio > 1). A ratio < 1 was described in cases of vermian hypoplasia [30].…”

Section: Fourth Ventriclementioning

confidence: 98%

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The Fetal Posterior Fossa on Prenatal Ultrasound Imaging: Normal Longitudinal Development and Posterior Fossa Anomalies

Pertl¹,

Eder²,

Stern³

et al. 2019

Ultraschall in Med

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Fetal neurosonography and the assessment of the posterior fossa have gained in importance during the last 2 decades primarily due to the development of high-resolution ultrasound probes and the introduction of 3 D sonography. The anatomical development of the posterior fossa can be visualized well with the newest ultrasound technologies. This allows better knowledge of the anatomical structures and helps with understanding of the development of malformations of the posterior fossa. In this article the longitudinal development of the posterior fossa structures will be reviewed. The embryologic description will be compared with ultrasound descriptions. These embryologic and anatomic illustrations form the basis for the screening and diagnosis of malformations of the posterior fossa. During the first trimester, screening for open spina bifida as well as cystic malformations of the posterior fossa is possible. In the second and third trimester, malformations of the posterior fossa can be subdivided into 3 groups: fluid accumulation in the posterior fossa (Dandy-Walker malformation, Blake’s pouch cyst, mega cisterna magna, arachnoid cyst, vermian hypoplasia), decreased cerebellar biometrics (volume) (cerebellar hypoplasia, pontocerebellar hypoplasia) and suspicious cerebellar anatomy (Arnold-Chiari malformation, rhombencephalosynapsis, Joubert syndrome). This algorithm, in combination with knowledge of normal development, facilitates the diagnostic workup of malformations of the posterior fossa.

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“…Es ist jedoch verse diameter should always be greater than the AP diameter (ratio > 1). A ratio < 1 was described in cases of vermian hypoplasia [30].…”

Section: Fourth Ventriclementioning

confidence: 98%

“…In cases of Joubert syndrome or other forms of pronounced vermian dysgenesis/agenesis, the width is smaller than the AP diameter of the fourth ventricle (4VI < 1, ▶ Fig. 13) [30].…”

Section: Joubert Syndrome (And Related Disorders = Jsrd)mentioning

confidence: 99%

The Fetal Posterior Fossa on Prenatal Ultrasound Imaging: Normal Longitudinal Development and Posterior Fossa Anomalies

Pertl¹,

Eder²,

Stern³

et al. 2019

Ultraschall in Med

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“…Quarello (63) resalta la forma normal cuadrangular del cuarto ventrículo con el diámetro transverso de mayor tamaño que el antero-posterior y, en los casos con síndrome de Joubert, observó que la forma del cuarto ventrículo era alargada. Haratz (64) , en base a estos estudios, en una serie prospectiva de 384 fetos normales propone la valoración rápida del cuarto ventrículo por la relación entre diámetro latero-lateral y antero-posterior, denominándolo indice del cuarto ventrículo ( fourth ventricle índex -4VI), el cual es mayor de 1 en fetos normales, independiente de la edad gestacional (figura 6A). Por medio de esa evaluación se podría lograr la detección de patologías como el síndrome de Joubert, romboencefalosinapsis, hipoplasia pontocerebelar y malformaciones corticales de tipo adoquinado (65)(66)(67)(68)(69)(70) .…”

Section: Visualización De La Cisura De Silviounclassified

Evaluación del cerebro fetal: nuevas herramienta

Paredes

Malinger

2021

Rev peru ginecol obstet.

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La evaluación del cerebro fetal es un punto imprescindible en el ultrasonido obstétrico, por la gran cantidad de malformaciones que pueden ser diagnosticadas. La guía de ISUOG nos brinda los cortes elementales para la sospecha de la patología cerebral; pero, podemos ampliar y mejorar nuestro ultrasonido con la visualización de estructuras fácilmente reproducibles, tales como el complejo anterior, cuerpo calloso, cisura de Silvio y el cuarto ventrículo. Presentamos algunas herramientas para complementar la evaluación del cerebro fetal.

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“…This long period of development(protracted development) makes the cerebellum vulnerable to common developmental disorders such as Dandy-Walker malformations and pontocerebellar hypoplasia (Ten Donkelaar and Lammens 2009).There are four important phases of cerebellar development namely, cerebellar territory characterization; the formation of ventricular zone and rhombic lip forming Purkinje cells, deep cerebellar nucleus and granule cells; the migration of granule layer from external to internal and lastly the cerebellar circuitry formation (ten Donkelaar et al 2003).Apart from the formation of cerebellar hemispheres, the cerebellar vermis, a small, hindbrain structure develop from the rostral segments of the rhombencephalon in early gestation (Martinez et al 2013, Millen andGleeson 2008).The cerebellum contribute to both motor and non-motor functions such as movement, proprioception, and cognition (Basson and Wingate 2013, Koziol et al 2014, Ben-Yehudah, Guediche, and Fiez 2007. Cerebellar malformations are common (Santoro et al 2019, Howley et al 2018 and have long term consequences in children (Pinchefsky et al 2019, Abel andTahir 2019),therefore frontiers in obstetric and radiological societies emphasize the important for routine screening of the cerebellum and vermis in utero (Haratz et al 2019, Quarello et al 2014. Early detection (prenatal diagnosis of the cerebellar abnormality is essential and have some prognostic impacts (Patek et al 2012, Gandolfi Colleoni et al 2012, Wuest et al 2017.Obstetric ultrasound has been a routine diagnostic tools in evaluation of fetal well-being in utero (Whitworth, Bricker, andMullan 2015, Henrichs et al 2019), however, the fetal cerebellar structures such as the vermis, being small in size and deep in skull base, the routine axial sonography may not suffice to depict the subtle changes during cerebellar development (Yang et al 2012, Pugash et al 2008.…”

Section: Introductionmentioning

confidence: 99%

“…The cerebellum contribute to both motor and non-motor functions such as movement, proprioception, and cognition(Basson and Wingate 2013, Koziol et al 2014, Ben-Yehudah, Guediche, and Fiez 2007). Cerebellar malformations are common (Santoro et al 2019, Howley et al 2018) and have long term consequences in children(Pinchefsky et al 2019, Abel and Tahir 2019),therefore frontiers in obstetric and radiological societies emphasize the important for routine screening of the cerebellum and vermis in utero(Haratz et al 2019, Quarello et al 2014). Early detection (prenatal diagnosis of the cerebellar abnormality is essential and have some prognostic impacts (Patek et al 2012, Gandolfi Colleoni et al 2012, Wuest et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Fetal cerebellar development: 3D morphometric analysis of fetal postmortem MRI among Chinese fetuses

Suluba

Liu

2021

Preprint

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The development of the cerebellum starts from early gestational period and extends postnatal. Because of its protracted development, the cerebellum is susceptible to developmental anomalies such as Dandy-Walker malformations, Blakes pouch cysts and vermin hypoplasia. Measurements of fetal cerebellar parameters of a normal growing fetus in each week of gestation is important for setting up morphometric standards and hence used as clinical reference data. Any deviation from the normal cerebellar parameters alerts the clinicians for the possibility of presence of cerebellar malformations. Study objective: The objective of this study was to assess the fetal cerebellar growth by quantifying the following parameters; fetal cerebellar volume, anterior-posterior diameter and superior-inferior diameter. Methods: We used 3T and 7T MRI to scan the postmortem fetal brains at different stages of development and subsequently analyze the images using ITK-SNAP software. Results: The mean superior-inferior cerebellar diameter was found to be 19.12+2. 70mm.The linear(y=bo+b1t) model was the best fit (r2=0.996, F=32022.961) to describe the relationship between the gestational age and the superior-inferior diameter(y=5.89+0.49t). There was significant correlation between the superior-inferior cerebellar diameter and the gestation age, Pearson correlation coefficient of 0.999, r=0.001. The median cerebellar volume was 8607.7mm, the mean rank high among males(78.12) as compared to female(68.25). There was no statistically significant difference of the cerebellar volume between males and females (u=2193.5,p=0.16). The quadratic(y=bo+b1t+b2t2) model was the best fit regression equation (r2=0.994,F=10791.157) describing the relationship between the cerebellar volume and the gestational age. The median anterior-posterior diameter was 12.45 mm. There was significant correlation between anterior-posterior diameter and the gestational age with Spearmans rho of (0.997, p=0.01). The linear model was the best fit the best fit model (y=bo+b1t) describing the relationship between anterior-posterior diameter and the gestational age(y=3.31+0.5t) r2=0.998, F=70646.838. Conclusion: Significant correlation between the superior-inferior cerebellar diameters, the anterior-posterior cerebellar diameter and the gestational age was found. These two linear parameters follow the first-degree polynomial in relation to the gestational age. The cerebellar volume follows the second-degree polynomial as it increases with the gestational age and correlate significantly with the gestational age. This study has provided new insight to the development of the cerebellum, and setup a benchmark data of which the deviation from it will alert the clinicians for the possibility of presence of cerebellar malformations. Key words: Cerebellar Development, Cranial Magnetic Resonance imaging, Cerebellar Malformations

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Fourth ventricle index: sonographic marker for severe fetal vermian dysgenesis/agenesis

Abstract: The 4VI is sonographic marker for severe fetal vermian dysgenesis / agenesis in the absence of an open 4v. It may be easily incorporated into the routine brain scan and a 4VI <1 indicate the need of dedicated fetal neuroimaging studies for appropriate diagnosis and prenatal counseling.

Cited by 10 publications

References 23 publications

The Fetal Posterior Fossa on Prenatal Ultrasound Imaging: Normal Longitudinal Development and Posterior Fossa Anomalies

The Fetal Posterior Fossa on Prenatal Ultrasound Imaging: Normal Longitudinal Development and Posterior Fossa Anomalies

Evaluación del cerebro fetal: nuevas herramienta

Fetal cerebellar development: 3D morphometric analysis of fetal postmortem MRI among Chinese fetuses

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