Main Congenital Cerebral Anomalies: How Prenatal Imaging Aids Counseling

Garel, Catherine; Moutard, Marie‐Laure

doi:10.1159/000358519

Cited by 36 publications

(46 citation statements)

References 45 publications

(64 reference statements)

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“…2). This reflects the general opinion that fetal MRI is most useful in the diagnosis of CNS abnormalities and the profile of referrals to our tertiary centre [7,9,10,15,16,17,18]. Rare/other anomalies were the second largest group (14%) and consisted of a diverse list of referral indications including seroconversion for infections, skeletal anomalies and fetal neck masses for further characterisation and evaluation of the patency of the fetal airway prior to delivery (fig.…”

Section: Discussionsupporting

confidence: 57%

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The Contribution of MRI after Fetal Anomalies Have Been Diagnosed by Ultrasound: Correlation with Postnatal Outcomes

Verburg

Fink

Reidy³

et al. 2015

Fetal Diagn Ther

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Objective: The aim of this study was to investigate the additional value of fetal magnetic resonance imaging (MRI) in the assessment and management of fetuses with abnormal findings on ultrasound. Methods: A total of 257 patients who had fetal MRI following the ultrasound diagnosis of a fetal anomaly, or were at high risk, were included. The patients were grouped by referral category for fetal MRI. Fetal MRI was compared to ultrasound in the detection of anomalies, i.e. whether additional findings were identified and if this changed diagnosis, prognosis and management during pregnancy. Results: Ultrasound findings were confirmed on fetal MRI in 89% of the cases. Additional findings were seen with MRI in 28% of all patients. The diagnosis changed in 21% and the prognosis in 19% of the cases. Perinatal management changed in 8%. The antenatal findings were confirmed in all cases that had a postmortem examination following termination of pregnancy. In all the pregnancies that continued to delivery and for which the postnatal outcome is known, the findings correlated in 97% of the cases. Conclusion: Fetal MRI provided additional detection of fetal anomalies, leading to a change in diagnosis and prognosis in 19% of the cases. Neonatal and postmortem findings mostly confirmed the fetal MRI diagnosis, suggesting it to be a useful tool for clinical decision making in perinatal management.

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Section: Discussionsupporting

confidence: 57%

“…Historical controls or extrapolation from paediatric studies may not be pertinent to the fetal population [18]. It is possible that an anomaly found in a fetus may not express itself clinically once the child is born.…”

Section: Discussionmentioning

confidence: 99%

The Contribution of MRI after Fetal Anomalies Have Been Diagnosed by Ultrasound: Correlation with Postnatal Outcomes

Verburg

Fink

Reidy³

et al. 2015

Fetal Diagn Ther

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“…However, there are some asymptomatic cases with BPC, which were discovered incidentally after routine examination by ultrasonography [6] or MR imaging [3]. Furthermore, antecedent triggers such as meningitis existed in some [4], showing that the clinical presentation of BPC differs among patients.…”

Section: Discussionmentioning

confidence: 99%

Postnatal development of Blake’s pouch cyst: a case report and new insight for its pathogenesis

et al. 2014

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Blake's pouch cyst (BPC), a rare cystic malformation in the posterior fossa, is believed to be caused by the congenital expansion of the posterior membranous area that normally regresses during embryogenesis. However, due to the wide spectrum of the onset pattern and age of patients, the natural history and the pathogenesis are poorly understood. The authors describe the case of a girl who admitted with headache and right abducens nerve paresis at the age of 3 years and 10 months. Magnetic resonance (MR) imaging demonstrated a tetraventricular hydrocephalus, an open aqueduct, and a posterior fossa cyst compatible with BPC. Multiple tumors were also noticed in the ventricular wall. Tumor biopsy and an endoscopic third ventriculostomy were performed.

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“…Some individuals may remain asymptomatic [29]. Nonetheless, even in isolated DWM, many neurological complications may occur, including epilepsy, hypotony or mental retardation [30].…”

Section: Posterior Fossa Abnormalitiesmentioning

confidence: 99%

Three-dimensional neurosonography — a novel field in fetal medicine

Lipa¹,

Pooh²,

Wielgoś³

2017

Ginekol Pol

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Neurosonography is a promising technique for prenatal diagnosis, combining features of ultrasound imaging with fetal neurology. The brain is a three-dimensional structure, therefore observing brain structure in the three basic planes (sagittal, coronal and axial) is mandatory. The anterior fontanelle and sagittal suture may serve as acoustic ultrasound windows in the transvaginal brain scan, allowing to obtain high-resolution neuroimages of the intracranial structures. Furthermore, three-dimensional (3D) ultrasound combined with the transvaginal brain approach provides detailed and sophisticated neuroimages. Three orthogonal planes of the brain, tomographic ultrasound imaging (TUI) and other off-line approaches (e.g. volume contrast imaging (VCI) or HDlive silhouette imaging) may be obtained from a single 3D dataset. 3D Doppler ultrasound enables visualization of the intracerebral vascularity, allowing to obtain more precise information on cerebral perfusion. Various abnormal brain conditions, including ventriculomegaly, agenesis of the corpus callosum, posterior fossa abnormalities and others, can be well-demonstrated. Due to high rates of the associated anomalies and uncertain prognosis, any suspicion of CNS abnormalities shall imply detailed ultrasonographic evaluation of the fetal anatomy to exclude the associated anomalies. Despite a growing number of neuroimaging modalities, prenatal counselling remains a challenge as prediction of brain functionality and the neurological prognosis often remain uncertain. New investigations on the relations between various migration disorders and gene mutations, as well as recent clinical research on the relations between neuroimaging detection of local migration disorders using sophisticated imaging technologies and the postnatal neurological prognosis will contribute to the development of maternal-fetal medicine as well as pediatric neurology.

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Main Congenital Cerebral Anomalies: How Prenatal Imaging Aids Counseling

Cited by 36 publications

References 45 publications

The Contribution of MRI after Fetal Anomalies Have Been Diagnosed by Ultrasound: Correlation with Postnatal Outcomes

The Contribution of MRI after Fetal Anomalies Have Been Diagnosed by Ultrasound: Correlation with Postnatal Outcomes

Postnatal development of Blake’s pouch cyst: a case report and new insight for its pathogenesis

Three-dimensional neurosonography — a novel field in fetal medicine

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