Role Of Magnetic Resonance Imaging in Fetal Ventriculomegaly

Abstract

Background: Fetal ventriculomegaly is diagnosed when maximal diameter of the atrium of the lateral ventricles exceeds 10 mm. The overall prevalence of fetal ventriculomegaly ranges between 1-2 per 1000. The etiopathogenesis of fetal ventriculomegaly can be either due to imbalance between production and absorption of CSF or abnormal cerebral development. In addition to these 2 mechanisms destructive disease processes, vascular insults and intrauterine infections can also cause fetal ventriculomegaly. In addition to objectively assessing the severity of fetal ventriculomegaly MRI can also detect structural anomalies, white matter pathologies and destructive lesions affecting fetal brain. This study was performed to evaluate the utility of fetal MRI for prenatal assessment of fetal ventriculomegaly. Aims and Objectives: To evaluate the utility of fetal MRI for prenatal assessment of fetal ventriculomegaly. Methods: This was a prospective cohort study conducted in the department of radio-diagnosis in a tertiary care hospital situated in a metropolitan city over a period of 24 months. All pregnant women who have been referred for fetal MRI after a diagnosis of fetal ventriculomegaly on ultrasound were included in this study. MRI was done using GE 1.5 Tesla TWIN SPEED, HDX MRI machine using predefined protocol. The data was collected on pre-designed study pro forma. The data was entered in Microsoft Excel Program and checked for any inconsistencies. Data was analysed using SPSS 16.0 version. Results: The prevalence of ventriculomegaly was found to be 40% (12 out of 30). Out of this bilateral ventriculomegaly was seen in 8 cases (66.66%) while unilateral ventriculomegaly was seen in 4 cases (33.33%). Isolated ventriculomegaly was seen in 6 cases (50%) while ventriculomegaly was associated with other CNS anomalies in rest (50%). Out of 12 cases with ventriculomegaly 7 patients (58.33%) had mild ventriculomegaly and moderate and severe ventriculomegaly was seen in 3 (25%) and 2 (16.67%) patients respectively. Conclusions: MRI is a valuable imaging modality for the diagnosis of fetal ventriculomegaly. It can reliably diagnose ventriculomegaly as well as any associated abnormalities. It can be further used to decide management and predict the outcome of patients with fetal ventriculomegaly.