title: Magnetic resonance volumetric assessments of brains in fetuses with ventriculomegaly correlated to outcomes.
abstract: OBJECTIVE
  The purpose of this study was to correlate 2-dimensional magnetic resonance (MR) measurements of lateral ventricular width and 3-dimensional measurements of lateral ventricular and supratentorial parenchymal volumes to postnatal outcomes in fetuses with ventriculomegaly.
  
  
  METHODS
  A total of 307 fetuses (mean gestational age, 26.0 weeks; range, 15.7-39.4 weeks) had MR volumetry after referral for ventriculomegaly. Fetuses were grouped into those with (n = 114) and without (n = 193) other central nervous system (CNS) anomalies. Pregnancy and postnatal neurodevelopmental outcomes up to 3 years of age were obtained. A subgroup analysis was performed excluding fetuses with other CNS anomalies. Logistic regression analysis was performed to assess which measurement was most predictive of outcomes.
  
  
  RESULTS
  There were 50 terminations, 2 stillbirths, and 255 live births. Seventy-five cases were lost to follow-up. Among 180 live-born neonates with follow-up, 140 had abnormal and 40 had normal outcomes. Atrial diameter (P < .0001), frontal horn diameter (P < .0001), and ventricular volume (P = .04) were predictive of live birth, with 92% specificity at 60% sensitivity. Among fetuses without other CNS anomalies, 180 of 193 pregnancies (93%) resulted in live deliveries, with atrial diameter (P < .0001), frontal horn diameter (P = .003), and ventricular volume (P = .008) associated with live birth and atrial diameter having the highest specificity (>99% at 60% sensitivity). Parenchymal volume was not associated with normal or abnormal outcomes (either live birth versus death or normal versus abnormal neurodevelopmental outcome). Among live-born neonates, no age-adjusted threshold for any of the measurements reliably distinguished between normal and abnormal neurodevelopmental outcomes.
  
  
  CONCLUSIONS
  Ventricular volume and diameter, but not parenchymal volume, correlate with live birth in fetuses with ventriculomegaly. However, once live born, neither 2- nor 3-dimensional measurements can distinguish a fetus that will have a normal outcome.
authors.affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.
authors.forename: Danielle B
authors.initials: DB
authors.lastname: Pier
authors.forename: Deborah
authors.initials: D
authors.lastname: Levine
authors.forename: Miliam L
authors.initials: ML
authors.lastname: Kataoka
authors.forename: Judy A
authors.initials: JA
authors.lastname: Estroff
authors.forename: Xiang Q
authors.initials: XQ
authors.lastname: Werdich
authors.forename: Janice
authors.initials: J
authors.lastname: Ware
authors.forename: Marjorie
authors.initials: M
authors.lastname: Beeghly
authors.forename: Tina Y
authors.initials: TY
authors.lastname: Poussaint
authors.forename: Adre
authors.initials: A
authors.lastname: Duplessis
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.forename: Henry A
authors.initials: HA
authors.lastname: Feldman
mesh_terms: D001900:Boston / Q000453:epidemiology; D001921:Brain / Q000196:embryology / Q000473:pathology*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000196:embryology / Q000453:epidemiology* / Q000473:pathology*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic