Vein of galen aneurysmal malformation: prognostic markers depicted on fetal MRI.
Fetal magnetic resonance imaging (MRI) serves a dual role in the prenatal diagnostic work up of a vein of Galen aneurysmal malformation (VGAM). First, it may confirm the prenatal ultrasound findings and secondly it may identify prognostically important secondary complications of the VGAM. Progressive heart failure with development of fetal hydrops and hemispheric white matter injuries are associated with a poor outcome in children with a VGAM. We present the prenatal findings using both ultrasound and MRI of a fetus with VGAM including bilateral injury of the cerebral hemispheres, severe dilatation of the jugular veins, cardiomegaly, and hydrops fetalis. The neonate died within 30 minutes after delivery. Moreover, fetal MRI revealed complete placenta praevia, uterine fibroids, and wrapping of the umbilical cord around the fetal neck. This additional information is unrelated to the fetal pathology, but could have been of importance to plan the delivery.
Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science.
Matthias W
MW
Wagner
Maternal Fetal Medicine, McKusick-Nathans Institute of Genetic Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Arthur J
AJ
Vaught
Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science.
Andrea
A
Poretti
Maternal Fetal Medicine, McKusick-Nathans Institute of Genetic Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Karin J
KJ
Blakemore
Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science thuisma1@jhmi.edu.
Thierry A G M
TA
Huisman
D000015:Abnormalities, Multiple / Q000175:diagnosis*; D000328:Adult; D006332:Cardiomegaly / Q000175:diagnosis*; D005260:Female; D005333:Fetus / Q000473:pathology*; D006801:Humans; D015160:Hydrops Fetalis / Q000175:diagnosis*; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D010923:Placenta Previa / Q000175:diagnosis*; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D016216:Ultrasonography, Prenatal; D054080:Vein of Galen Malformations / Q000175:diagnosis*
cardiac failure; fetal magnetic resonance imaging; melting brain; vascular malformation; vein of Galen malformation