Diagnosis of Vein of Galen aneurysmal malformation using fetal MRI.
To present three fetal vein of Galen aneurysmal malformations (VGAMs), which were diagnosed through magnetic resonance imaging (MRI), and highlight these cardiovascular findings.



We retrospectively reviewed three fetuses with VGAM at 31, 32, and 33 weeks of gestation. Feeding arteries and draining veins were observed by MRI. Secondary changes in the brain and high-output heart failure caused by high blood flow in the lesion were evaluated. Two fetuses were born, and neonatal MRI was performed. One fetus was terminated.



A characteristic dilated structure in the midline of the brain presented in each fetus. The arteriovenous fistula led to anatomical brain changes such as in the hydrocephalus, dilated feeding vessels (one or more), jugular vein, and/or superior vena cava. Substantial brachiocephalic vessel dilation was observed in two fetuses. Following parturition, one baby had neonatal asphyxia and sinus thrombosis, and MRI revealed hypoxic-ischemic encephalopathy. Cardiomegaly was detected in all three cases.



With a large field of view, fetal MRI can observe brain VGAM, as well as the heart and affected large vessels. It can determine hydrocephalus, ischemia, intracranial hemorrhage, and sinus thrombosis. Providing such information on the infant's entire body can aid clinicians in determining the most appropriate treatment.



4 J. Magn. Reson. Imaging 2017;46:1535-1539.
Department of Medical Imaging, Second Hospital of Hebei Medical University, Shijiazhuang, China.
Li-Xia
LX
Zhou
Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Su-Zhen
SZ
Dong
Department of Rheumatology, Second Hospital of Hebei Medical University, Shijiazhuang, China.
Ming-Feng
MF
Zhang
D000328:Adult; D001164:Arteriovenous Fistula; D001921:Brain / Q000000981:diagnostic imaging; D002550:Cerebral Veins; D003560:Cysts / Q000000981:diagnostic imaging*; D017809:Fatal Outcome; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D012189:Retrospective Studies; D054080:Vein of Galen Malformations / Q000000981:diagnostic imaging*
Vein of Galen; aneurysmal malformation; fetal MRI; fetal brain; magnetic resonance imaging; prenatal imaging