Prenatal assessment of ventriculomegaly: an anatomical study.
2003
BACKGROUND: The aim of the study was to analyze the development of the lateral ventricles during the 1st and 2nd trimester of fetal life using computerized image processing, and to compare the findings with the results obtained by ultrasound imaging and MRI. MATERIAL/METHODS: The material consisted of 32 fetuses from spontaneous abortions, 54-235 mm crown-rump length. After detached craniotomy, the brains were cut into axial sections; the sections were filmed with a video camera and then analyzed using specialized software RESULTS: In 12 analyzed brains, no significant pathological changes were observed in the cerebral hemispheres, whereas the remaining 20 (63%) demonstrated visible pathology. In 10 cases there were areas of leukomalacia, in 5 intra- and periventricular hemorrhages, and in 2 fetuses ventriculomegaly with lateral ventricular triangles over 10 mm wide (in cases of active hydrocephalus and colpocephaly). In 1 case of an 18-week-old fetus, lateral ventricular morphology typical of hydrocephalus (generalized distension) was observed with ventricular triangles 8.5 mm wide. The other 2 fetuses demonstrated developmental defects. The frontal horns were the most markedly enlarged in both cases of hydrocephalus (100%) and were semicircular, whereas after intra- and periventricular hemorrhages they were less enlarged and triangular, with the base of the triangle directed to the front and frequent significant asymmetry. CONCLUSIONS: The shape of the ventricular system, including that of the frontal horns, is important in the diagnostics of fetal CNS.
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