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Research ArticlePediatrics

Prenatal Diagnosis of Fetal Ventriculomegaly: Agreement between Fetal Brain Ultrasonography and MR Imaging

S. Perlman, D. Shashar, C. Hoffmann, O.B. Yosef, R. Achiron and E. Katorza
American Journal of Neuroradiology June 2014, 35 (6) 1214-1218; DOI: https://doi.org/10.3174/ajnr.A3839
S. Perlman
aFrom the Antenatal Diagnostic Unit (S.P., D.S., R.A., E.K.)
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D. Shashar
aFrom the Antenatal Diagnostic Unit (S.P., D.S., R.A., E.K.)
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C. Hoffmann
bDepartment of Obstetrics and Gynecology, and Departments of Diagnostic Imaging (C.H.)
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O.B. Yosef
cPediatric Neurology (O.B.Y.), Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel. (Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.)
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R. Achiron
aFrom the Antenatal Diagnostic Unit (S.P., D.S., R.A., E.K.)
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E. Katorza
aFrom the Antenatal Diagnostic Unit (S.P., D.S., R.A., E.K.)
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  • Fig 1.
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    Fig 1.

    Distribution of number of fetuses providing data as a function of gestational age (n = 162).

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    Fig 2.

    A, Sonographic measurement of the fetal lateral ventricles in the axial transventricular plane. B, Measurement of the fetal lateral ventricles in a T2-weighted MR image (coronal plane) at the level of the ventricles; ventricular diameter is measured at the midheight of the ventricle.

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    Fig 3.

    Plots of the difference between sonographic and MR imaging ventricular measurements against their mean (A, narrower ventricle; B, wider ventricle).

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    Fig 4.

    Plots of the difference between sonography and MR imaging ventricular measurements against the time interval between sonography and MR imaging. Cases of great differences between the 2 modalities: 1) very narrow ventricles on MR imaging, most likely below the measurement resolution by sonography (5 mm); 2) very wide ventricles (>20 mm) in both modalities; and 3) a rare case of disagreement between sonography and MR imaging.

Tables

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    Table 1:

    Distribution of numbers of fetuses providing data as a function of the indication for neurosonography

    IndicationNo.Mean Gestational WeekMinMaxMedian
    CMV seroconversion3533.63304033
    Ventricular asymmetry5431.78213732
    Abnormal head circumference1534.27293835
    Abnormal posterior fossa1031.60263532
    Cystic lesions833.75313733
    Family history of CNS illness632.33313432
    Midline abnormalities631.67233732
    Obstetric complications and extra-CNS anatomic findings2831.00233632
    • Note:—Min indicates minimum; Max, maximum; CMV, cytomegalovirus.

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    Table 2:

    Reproducibility of measurements of the lateral ventricles for ultrasound and MRI

    Differences in Measurement of Ventricles, Ultrasound-MRI (mm)Definition of Ventriculomegaly κ Coefficient
    Mean95% Limits of AgreementICC (95% CI)
    MRI radiologist 1
        Ventricle (a)0.33 ± 1.58(−2.76–1.58)0.91 (0.88–0.94)93.8
        Ventricle (b)−0.26 ± 1.58(−3.35–1.58)0.94 (0.91–0.95)83.4
    MRI radiologist 2
        Ventricle (a)−0.88 ± 1.52(−3.86–1.52)0.9 (0.78–0.95)93.8
        Ventricle (b)−1.09 ± 1.5(−4.05–1.5)0.92 (0.75–0.96)84.2
    • Note:—ICC indicates intraclass correlation coefficient.

    • View popup
    Table 3:

    Comparison between ultrasonography and MRI data in the evaluation of ventricular diameter below and above the clinical cutoff of 10 mm

    Ultrasonography Axial Plane
    Ventricle (a)Ventricle (b)
    <10 mm≥10 mm<10 mm≥10 mm
    MRI coronal plane, radiologist 1
        <10 mm1385*10314*
        ≥10 mm5*1413*32
    MRI coronal plane, radiologist 2
        <10 mm1341**10820**
        ≥10 mm9**185**25
    • ↵* Cases of disagreement for the diagnosis of ventriculomegaly (ventricular width ≥ 10 mm) between ultrasound and MRI for radiologist 1, total of 37 cases.

    • ↵** Cases of disagreement for the diagnosis of ventriculomegaly between ultrasound and MRI for radiologist 2, total of 35 cases.

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    Table 4:

    Interobserver agreement: MRI

    Mean95% Limits of AgreementICC95% CI
    Ventricle (a)−1.20 ± 1.11−3.39–0.970.910.41–0.97
    Ventricle (b)−0.82 ± 1.03−2.84–1.190.960.84–0.98
    • Note:—ICC indicates intraclass correlation coefficient.

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American Journal of Neuroradiology: 35 (6)
American Journal of Neuroradiology
Vol. 35, Issue 6
1 Jun 2014
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Cite this article
S. Perlman, D. Shashar, C. Hoffmann, O.B. Yosef, R. Achiron, E. Katorza
Prenatal Diagnosis of Fetal Ventriculomegaly: Agreement between Fetal Brain Ultrasonography and MR Imaging
American Journal of Neuroradiology Jun 2014, 35 (6) 1214-1218; DOI: 10.3174/ajnr.A3839

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Prenatal Diagnosis of Fetal Ventriculomegaly: Agreement between Fetal Brain Ultrasonography and MR Imaging
S. Perlman, D. Shashar, C. Hoffmann, O.B. Yosef, R. Achiron, E. Katorza
American Journal of Neuroradiology Jun 2014, 35 (6) 1214-1218; DOI: 10.3174/ajnr.A3839
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