The midsagittal view of the fetal brain: a useful landmark in recognizing the cause of fetal cerebral ventriculomegaly

Vincenzo D'Addario 1. , Vincenzo Pinto 2. , Luca Di Cagno 3. ,  and Armando Pintucci 4.
  • 1. Fetal Medicine Unit, Department of Obstetrics and Gynecology, University Medical School, Bari, Italy
  • 2. Fetal Medicine Unit, Department of Obstetrics and Gynecology, University Medical School, Bari, Italy
  • 3. Fetal Medicine Unit, Department of Obstetrics and Gynecology, University Medical School, Bari, Italy
  • 4. Fetal Medicine Unit, Department of Obstetrics and Gynecology, University Medical School, Bari, Italy

Abstract

Aim: To evaluate the positive predictive value of the midsagittal view of the fetal brain in recognizing the cause of ventriculomegaly diagnosed with traditional axial scan.

Methods: Fifty-eight pregnant women, referred to our Center following a generic diagnosis of ventriculomegaly have been evaluated: 38 had marked and 20 had borderline ventriculomegaly. The fetal brain was scanned by the midsagittal view using a transabdominal probe in fetuses in breech presentation or transverse lie and a transvaginal probe in fetuses in cephalic presentation. The possible cause of ventriculomegaly was postulated by combining the findings of the corpus callosum/cavum septi pellucidi complex with those of the posterior fossa. The prenatal diagnoses were compared with the anatomical specimens of aborted fetuses or with postnatal neuroimaging.

Results: The prenatal diagnoses were confirmed in 54/58 cases (PPV 93.1%). In the marked ventriculomegaly group, one case of partial agenesis of the corpus callosum was mistaken for a complete agenesis. In the group of borderline ventriculomegaly, two cases of partial agenesis of the corpus callosum were confused with a complete agenesis, while one case of suspected isolated ventriculomegaly was diagnosed after birth as partial agenesis of the corpus callosum.

Conclusions: The sagittal scan of the fetal brain is a useful source of information and allows the contemporary view of both corpus callosum and posterior fossa, where various typical sonographic findings are present in ventriculomegaly.

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