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The Role of Magnetic Resonance Imaging in the Evaluation of Isolated Mild Ventriculomegaly

Department of Obstetrics and Gynecology, Hadassah University Hospital–Mount Scopus, Jerusalem, Israel (D.V.V., S.P., S.Y.); Department of Radiology, Sourasky Medical Center, Tel Aviv, Israel (L.B.-S.); and Department of Radiology, Hadassah University Hospital–Ein Kerem, Jerusalem, Israel (N.Y., A.L., M.N., J.M.G.).

Address correspondence and reprint requests to Simcha Yagel, MD, Department of Obstetrics and Gynecology, Hadassah University Hospital–Mount Scopus, PO Box 24035, Jerusalem 91240, Israel. E-mail: syagel{at}hadassah.org.il.

Objective. Isolated mild ventriculomegaly is defined as dilatation of the lateral ventricle from 10 to 15 mm, with no other structural abnormalities observed at the time of diagnosis. Its reported frequency is between 1 per 50 and 1 per 700 deliveries. There are no universal recommendations for evaluation of isolated mild ventriculomegaly. Targeted sonography, karyotype analysis, and viral antigen testing, particularly for cytomegalovirus, are most often used for further investigation of this finding. We studied the role of magnetic resonance imaging as part of the prenatal evaluation of isolated mild ventriculomegaly. Methods. Thirty-six pregnant women were referred to 2 Hadassah hospitals between 1999 and 2002 for evaluation of isolated mild ventriculomegaly. They underwent targeted sonography to exclude other anomalies, genetic amniocentesis for fetal karyotype, and serologic cytomegalovirus tests. Mild ventriculomegaly was the only pathologic finding diagnosed. Fetal brain magnetic resonance imaging was performed to evaluate the correlation between sonographic and magnetic resonance imaging findings and the additional contribution of magnetic resonance imaging in evaluating isolated mild ventriculomegaly. Results. Thirty-six magnetic resonance imaging studies were performed. All tests were adequate for evaluation. In 3 (8.3%) of 36 cases, magnetic resonance imaging showed additional findings: in a severely obese woman, ventricular dilatation up to 18 mm and periventricular cystic lesions with abnormal sulcation suggestive of diffuse parenchymal abnormality were diagnosed, and in 2 cases, bleeding in germinal centers was found. On subsequent sonographic examination, no other finding but isolated mild ventriculomegaly was diagnosed. In the remaining 33 women (91.7%), magnetic resonance imaging studies correlated well with sonographic findings. Further sonographic follow-up in this subgroup failed to reveal any other pathologic findings. Conclusions. Our study supports the view that magnetic resonance imaging should be considered as part of the evaluation of isolated mild ventriculomegaly, especially when objective difficulties preclude detailed sonographic examination.

Key Words: fetal brain imaging • isolated mild ventriculomegaly • magnetic resonance imaging • prenatal diagnosis • sonography

Abbreviations: CMV, cytomegalovirus • CNS, central nervous system • IMV, isolated mild ventriculomegaly • MRI, magnetic resonance imaging

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