Abstract
BACKGROUND AND PURPOSE: Fetuses with isolated nonsevere ventriculomegaly (INSVM) are at risk of presenting neurodevelopmental delay. However, the currently used clinical parameters are insufficient to select cases with high risk and determine whether subtle changes in brain development are present and might be a risk factor. The aim of this study was to perform a comprehensive evaluation of cortical development in INSVM by magnetic resonance (MR) imaging and assess its association with neonatal neurobehavior.
MATERIALS AND METHODS: Thirty-two INSVM fetuses and 29 healthy controls between 26–28 weeks of gestation were evaluated using MR imaging. We compared sulci and fissure depth, cortical maturation grading of specific areas and sulci and volumes of different brain regions obtained from 3D brain reconstruction of cases and controls. Neonatal outcome was assessed by using the Neonatal Behavioral Assessment Scale at a mean of 4 ± 2 weeks after birth.
RESULTS: Fetuses with INSVM showed less profound and underdeveloped sulcation, including the Sylvian fissure (mean depth: controls 16.8 ± 1.9 mm, versus INSVM 16.0 ± 1.6 mm; P = .01), and reduced global cortical grading (mean score: controls 42.9 ± 10.2 mm, versus INSVM: 37.8 ± 9.9 mm; P = .01). Fetuses with isolated nonsevere ventriculomegaly showed a mean global increase of gray matter volume (controls, 276.8 ± 46.0 ×10 mm3, versus INSVM 277.5 ± 49.3 ×10 mm3, P = .01), but decreased mean cortical volume in the frontal lobe (left: controls, 53.2 ± 8.8 ×10 mm3, versus INSVM 52.4 ± 5.4 ×10 mm3; P = < .01). Sulcal depth and brain volumes were significantly associated with the Neonatal Behavioral Assessment Scale severity (P = .005, Nagelkerke R2 = 0.732).
CONCLUSIONS: INSVM fetuses showed differences in cortical development, including regions far from the lateral ventricles, that are associated with neonatal neurobehavior. These results suggest the possible use of these parameters to identify cases at higher risk of altered neurodevelopment.
ABBREVIATIONS:
- INSVM
- isolated nonsevere ventriculomegaly
- NBAS
- Neonatal Behavioral Assessment Scale
- VM
- ventriculomegaly
Footnotes
Disclosures: Nadine Hahner—RELATED: Grant: Agéncia de Gestió d'Ajusts Universitaris i de Recerca, SGR grant No. 1531; CERCA Programme Generalitat de Catalunya; The Cerebra Foundation for the Brain-Injured Child, Carmarthen Wales; European Commission Education, Audiovisual and Culture Executive Agency, 2013-0040; Ministerio de Economia y Competividad–Instituto de Salud Carlos III, PI16/00861; “La Caixa” Foundation, LCF/PR/GN14/10270005*; Support for Travel to Meetings for the Study or Other Purposes: European Commission Education, Audiovisual and Culture Executive Agency, 2013-0040.* Jan Deprest—RELATED: Grant: European Commission Education, Audiovisual and Culture Executive Agency, 2013-0040; UNRELATED: Board Membership: Editorial Board of Gynaecological Surgery.* Eduard Gratacos—RELATED: Grant: Agéncia de Gestió d'Ajusts Universitaris i de Recerca, SGR grant No. 1531; CERCA Programme Generalitat de Catalunya; The Cerebra Foundation for the Brain-Injured Child, Carmarthen, Wales; European Commission Education, Audiovisual and Culture Executive Agency, 2013-0040; Ministerio de Economia y Competividad–Instituto de Salud Carlos III, PI16/00861; “La Caixa” Foundation, LCF/PR/GN14/10270005.* *Money paid to institution.
The research leading to these results was partially funded by the Erasmus + Programme of the European Union (Framework Agreement No. 2013-0040), Instituto de Salud Carlos III (PI16/00861) integrados en el Plan Nacional de I+D+I y cofinanciados por el ISCIII-Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional “Una manera de hacer Europa,” CERCA Programme/Generalitat de Catalunya, “la Caixa” Foundation (LCF/PR/GN14/10270005), AGAUR 2017 SGR grant No. 1531, and The Cerebra Foundation for the Brain-Injured Child, Carmarthen, Wales.
The publication reflects only the views of the authors, and the Commissions holder of the grants cannot be held responsible for any use that may be made of the information contained therein.
Paper previously presented orally at: Ultrasound Meets Magnetic Resonance, September 28–29, 2018, Paris, France; and The Fetal Medicine Foundation World Congress, June 24–28, 2018, Athens, Greece: Regional Differences of Cortical Grey Matter Development in Fetuses with Isolated Non-Severe Ventriculomegaly, Hahner N, Benkarim O, Piella G, Sanroma G, Bargallo N, Gonzalez Ballester MA, Gratacos E, Eixarch E; Poster presentation at: International Society of Ultrasound in Obstetrics and Gynecology Congress, September 16–17, 2017, Vienna, Austria: Differential Cortical Development in Fetuses with Isolated Non-Severe Ventriculomegaly Assessed by MRI, Hahner N, Puerto B, Perez-Cruz M, Gratacos E, Eixarch E.
- © 2019 by American Journal of Neuroradiology
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