Ventriculomegaly with non-CNS anomalies

We correlated fetal magnetic resonance (MR) imaging findings with postnatal clinical findings to assess ventriculomegaly with non-CNS anomalies. From 2002 to 2010, 52 fetuses underwent a MRI for evaluation of ventriculomegaly after ultrasonography (US). Ten of the 52 demonstrated anomalies outside the central nervous system (CNS), including trisomy 8, trisomy 18, X-linked hydrocephalus, CHARGE/Potter sequences, VATER association, oral-facial-digital syndrome, esophageal atresia type C, or external auditory canal stenosis. Examinations were performed between 24 and 35 weeks' gestation. MR imaging was performed in a 1.5-tesla unit using a phased-array coil without preparation. Fetal MR imaging showed abnormalities of the kidney, bladder, duodenum, and thumbs but did not permit diagnosis of esophageal atresia type C or craniofacial, anorectal, or skeletal anomalies. Cardiac anomaly was most frequent, but fetal MR imaging did not allow final diagnosis of congenital heart disease. On both US and MR imaging, esophageal atresia type C and anorectal anomaly were undetected; normal rectal signal in a case of anorectal anomaly without urorectal fistula did not lead to suspicion of anomaly. Observation of adducted thumbs on MR imaging is an important sign of X-linked hydrocephalus. The slice area used in this study did not cover polydactyly, which accompanies oral-facial-digital syndrome. US and MR imaging are complementary imaging methods used to evaluate ventriculomegaly. Fetal MR imaging should cover the kidney, bladder, and fingers. Further work is needed to determine the anomalies that can be clearly detected by fetal MR imaging. (author)