1 – Neuroradiology Department, CHLC, EPE
XII Congresso Nacional de Neurorradiologia, 11 - 13 Novembro 2016, Lisboa
Introdução: Periventricular (PV) cysts are a common finding on fetal MRI. Differential diagnoses include a wide range of entities, from benign ventricular adhesions to disorders of metabolism, with widely varied prognosis. Hence, radiologists, obstetricians and parents are faced with a difficult decision when presented with this diagnosis. While for obstetricians certain locations (connatal) of cysts are viewed as benign, our view as neuroradiologists is that this is not always true. As such, we decided to review our Center’s fetal MRI database for PV cysts to correlate their location with associated anomalies and child outcome.
Métodos: Materials and Methods: We reviewed all our Center’s fetal MRI from January 2010 to September 2016. In the reviewed examinations, 28 (8.7%) had periventricular cysts detected on MRI, 3 of which were follow up studies. We divided the detected cysts into connatal (if above the superior margin of the frontal horns of the lateral ventricles), subependimal and of the germinal matrix. These cysts were further categorized in isolated or associated with other malformations. Whenever available, post-mortem/postnatal examinations were reviewed and a correlation between location of PV cysts, associated anomalies and outcome was established.
Results: Of the reviewed examinations, about half had isolated cysts; these patients had mostly good developmental outcomes. Of the 13 with other anomalies, three have normal development, five have neurological deficits, two patients have chromosomopathies and one has an inborn error of metabolism. Five pregnancies were interrupted (20%). Nine patients had follow up imaging examinations and seven only postnatal developmental evaluations. Three patients were lost to follow up.
Conclusion: PV cysts are a common finding and reason for referral for fetal MRI. Although isolated cysts carry most often a good prognosis, concomitant subtle changes in the fetal head or other congenital anomalies can be related to developmental delays/neurological deficits.
Palavras Chave: fetal MRI; periventricular cysts; connatal cysts