1 - Neuroradiology Department,
2 - Neurosurgery department,
3 - Gynecology and Obstetrics Department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
ESMNR 2015, 13-16 May 2015, Porto, Portugal
Diffuse benign villous hyperplasia (DVH) is a rare congenital condition characterized by bilateral enlargement of the choroid plexus and increased ventricular size. MRI is the imaging modality of choice in establishing the diagnosis.
We present a case of DVH diagnosed by fetal MRI (fMRI) and compare it to postnatal brain MRI findings. To our knowledge, no other cases have been diagnosed in utero using this imaging modality.
A primiparous mother had an ultrasound at 21 weeks’ gestation, which showed asymmetrical enlargement of the lateral ventricles. Brain fMRI was performed at 23 weeks’ gestation (and again at 27w), showing moderate lateral ventricle dilatation with enlarged choroid plexus, occupying both atria and occipital horns. Biparietal and fronto-occipital diameters were above P90. Given the findings, DVH was considered the most probable diagnosis and parents decided to carry pregnancy to term. After birth (at 39 weeks) physical and neurological examination was normal, apart from cephalic perimeter (CP) above 95th percentile. Postnatal brain MRIs were performed at 5 weeks and 9 months and corroborated the prenatal findings. No other abnormalities were noted. Ventricular size remained stable, with no need for shunting.
Enlarged lateral ventricles are a common reason of referral for fMRI. This case depicts a rare entity, diagnoses by fMRI and illustrating the crucial role of this imaging modality in prenatal CNS evaluation.
DVH is a benign entity demanding differential diagnosis with more ominous disorders, like CP tumors.