Cortical maturation in fetuses referred for ‘isolated’ mild ventriculomegaly: a longitudinal ultrasound assessment

Abstract

OBJECTIVES: To compare cortical maturation between fetuses with isolated mild ventriculomegaly (IMV) and healthy fetuses, and to explore its potential prognostic value in IMV. METHODS: This prospective study quantified cortical maturation by ultrasound in 24 fetuses with IMV and 46 healthy fetuses. Depth and grading the developmental pattern of the parieto-occipital fissure (POF), calcarine fissure (CF) and sylvian fissure, and grading the Sylvian fissure operculization at 23-25, 27-28 and 31-32 weeks gestation were determined. RESULTS: At 23-25 and 27-28 gestational weeks, POF and CF mean depths were statistically lower in the IMV group. The POF and CF depth distribution had a normal distribution in the control group but displayed a bimodal distribution in the IMV group. IMV with progression of ventricular dilatation showed mean depth of CF lower than IMV in which ventriculomegaly regressed or remained stable. The sensitivity, specificity, positive predictive value and negative predictive value of a CF depth below the fifth percentile to predict progression of ventricular dilatation were, at 28 weeks, 100%, 88%, 67% and 100%, respectively. CONCLUSIONS: Cortical fissure assessment by ultrasound allowed the differentiation of a subgroup of IMV fetuses with a higher risk of progression of ventricular dilatation.