Griffiths, P.D. orcid.org/0000-0002-2706-5897, Brackley, K., Bradburn, M. et al. (9 more authors) (2017) Anatomical subgroup analysis of the MERIDIAN cohort: Ventriculomegaly. Ultrasound in Obstetrics & Gynecology, 50 (6). pp. 736-744. ISSN 0960-7692
Abstract
Objective
To assess the contribution of in utero magnetic resonance (iuMR) imaging in fetuses diagnosed with ventriculomegaly as the only abnormal intracranial finding on antenatal ultrasonography (USS) in the MERIDIAN cohort.
Methods
We report a sub-group analysis from the MERIDIAN study, of cases of fetal ventriculomegaly diagnosed on USS who then had iuMR imaging within 2 weeks of USS and for whom outcome reference data were available. The diagnostic accuracy of USS and iuMR are reported in relation to the severity of ventriculomegaly. We also study the difference in measurements of trigone size on the two imaging methods and present the clinical impact of adding iuMR to the diagnostic pathway.
Results
USS failed to detect 31 additional brain abnormalities other than ‘ventriculomegaly’ in the subgroup of 306 fetuses, giving an overall diagnostic accuracy of 89.9% for USS, whilst iuMR correctly detected 27 giving a diagnostic accuracy of 98.4% (statistically significant p < 0.0001). There were other brain abnormalities in 14/244 of fetuses with mild ventriculomegaly on USS (diagnostic accuracy 94.3%), and iuMR correctly diagnosed 12 of those (diagnostic accuracy 98.8%). All of those results reached statistical significance in favour of iuMR. There was a close agreement between the size of trigones measured on USS and on iuMR, with categorical differences in only 16% of cases. iuMR did not systematically over-estimate trigone size, as suspected before the study commenced. Complete prognosis data were available in 295/306 fetuses and the prognosis category changed after iuMR in 69/295 (23.4%) cases. The overall effect of iuMR on clinical management was considered to be either ‘significant’, ‘major’ or ‘decisive’ in 76/295 (25.8%) cases.
Conclusion
Our data suggest that any woman whose fetus has ventriculomegaly as the only intracranial finding on USS should be offered an adjuvant investigation of iuMR for further evaluation.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2017 Wiley. This is the peer reviewed version of the following article: "Griffiths, P. D., Brackley, K., Bradburn, M., Connolly, D. J., Gawne-Cain, M. L., Griffiths, D. I., Kilby, M. D., Mandefield, L., Mooney, C., Robson, S. C., Vollmer, B. and Mason, G. (2017). Anatomical subgroup analysis of the MERIDIAN cohort: Ventriculomegaly. Ultrasound in Obstetrics and Gynaecology", which has been published in final form at https://doi.org/10.1002/uog.17475. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. |
Keywords: | fetus; ventriculomegaly; ultrasonography; magnetic resonance imaging; diagnostic accuracy |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > Department of Infection, Immunity and Cardiovascular Disease The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Funding Information: | Funder Grant number DEPARTMENT OF HEALTH 09/06/01 |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 28 Apr 2017 10:47 |
Last Modified: | 13 Jul 2023 14:54 |
Published Version: | https://doi.org/10.1002/uog.17475 |
Status: | Published |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1002/uog.17475 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:115655 |