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MR Imaging Appearance of Fetal Cerebral Ventricular Morphology¹

¹ From the Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston MA 02215 (D.L., T.S.M.); Department of Radiology, Saint-Luc, Hospitalier de l’Universite de Montreal St-Denis, Montreal, Quebec, Canada (I.T.); and Department of Radiology, Lucille Salter Packard Children’s Hospital at Stanford, Palo Alto, Calif (P.D.B.). Received August 6, 2001; revision requested September 28; revision received October 15; accepted December 10. Supported by NIH grant NS37942. Address correspondence to D.L. (e-mail: dlevine@caregroup.harvard.edu).

View larger version (182K): [in a new window]   Figure 1. Transverse MR image shows normal ventricular configuration in a normal fetus at 32 weeks of gestational age. Ventricles appear normal. Image obtained with half-Fourier single-shot RARE technique with echo spacing of 4.2 msec; TE, 60 msec; echo train length of 72; one acquisition; 4-mm section thickness; 26 x 35-cm field of view; 128 x 256 acquisition matrix; and 19-second sequence acquisition time.

View larger version (128K): [in a new window]   Figure 2. Transverse MR image of fetus at 18 weeks of gestational age shows primitive fetal ventricular configuration, defined as disproportionate enlargement of the occipital horns (o) in relation to the frontal horns (f), with overall preservation of ventricular morphology. Image obtained with half-Fourier single-shot RARE technique with echo spacing of 4.2 msec; TE, 60 msec; echo train length of 72; one acquisition; 4-mm section thickness; 22 x 30-cm field of view; 128 x 256 acquisition matrix; and 13-second sequence acquisition time.

View larger version (125K): [in a new window]   Figure 3. Transverse MR image shows colpocephaly with parallel orientation of the frontal horns in fetus at 34 weeks of gestational age. Fetus had complete agenesis of the corpus callosum. Image shows loss of the normal frontal angle (f) with parallel orientation of the lateral ventricles and relative dilatation of the occipital horns (o), resulting in a "teardrop" shape. Image obtained with a half-Fourier single-shot RARE technique with echo spacing of 4.2 msec; TE, 60 msec; echo train length of 72; one acquisition; 3-mm section thickness; 30 x 30-cm field of view; 128 x 256 acquisition matrix; and 17-second sequence acquisition time.

View larger version (120K): [in a new window]   Figure 4. Transverse MR image shows colpocephaly with normal orientation of the frontal horns in fetus at 33 weeks of gestational age. Image shows marked enlargement of the occipital horns (O) with slitlike frontal horns (arrows) that have normal angulation. Enlarged occipital horns suggest dysgenesis of the posterior aspect of the corpus callosum. Image obtained with a half-Fourier single-shot RARE technique with echo spacing of 4.2 msec; TE, 60 msec; echo train length of 72; one acquisition; 4-mm section thickness; 22 x 30-cm field of view; 128 x 256 acquisition matrix; and 16-second sequence acquisition time.

View larger version (139K): [in a new window]   Figure 5. Transverse MR image shows angular configuration in a fetus with a myelomeningocele at 20 weeks of gestational age. Image shows angular shape of the ventricular contour, with sharp angles at the frontal and occipital margins (arrows). Image obtained with a half-Fourier single-shot RARE technique with echo spacing of 4.2 msec; TE, 60 msec; echo train length of 72; one acquisition; 5-mm section thickness; 26 x 35-cm field of view; 128 x 256 acquisition matrix; and 31-second sequence acquisition time.

View larger version (154K): [in a new window]   Figure 6. Transverse MR image shows fused frontal horns with only a small amount of the septum pellucidum (arrows) seen inferiorly in a fetus with partial agenesis of the septum pellucidum at 34 weeks of gestational age. This diagnosis was confirmed at postnatal imaging. Image obtained with a half-Fourier single-shot RARE technique with echo spacing of 4.2 msec; TE, 60 msec; echo train length of 72; one acquisition; 4-mm section thickness; 24 x 24-cm field of view; 128 x 256 acquisition matrix; and 16-second sequence acquisition time.

View larger version (134K): [in a new window]   Figure 7. Transverse MR image shows global dilatation of the lateral ventricles in fetus at 19 weeks of gestational age. Image also shows mild ventriculomegaly (atrial size, 14 mm) with globally dilated ventricular morphology. Image obtained with a half-Fourier single-shot RARE technique with echo spacing of 4.2 msec; TE, 60 msec; echo train length of 72; one acquisition; 3.5-mm section thickness; 22 x 30-cm field of view; 192 x 256 acquisition matrix; and 19-second sequence acquisition time.

View larger version (125K): [in a new window]   Figure 8. Coronal MR image shows marked ventricular distortion in fetus with holoprosencephaly at 20 weeks of gestational age. Image obtained with a half-Fourier single-shot RARE technique with echo spacing of 4.2 msec; TE, 60 msec; echo train length of 72; one acquisition; 4-mm section thickness; 22 x 30-cm field of view; 192 x 256 acquisition matrix; and 31-second sequence acquisition time. M = monoventricle.

View larger version (122K): [in a new window]   Figure 9a. Transverse MR images show changing configuration, depending on level of imaging. (a) Image obtained in a fetus at 23 weeks of gestational age shows normal configuration of lateral ventricles. (b) Slightly inferior section plane in the same fetus causes a change in classification of ventricular configuration to primitive fetal ventricular configuration. The overall impression of this case is normal configuration. Images obtained with a half-Fourier single-shot RARE technique with echo spacing of 4.2 msec; TE, 60 msec; echo train length of 72; one acquisition; 3-mm section thickness; 24 x 28-cm field of view; 192 x 256 acquisition matrix; and 22-second sequence acquisition time.

View larger version (114K): [in a new window]   Figure 9b. Transverse MR images show changing configuration, depending on level of imaging. (a) Image obtained in a fetus at 23 weeks of gestational age shows normal configuration of lateral ventricles. (b) Slightly inferior section plane in the same fetus causes a change in classification of ventricular configuration to primitive fetal ventricular configuration. The overall impression of this case is normal configuration. Images obtained with a half-Fourier single-shot RARE technique with echo spacing of 4.2 msec; TE, 60 msec; echo train length of 72; one acquisition; 3-mm section thickness; 24 x 28-cm field of view; 192 x 256 acquisition matrix; and 22-second sequence acquisition time.