THE ASSESSMENT OF THE BIOMETRIC PARAMETERS WITH FETAL MAGNETIC RESONANCE IMAGING IN FETUSES WITH MILD-ISOLATED VENTRICULOMEGALY Fetal İzole Ventrikülomegalide Biyometrik Parametrelerin Manyetik Rezonans Görüntüleme ile Değerlendirilmesi
Amaç: Hafif izole ventrikülomegali tespit edilen fetal olgularda beyin biyometrik parametrelerinin fetal manyetik
rezonans görüntüleme (MRG) ile değerlendirilmesidir.
Gereç ve Yöntemler: Antenatal ultrasonda (USG) hafif izole ventrikülomegali tespit edilen ve MRG ile değerlendirilmiş
36 fetüsün MRG görüntüleri retrospektif olarak değerlendirildi. Değerlendirmede fetal beynin
tegmento-vermian açısı, vermis anteroposterior ve superoinferior mesafeleri, korpus kallozum uzunluğu,
fronto-oksipital mesafe, serebellum transvers mesafesi, serebral ve kalvarial biparietal çap, interhemisferik
mesafe, 3. ventrikül genişliği ve sisterna magna mesafesi 2 deneyimli radyolog tarafından birbirlerinden
bağımsız olarak ölçüldü. Ölçümler çeşitli sebeplerle MRG çekilmiş ancak herhangi bir santral sistemi anomalisi
bulunmayan, 34 normal fetüsün beyin biyometrik ölçümleri ile karşılaştırıldı. P değerinin 0.05). Her iki grupta da vermis anteroposterior
ve superoinferior mesafeleri, korpus kallozum uzunluğu, fronto-oksipital mesafe, serebellum transvers mesafesi,
serebral ve kalvarial biparietal çap, interhemisferik mesafe, 3. ventrikül genişliği ve sisterna magna
mesafesinin gestasyonel yaş ile birlikte artış gösterdiği, tegmento-vermian açının ise azaldığı saptandı. İnterhemisferik
mesafe ve 3. ventrikül genişliği gebelik boyunca her iki grupta da stabil iken, hafif-izole ventrikülomegali
grubunda sisterna magna mesafesinin gestasyonel yaş arttıkça artma eğiliminde olduğu görüldü.
Sonuç: Çalışmamızda normal ve izole VM grupları arasında beyin biyometrik değerlerinde farklılık bulunmamıştır.
VM'li fetüslerde fetal MRG eşlik eden patolojileri ve normal intrakraniyal anatomiyi değerlendirmek
için kullanılmaktadır. Daha doğru sonuçlara ulaşmak için ileri çalışmalar gereklidir.
Anahtar Kelimeler: Biometri; Fetal; Manyetik rezonans görüntüleme; Prenatal; Ventrikülomegali
ABSTRACT
Objective: To evaluate the biometric parameters of fetal brain in mild-isolated ventriculomegaly (VM) by
using fetal brain magnetic resonance imaging (MRI).
Material and Methods: In this retrospective study, we reviewed the fetal brain biometry in 36 fetuses with
mild-isolated VM and 34 fetuses who had no central nervous system abnormality by using MRI. All the images
were interpreted by two radiologists. The evaluated parameters of both groups were tegmento-vermian
angle, anteroposterior and superoinferior diameter of vermis, length of the corpus callosum, fronto-occipital
diameter, laterolateral diameter of the cerebellum, cerebral and calvarial biparietal diameter, width of
interhemispheric distance, third ventricle, and cisterna magna.
Results: The mean gestational age was not significantly different between the normal group and mild-isolated
VM group 24.73 (SD ± 0.60) and 24.52 (SD ± 0.64), respectively (p=0.595). No statistically significant
difference was found in biometric parameters between the groups (p > 0.05). The anteroposterior and
superoinferior diameter of the vermis, length of the corpus callosum, fronto-occipital diameter, cerebellar
laterolateral diameter, cerebral and calvarial biparietal diameter increased and tegmento-vermian angle
decreased with gestational age. Interhemispheric distance and third ventricle diameter were stable in both
groups, and the width of cisterna magna also was stable in the normal group, while tended to be increased
in the mild-isolated VM group.
Conclusion: Intracranial anatomy should be evaluated carefully in fetuses with VM to rule out associated
abnormalities although no differences in biometric values between normal and isolated VM groups in our
study. Further studies are required to reach more accurate results.
Keywords: Biometry; Fetal; Magnetic Resonance Imaging; Prenatal; Ventriculomegaly
Effect of Lumbar Spinal Stenosis on Pain, Daily Activities of Living and Muscular Activity
Objective: The aim of this study was investigate whether or not lumbar spinal stenosis (LSS) had effect onpain, daily living activities and muscular activation.Material and Methods: Individuals diagnosed as lumbar spinal stenosis with average of 55,19 ± 10,41 yearsold was included to the study. Individuals were divided into three groups as mild, moderate and severe bydural pouch magnetic resonance imaging inspection. Resting and activity pain assessment was made withvisual analog scale (VAS), muscular activity of the rectus femoris, biceps femoris, tibialis anterior and medialpart of the gastrocnemius was measured with surface electromyography (sEMG), and daily living activitieswas assessed with Oswestry lower back disability index.Results: Significant difference was found in VAS and ODI values according to the LSS severity (p<0,05). Painin resting and during activities were different from each other (p<0,05). It was found that individuals withsevere LSS had more lower limb muscular activity compared to moderate and mild individuals, and individuals with moderate LSS had more muscular activity compared to the mild ones (p<0,05).Conclusion: It was determined that disability and pain increases as the LSS severity increases. It was observed that more pain occurs while patients are active. It was concluded that early diagnosis of LSS is importantand necessary preventions should be taken to prevent further increase in severity.
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