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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  • 1. Society for Maternal-Fetal Medicine (SMFM); Electronic address: pubs@smfm.org, Fox NS, Monteagudo A, Kuller JA, Craigo S, Norton ME. 2018. Mild fetal ventriculomegaly: diagnosis, evaluation, and management. Am J Obstet Gynecol 219(1):B2-B9.
  • 2. Durfee SM, Kim FM, Benson CB. Postnatal outcome of fetuses with the prenatal diagnosis of asymmetric hydrocephalus. J Ultrasound Med. 2001;20(3):263-8.
  • 3. Levine D, Barnes PD, Robertson RR, Wong G, Mehta TS. Fast MR imaging of fetal central nervous system abnormalities. Radiology 2003;229(1):51-61.
Bozok Tıp Dergisi-Cover
  • ISSN: 2146-4006
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2015
  • Yayıncı: Bozok Üniversitesi
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