Contrastive Study Of The Diagnostic Efficiency Of MRI And USG In The Fetal Lateral Ventricular Dilatation With Malformation

Objective:We make comparative analysis of the efficacy of MRI and USG in the diagnosis of fetal lateral ventricular dilatation with malformation,to investigate the magnetic resonance imaging characteristics of fetal lateral ventricular dilatation with malformation,to improve the diagnostic ability of mri for fetal lateral ventricular dilatation with malformation.Materials and Methods:We did retrospective analysis of 211 live singletons with lateral ventricular dilatation diagnosed by USG and MRI.Pregnant women are between 18 and 42 years old,the mean age is 28.21 years,gestational age was 17-38 weeks,with an average gestational age of 27.59 weeks.USG diagnosis reports made within a week before the MR examination were used.Reference standard: MR diagnosis was performed retrospectively by two senior physicians with double-blind method,they negotiate and reach a consensus when inconformity happened.Case grouping:according to the degree of lateral ventricle expansion,the patients were divided into mild,moderate and severe lateral ventricle expansion group;isolated lateral ventricle dilation,which contains cases of lateral ventricle dilation without congenital diseases,and non-isolated lateral ventricle dilation,which contains cases of lateral ventricle dilation with congenital diseases.Then to make contrastive analysis of the consistency between MRI and USG in the diagnosis of fetal lateral ventricular dilatation,to compare the diagnostic efficacy of combined malformations and the proportion of lateral ventricular dilatation with various degrees of malformation,to explore the MRI characteristics of different congenital malformations,to summarize the congenital malformations easily missed by USG.Spss 20.0 software was used to analyze the experimental data,count data expressed as percentag;Kappa consistency test was used to analyze the consistency of the two groups of data,0.8<Kappa<1.0indicates good consistency;quadrilateral chi-square test and Fisher's exactprobability method was used for comparison according to the characteristics of the data,the statistical results showed that the difference was statistically significant at P<0.05.Results:Mild lateral ventricular dilatation group,115 cases: MRI diagnosed 111 cases wasonsistent with USG,4 cases was mild diagnosed by MRI,but moderate by USG.Moderate lateral ventricular dilatation group,67 cases: MRI diagnosed 58 cases was consistent with USG,8 cases was moderate diagnosed by MRI,but mild by USG,1cases was moderate diagnosed by MRI,but severe by USG.Severe lateral ventricular dilatation group,29 cases: MRI diagnosed 27 cases was consistent with the USG,MRI diagnosed severe lateral ventricular dilatation and USG diagnosed mild and moderate lateral ventricular dilatation in 1 case respectively.The results of MRI and USG in the diagnosis of mild,moderate and severe fetal lateral ventricular dilatation were well consistent.Isolated lateral ventricle dilation group,80 cases:MRI diagnosed 80 cases was consistent with the gold standard,0 cases was not,the accuracy was 100.0%,while USG diagnosed 72 cases was consistent with the gold standard,8 cases was not,the accuracy was 90.0%,the difference was statistically significant.Non-isolated lateral ventricular dilatation group,131 cases: MRI diagnosed117 cases was consistent with the gold standard,14 cases was not,the accuracy was89.3%,while USG diagnosed 55 cases was consistent with the gold standard,76 cases was not,the accuracy was 40.0%;the difference was statistically significant.MR diagnosed 115 cases of mild lateral ventricular dilatation,59 cases wereCombined with congenital malformation,accounted for 51.3%,while USG diagnosed 120 cases of mild lateral ventricular dilatation,32 cases were combined with congenital malformation,accounted for 26.9%.MR diagnosed 67 cases of moderate lateral ventricular dilatation,43 cases were combined with congenital malformation,accounted for 64.2%,while USG diagnosed 63 cases of mild lateral ventricular dilatation,22 cases were combined with congenital malformation,accounted for 34.9%.MR diagnosed 29 cases of severe lateral ventricular dilatation,29 cases were combined with congenital malformation,accounted for 100.0%,while USG diagnosed 28 cases of mild lateral ventricular dilatation,12 cases were combined with congenital malformation,accounted for 42.9%.Congenital malformations associated with lateral ventricular dilatation were such as: the enlarged posterior fossa,callosal agenesis,paraventricular softening foci,etc.Conclusion:1.MRI and USG have good consistency in diagnosing mild,moderate and severe fetal lateral ventricular dilatation.2.MRI is superior to USG in the diagnosis of non-isolated lateral ventricular dilatation.3.The rate of mild lateral ventricular dilatation combined with congenital malformations is as high as 51.3%,further MR examination is required to detect combined malformations.4.The degree of lateral ventricular dilatation was positively correlated with the proportion of associated malformations.5.The most common malformations associated with mild lateral ventricular dilatation was posterior fossa dilatation and corpus callosum dysplasia,the corpus callosum dysplasia was the most common congenital malformation associated with moderate and severe lateral ventricular dilatation,production inspection should be targeted.6.USG diagnosis of fetal lateral ventricular dilatation with congenital malformations can miss the diagnosis of hyaline dysplasia,dysplasia of the corpus callosum with midline lipoma,paraventricular softening foci,gray matter heterotopia,tuberous sclerosis,smooth brain,the expansion of medicisterna,etc;the ability of USG to diagnose posterior fossa disease such as Dandy-Walker deformity is insufficient;USG lacks of confidence in diagnosis of the unilateral ventricular malformation,the holoprosencephaly and intracranial hemorrhage,they need to be confirmed by MRI.