EP03.09: Prenatal diagnosis of ultrasound and MRI in the Vein of Galen aneurysmal malformation

Abstract

To explore the clinical value of prenatal ultrasound and magnetic resonance imaging (MRI) in the Vein of Galen aneurysmal malformation (VGAM). This was a retrospective study of all cases of prenatal diagnosed VGAM by ultrasound and MRI in Hubei maternal and child health hospital during a 7-year period. The ultrasonographic characteristics of VGAM were compared with MRI. 17 cases of prenatal diagnosis of VGAM were managed in our hospital, fifteen cases were diagnosed by prenatal ultrasound and two cases were diagnosed by MRI who were underestimated by prenatal ultrasound. Prenatal diagnosis is usually made during the third trimester. The sonographic features is a hypoechogenic structure located in the middle of the posterior part of the thalamus, with colour Doppler ultrasonography showing turbulent arterial ande venous flow. Nine of fifteen cases were examined with Real time three dimensional power Doppler sonography (3D) and the sagittal sinus of all cases were dilated. There were fifteen (88.2%) terminations and two (11.8%) neonatal deaths. Three (17.6%) cases were isolated and fourteen (82.4%) cases were associated with other abnormalities. VGAM always associated with cardiac anomalies (including cardiomegaly, dialation of jugular vein, dialation of superior vena cava, tricuspid valve regurgitation and fetal hydrops, thirteen cases totally) and cerebral damage (including ventriculomegaly, periventricular leukomalacia, intraventricular hemorrhage, eleven totally). VGAM can be prenatally diagnosed by characteristic ultrasonographic features, prenatal ultrasound is the primary screening method of fetal VGAM. 3D ultrasound can display the angioarchitecture and the communications between widened vascular sinus. MRI can be used to evaluate the development and damage of nervous system. So, the combination of prenatal ultrasound and MRI can be used to provide more accurate and comprehensive diagnosis of VGAM.