Abstract
Objectives: Fetal magnetic resonance (MR) has greatly improved the ability to counsel patients with fetal diagnosis of ventriculomegaly, since it allows accurate study of the lateral ventricles as well as the whole brain structure in search for additional anomalies. Quantitative MR indices along with qualitative assessment may certainly improve the diagnostic utility of MR to predict postnatal outcomes. Our aim was to assess inter and intraobserver variability in determining fetal lateral ventricle volume using brain MR in fetuses referred for ventriculomegaly (VM). Methods: Lateral ventricle volumes were measured by using planimetry on single-shot rapid acquisition with relaxation enhancement MR images obtained in 30 fetuses with sonographically diagnosed VM (atrial width between 10 and 28 mm). All fetuses aged between 20 and 26 gestational weeks. Exams were performed in a Sonata Maestro Class 1,5-T system (Siemens, Erlangen, Germany) and measurements attained in a Leonardo workstation using ARGUS VA60C software. Ventricular volumes were independently assessed (60 ventricles) in the coronal section plane by two experienced observers, twice by the first observer with at least 1 month of interval between measurements. Reliability and agreement of the volumes were evaluated with intraclass correlation coefficients (ICCs), and proportionate Bland-Altman plots were constructed. Results: Inter and intraobserver analysis showed good agreement between measurements, as shown on the dispersion and BlandAltman plots (most of the measurements were within the mean ±2 SD). ICC was 0.999 for both intra and interobserver (95% CI: 0.999; 1.000; and mean of differences was 0.01 (95% LA: ±2.26; SD: ±1.15) and 0.26 (95% LA: ±1.28 and SD: ±0.65) respectively. Conclusions: Fetal lateral ventricle volume can be readily assessed during the second and third trimesters of gestation. The reliability and validity of MR volume measurements are high, with very good interobserver agreement.
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