P24.04: The many faces of prenatal imaging diagnosis of ventriculomegaly related to aqueduct obstruction

Abstract

To describe the different prenatal imaging patterns of ventriculomegaly related to aqueduct obstruction (AO) throughout pregnancy and underline their impact on prenatal counselling Retrospective review of consecutive prenatal cases of isolated AO diagnosed over a 7 years period (2010-2016). Prenatal imaging findings, post-natal imaging or pathological data as well as post-natal outcome were analysed. 12 cases were included in our study. All cases were referred for ventriculomegaly associated with a sonographic obstructive pattern in 10 cases. In 4 cases, termination of pregnancy was performed due to early severe ventriculomegaly in 3 cases (18, 29, 39 mm) suggestive of complete AO. Fetal MR performed in these 8 cases demonstrated distal or proximal obstruction in 4 cases respectively, related to focal nodular lesion in 6 cases. Post-natal MR confirmed AO in all cases. Post-natal outcome was favourable in all our 8 cases despite severity of ventriculomegaly in 6 cases. Prenatal imaging diagnosis of AO has many faces including severe early ventriculomegaly related to complete obstruction, stable or slowly evolutive ventriculomegaly and a pattern, which has not been reported previously, characterised by rapidly evolutive ventriculomegaly in late pregnancy responsible of white matter damages.