Diagnosis Of Choroid Plexus Cysts Research Articles

Prenatal Diagnosis of Choroid Plexus Cyst: What Next?

Fetal choroid plexus cysts (CPC) are often detected on prenatal ultrasounds and pose a need to formulate protocol for management and counseling. A total of 1024 unselected cases between gestational ages 11 and 20 weeks were sonologically screened for CPC in 1-year period. On ultrasound, CPC are seen as sonolucent spaces in the echogenic choroid plexus of lateral ventricles of brain measuring at least 2-3 mm in diameter. Those diagnosed with CPC were subjected to thorough anomaly scan. Prenatal karyotype was offered in cases of associated anomalies. The incidence of CPC is 1% (10/1024) in this study. Associated anomalies were found in 20% (2/10) of cases, which were offered invasive testing for fetal karyotype. All the cases with isolated CPC had good outcome. Isolated CPC with low-risk biochemical screening for aneuploidies are now considered normal variants rather than a pathology, need no invasive testing and carry a good prognosis. CPC associated with other anomalies warrant invasive testing and are more likely to be associated with Trisomy 18.

Steady-state coherent imaging sequence in MRI is useful in the diagnosis of choroid plexus cyst : a case report

Steady-state coherent imaging sequence in MRI is useful in the diagnosis of choroid plexus cyst : a case report

Clinical analysis of four cases of intracranial choroid plexus cysts

Objective To summarize and report the diagnosis and management of choroid plexus cysts.Methods The clinical date of 4 choroid plexus cysts cases from March 2005 and 2010 March were analyzed retrospectively,and pathology appearances,surgical treatment were evaluated.Methods Intracranial cystic lesion and compression symptoms were represented in 4 cases.The MR feature of the choroid plexus cyst was low signal intensity on T1- weighted and high signal intensity on T2-weighted.The cyst walls were not reinforcement while contrast enhancement.Histological examination revealed the choroid plexus cyst consisted of complete basement membranes covered with a layer of cuboidal or flat choroid plexus epithelium.4 cases were followed up for 0.5-5.0 years and showed satisfying results with no complication.Conclusion The clinical presentations of choroids plexus cysts are not representative.Attention to the diagnosis of choroid plexus cyst while radiological examination review a cystic lesion within the lateral ventrical and the cerebellopontine angle.Craniotomy or endoscopic cyst resection to remove the cysts is an effective treatment method. Key words: Choroid plexus cysts; Lateral ventricle; Cerebellopontine angle; Surgical procedures,operative

Choroid plexus cysts: Infant and early childhood developmental outcome

To determine the infant and early childhood developmental outcome associated with choroid plexus cysts diagnosed prenatally. Between January 1990 and August 1995, 8270 women underwent second-trimester ultrasound examinations. All women whose fetuses were diagnosed as having choroid plexus cyst(s) underwent ultrasonographic detailed anatomy survey, were offered fetal karyotyping, and were followed with serial ultrasounds. Fetal karyotype, associated structural anomalies, maternal serum triple analyte screen, neonatal outcomes, and infant and early childhood developmental milestones were recorded. The children were followed subsequently, and developmental assessment was performed with a modified Denver II Developmental Screening Test. A diagnosis of choroid plexus cyst was made in 89 fetuses (1.1%). The mean (+/-standard deviation [SD]) gestational age at diagnosis was 18.2 +/- 1.9 weeks (range 15-22). The cysts varied in size and laterality, with a mean (+/-SD) size of 5.9 +/- 3.3 mm (range 1-23). Three of the 61 women who underwent testing for fetal karyotype (4.9%) had abnormal karyotypes identified. All three karyotypes were trisomy 18, and all three trisomy 18 fetuses had additional sonographic abnormalities. All 28 women who chose not to undergo fetal karyotypic analysis delivered phenotypically normal infants. Infant and childhood developmental follow-up was performed on 76 children with cysts diagnosed prenatally. The mean (+/-SD) length of childhood follow-up was 35.5 +/- 16.2 months (range 12-82). All 76 children were found to be developmentally normal by the Denver II Developmental Screening Test. These observations suggest that the finding of isolated choroid plexus cysts is not associated with delayed infant and early childhood development or an increased risk of abnormal karyotype. The presence of isolated choroid plexus cysts does not warrant intensive infant and early childhood follow-up.

Isolated fetal choroid plexus cysts and trisomy 18: A review and meta-analysis

OBJECTIVE: Risk of trisomy 18 in a fetus with ultrasonographic diagnosis of choroid plexus cysts and no other anomalies is controversial. Using our data and current literature, we performed a meta-analysis and estimated the positive predictive value of isolated choroid plexus cysts fot risomy 18. STUDY DESIGN: Between Jan. 1, 1989, and Dec. 31, 1992, all women undergoing ultrasonographic examination at our institution were prospectively evaluated for fetal choroid plexus cysts and cytogenetic outcome. In addition, all reports dealing with fetal choroid plexus cysts obtained from MEDLINE (1983 through 1992) were assessed. Only prospective studies with > 10 cases of choroid plexus cysts were further evaluated to determine the total number of fetuses with choroid plexus cysts and otherwise normal sonograms. Frequency of aneuploidy was determined by analysis of our data and the included studies. To estimate the positive predictive value of choroid plexus cysts from trisomy 18, a theoretic 2 × 2 table was constructed with values available from the literature. RESULTS: Eighty fetuses with choroid plexus cysts were identified in our unit. Of 74 fetuses with isolated choroid plexus cysts, there were no cases of trisomy 18. Meta-analysis identified 2 cases of trisomy 18 among 748 fetuses with isolated cysts ( 1 374 ). To derive a positive predictive value of isolated choroid plexus cysts for trisomy 18, we reviewed the literature and found a total of 50 fetuses with trisomy 18 who underwent ultrasonographic examination in the midtrimester. There were 3 cases of isolated choroid plexus cysts, and 12 of 50 (24%) had otherwise normal ultrasonographic results. Using a midtrimester incidence of 1 in 2461 for trisomy 18 (Hsu LYF. In: Milunsky A, ed. Genetic disorders of the fetus. 3rd ed. Baltimore: Johns Hopkins University Press, 1992:155–210; Hook et al. Am J Hum Genet 1989;1945:855–861 and a prenatal prevalence of 0.95% for choroid plexus cysts (based on a review of the literature), we obtained a positive predictive value of 1 in 390. CONCLUSION: On the basis of the risk for trisomy 18 obtained from our meta-analysis ( 1 374 ) and its close approximation to the estimated positive predictive value ( 1 390 ), our data do not support the routine offering of invasive prenatal cytogenetic testing in cases of isolated choroid plexus cysts.

Isolated choroid plexus cyst(s): An indication for amniocentesis

Our purpose was to prospectively evaluate the risk of chromosomal abnormalities associated with isolated choroid plexus cyst(s) in gravid women undergoing second-trimester ultrasonographic examination. During a 24-month period 9100 pregnant women underwent midtrimester ultrasonographic evaluation. Women with a fetal diagnosis of choroid plexus cyst(s) were offered amniocentesis and a repeat examination in 4 to 6 weeks. A diagnosis of choroid plexus cyst(s) was made in 102 fetuses (1.1%). In four of these fetuses multiple congenital anomalies were noted. Three of the four fetuses had a chromosomal abnormality, two trisomy 18 and one unbalanced translocation, t(3;13). In the remaining 98 fetuses the choroid plexus cysts were isolated findings, that is, there were no other ultrasonographically detected anomalies. Seventy-five of these 98 fetuses underwent amniocentesis. An abnormal karyotype was identified in four fetuses: three had Down syndrome (two trisomy 21 and one unbalanced translocation, t[14;21]), and one trisomy 18. The offspring of the 23 patients in which amniocentesis was declined were phenotypically normal. In our prospective study the risk of chromosomal abnormality with isolated choroid plexus cyst(s) was 1:25, a risk that exceeds the 1:200 risk of pregnancy loss after amniocentesis and the 1:126 and 1:260 risk for aneuploidy and Down syndrome, respectively, in a 35-year-old pregnant women during the midtrimester. These findings indicate that amniocentesis should be offered to pregnant women in the presence of isolated fetal choroid plexus cyst(s).

Antenatal diagnosis of choroid plexus cyst: suggested management.

Antenatal diagnosis of choroid plexus cyst: suggested management.

The clinical significance of prenatally diagnosed choroid plexus cysts

The choroid plexus cyst is one of many malformations of the central nervous system that can be detected in utero by ultrasonography. Choroid plexus cysts occur in 2.3% of fetuses. Because previous reports have shown an association between choroid plexus cysts and chromosomal anomalies, we analyzed 82 prenatally diagnosed cases, 65 of whom had chromosome analysis performed. Of the latter group, 6.2% had chromosomal anomalies of the trisomy 18 type. The remaining 17 cases were clinically normal at birth. These cases of trisomy 18 were also associated with multiple structural anomalies. Therefore, we suggest that after the diagnosis of choroid plexus cysts is made, a complete ultrasonographic survey of the fetal anatomy be performed. Fetal karyotype determination may be offered to patients, especially in the presence of structural anomalies. (Am J Obstet Gynecol 1989;160:1207-10.)