Mild unilateral ventriculomegaly - 28 weeks gestation (fetal MRI)

Case contributed by Stacy Goergen
Diagnosis certain

Presentation

Unilateral ventriculomegaly on obstetric ultrasound.

Patient Data

Age: 28w2dGA
Gender: Female

There is mild unilateral lateral ventricular enlargement. No other abnormality was detected in the fetal brain or body (body imaging not shown).

Note the features of normal sulcation for this gestation. New sulci and gyri are developing immediately anterior and posterior to central sulcus. The cingulate sulcus is now visible but superior temporal sulcus not yet seen. The insular cortex is covered further by the temporal lobe as opercularization progresses.

Normal development at 28 weeks

Normal sulcation and operculisation.

Operculisation
Further covering of the insular cortex by the temporal lobe.

Sulcation
First image: the precentral and postcentral sulci (dotted arrows) are now present on either side of the central sulcus (solid arrow).
Middle image: further development of the cingulate fissure (straight arrows) and collateral sulcus (curved arrow).
Last image: cingulate fissure (dotted line) is in this case well seen on the sagittal series, with continuation into the marginal sulcus (curved arrow).  The parieto-occipital (straight arrow) and calcarine (dotted arrow) fissures are also well depicted on this slice.

Case Discussion

This case demonstrates isolated, mild unilateral ventriculomegaly.

Normal sulcation for this stage of gestation is demonstrated.

Compare with normal fetal brain MRI scans at 22 weeks24 weeks and 26 weeks gestation.

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