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Differential diagnosis in fetuses with absent septum pellucidum
Author(s) -
Malinger G.,
Lev D.,
Kidron D.,
Heredia F.,
Hershkovitz R.,
LermanSagie T.
Publication year - 2005
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.1787
Subject(s) - septum pellucidum , medicine , anatomy , holoprosencephaly , lateral ventricles , hydrocephalus , agenesis , fetus , choroid plexus , central nervous system , radiology , pregnancy , biology , genetics
Objective To elucidate the characteristic morphological features that may help in the prenatal differential diagnosis of absent septum pellucidum as demonstrated by ultrasound. Methods Twenty‐six fetuses were referred to the fetal neurology clinic due to mild to severe ventriculomegaly and a connection between the lateral ventricles. The following ultrasonographic features were evaluated: place and extent of the ventricular communication, non‐cleavage of the hemispheres and deep gray nuclei, callosal anomalies, position of the choroid plexus, and other central nervous system and facial or body anomalies. A flowchart was created in order to facilitate the final diagnosis. Results The presence of non‐cleavage and/or characteristic facial anomalies prompted the diagnosis of holoprosencephaly (HPE) in 14 fetuses, including two fetuses with the middle interhemispheric variant. Ten fetuses were diagnosed as having hydrocephalus based on the lack of the same features and the observation that the communication between the lateral ventricles was at the level of the third ventricle with almost normal anterior and posterior segments. In two fetuses the diagnosis of septo‐optic dysplasia vs. isolated agenesis of the cavum septi pellucidi was contemplated. Conclusions The use of the proposed flowchart enabled differentiation between hydrocephalus and HPE. The communication between the ventricles in hydrocephalic fetuses may be due to a disruption of the septum pellucidum or to a pathological enlargement of the foramen of Monro. Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.