E-ISSN: 2619-9467

Contents    Cover    Publication Date: 25 Jun 2019
Year 2019 - Volume 29 - Issue 2

Open Access

Peer Reviewed

ORIGINAL RESEARCH
1956 Viewed1198 Downloaded

Effect of Fetal Choroid Plexus Cysts on Middle Cerebral Artery Doppler Parameters

Full Text PDF  
J Clin Obstet Gynecol. 2019;29(2):43-9
DOI: 10.5336/jcog.2018-64368
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: To investigate the possible effects of isolated fetal choroid plexus cysts (CPCs) on middle cerebral artery (MCA) Doppler parameters. Material and Methods: A total of 113 pregnant women at 18 to 22 gestational weeks in whom level 2 ultrasonography (USG) was performed between August 2017 and January 2018 were included in the study. Fifty-five women (CPC group) had isolated fetal CPC, whereas 58 women (control group) had no fetal structural anomaly. We measured the following MCA Doppler parameters of fetuses: peak systolic velocity (PSV), end-diastolic velocity (EDV), the systolic/diastolic ratio (S/D), pulsatility index (PI), and resistance index (RI). We examined whether a significant difference exist between the CPC and control groups, and between the CPC and contralateral sides with respect to the Doppler parameters. Results: We found that cysts were present in the right lateral ventricle in 49.1% (n=27) individuals in the CPC group. There was no statistically significant difference between the groups in terms of PSV, EDV, PI and RI values; however, the S/D ratio exhibited statistical significance. The MCA S/D ratio of the control group was lower than that of the values reported for both cystic and contralateral sides in the CPC group. Moreover, we did not observe any significant difference in S/D ratios between the cystic and contralateral sides in the CPC group. Conclusion: Isolated fetal CPCs tend to occur more on the right side unilaterally. At 18 to 22 weeks of gestation, MCA S/D ratios of the cystic and contralateral sides in the CPC group were higher than that in the control group.
REFERENCES:
  1. Kurjak A, Schulman H, Predanic A, Predanic M, Kupesic S, Zalud I. Fetal choroid plexus vascularization assessed by color flow ultrasonography. J Ultrasound Med. 1994;13(11): 841-4. [Crossref] [PubMed]
  2. Zafar HM, Ankola A, Coleman B. Ultrasound pitfalls and artifacts related to six common fetal findings. Ultrasound Q. 2012;28(2):105-24. [Crossref] [PubMed]
  3. Rochon M, Eddleman K. Controversial ultrasound findings. Obstet Gynecol Clin North Am. 2004;31(1):61-99. [Crossref]
  4. Nyberg DA, Souter VL. Sonographic markers of fetal trisomies: second trimester. J Ultrasound Med. 2001;20(6):655-74. [Crossref]
  5. Epelman M, Daneman A, Blaser SI, Ortiz-Neira C, Konen O, Jarrín J, et al. Differential diagnosis of intracranial cystic lesions at head US: correlation with CT and MR imaging. Radiographics. 2006;26(1):173-96. [Crossref] [PubMed]
  6. Turner SR, Samei E, Hertzberg BS, DeLong DM, Vargas-Voracek R, Singer A, et al. Sonography of fetal choroid plexus cysts: detection depends on cyst size and gestational age. J Ultrasound Med. 2003;22(11):1219-27. [Crossref] [PubMed]
  7. Fong K, Chong K, Toi A, Uster T, Blaser S, Chitayat D. Fetal ventriculomegaly secondary to isolated large choroid plexus cysts: prenatal findings and postnatal outcome. Prenat Diagn. 2011;31(4):395-400. [Crossref] [PubMed]
  8. Shah N. Prenatal diagnosis of choroid plexus cyst: what next? J Obstet Gynaecol India. 2018;68(5):366-8. [Crossref] [PubMed]
  9. Yhoshu E, Mahajan JK, Singh UB. Choroid plexus cysts-antenatal course and postnatal outcome in a tertiary hospital in North India. Childs Nerv Syst. 2018;34(12):2449-53. [Crossref] [PubMed]
  10. Bronsteen R, Lee W, Vettraino IM, Huang R, Comstock CH. Second-trimester sonography and trisomy 18: the significance of isolated choroid plexus cysts after an examination that includes the fetal hands. J Ultrasound Med. 2004;23(2):241-5. [Crossref] [PubMed]
  11. Danışman N, Ekici E, Vicdan K, Gökmen O. [Choroid plexus cysts]. Perinatoloji Dergisi. 1995;3(1):8-12.
  12. Irani S, Ahmadi F, Javam M, Vosough Taghi Dizaj A, Niknejad F. Outcome of isolated fetal choroid plexus cyst detected in prenatal sonography among infertile patients referred to Royan Institute: a 3-year study. Iran J Reprod Med. 2015;13(9):571-6. [PubMed] [PMC]
  13. Naeini RM, Yoo JH, Hunter JV. Spectrum of choroid plexus lesions in children. AJR Am J Roentgenol. 2009;192(1):32-40. [Crossref] [PubMed]
  14. Norton KI, Rai B, Desai H, Brown D, Cohen M. Prevalence of choroid plexus cysts in term and near-term infants with congenital heart disease. AJR Am J Roentgenol. 2011;196(3): W326-9. [Crossref] [PubMed]
  15. Chamczuk AJ, Grand W. Endoscopic cauterization of a symptomatic choroid plexus cyst at the foramen of Monro: case report. Neurosurgery. 2010;66(6 Suppl Operative):376-7.
  16. Spennato P, Chiaramonte C, Cicala D, Donofrio V, Barbarisi M, Nastro A, et al. Acute triventricular hydrocephalus caused by choroid plexus cysts: a diagnostic and neurosurgical challenge. Neurosurg Focus. 2016;41(5):E9. [Crossref] [PubMed]
  17. Tamai S, Hayashi Y, Sasagawa Y, Oishi M, Nakada M. A case of a mobile choroid plexus cyst presenting with different types of obstructive hydrocephalus. Surg Neurol Int. 2018;9:47. [Crossref] [PubMed] [PMC]
  18. Tarzamni MK, Nezami N, Gatreh-Samani F, Vahedinia S, Tarzamni M. Doppler waveform indices of fetal middle cerebral artery in normal 20 to 40 weeks pregnancies. Arch Iran Med. 2009;12(1):29-34.[PubMed]
  19. Ursino M, Lodi CA. A simple mathematical model of the interaction between intracranial pressure and cerebral hemodynamics. J Appl Physiol (1985). 1997;82(4):1256-69. [Crossref] [PubMed]
  20. Pappalardo EM, Militello M, Rapisarda G, Imbruglia L, Recupero S, Ermito S, et al. Fetal intracranial cysts: prenatal diagnosis and outcome. J Prenat Med. 2009;3(2):28-30. [PubMed] [PMC]
  21. Nakayama Y, Tanaka A, Kumate S, Yoshinaga S. Cerebral blood flow in normal brain tissue of patients with intracranial tumors. Neurol Med Chir (Tokyo). 1996;36(10):709-14.[Crossref]
  22. Oglat AA, Matjafri MZ, Suardi N, Oqlat MA, Abdelrahman MA, Oqlat AA. A review of medical doppler ultrasonography of blood flow in general and especially in common carotid artery. J Med Ultrasound. 2018;26(1):3-13.[Crossref] [PubMed] [PMC]
  23. Singh SK, Mishra P. Doppler study of umbilical and fetal middle cerebral artery in severe preeclampsia and intra uterine growth restriction and correlation with perinatal outcome. Int J Reprod Contracept Obstet Gynecol. 2017;6(10):4561-6. [Crossref]