回顾性分析胎儿侧脑室扩张的妊娠结局与预后，并分析超声与MRI在侧脑室扩张诊断中的一致性，进一步探讨超声报告中提示需进一步临床咨询的侧脑室临界值。

选择2015年1月至2016年12月年深圳市人民医院100例超声诊断为侧脑室扩张或脑积水的单胎连续病例作为观察组，按侧脑室宽度，分为轻度扩张组（＞10，≤12 mm；59例）、中度扩张组（＞12，≤15 mm；24例）和重度扩张组（＞15 mm；17例）。根据是否合并侧脑室扩张以外的病变，分为孤立性侧脑室扩张（IVM）组51例和非孤立性侧脑室扩张（NIVM）组49例。另选择同期141例侧脑室宽度＞8 mm，≤10 mm单胎连续病例作为对照组。记录上述病例的临床、实验室、MRI资料及妊娠结局，使用χ²检验分析轻度扩张组、中度扩张组、重度扩张组及对照组间，以及IVM与NIVM组间的妊娠结局与预后是否有差异。采用Kappa检验分析超声与MRI在诊断侧脑室扩张中的一致性。采用受试者操作特征（ROC）曲线分析诊断侧脑室扩张的截断值。

（1）轻度扩张组、中度扩张组、重度扩张组和对照组出生阳性率分别为6.5%（3/46）、22.2%（2/9）、60.0%（3/5）和5.5%（7/128），差异具有统计学意义（χ²=22.148，P=0.001）；IVM和NIVM组异常妊娠结局率分别为33.3%（17/51）、63.3%（31/49），结局差异具有统计学意义（χ²=8.970，P=0.005）。（2）共36例行产前和（或）产后MRI检查，与超声相符率为77.8%（28/36），补充诊断率为19.4%（7/36）。超声与MRI在诊断侧脑室扩张中的一致性一般（Kappa值=0.543，P=0.001）。（3）ROC曲线分析出超声提示的侧脑室诊断截断值为9.7 mm。

侧脑室扩张越严重，胎儿预后越差；NIVM比IVM预后差。超声与MRI在诊断侧脑室扩张中一致性一般，但MRI对某些类型的异常（如皮质，白质和颅内出血）的补充检出率更高。产前超声是诊断侧脑室扩张的重要手段，侧脑室宽度＞9.7 mm时，应提示进一步产前咨询。

To retrospectively analyze the pregnancy outcome and prognosis of fetal lateral ventriculomegaly, analyze the consistency of ultrasound and magnetic resonance imaging (MRI) in the diagnosis of lateral ventriculomegaly, and further explore the ultrasound cut-off value of the lateral ventricle for further clinical consultation.

A total of 100 consecutive singleton cases diagnosed by ultrasound with lateral ventriculomegaly or hydrocephalus at Shenzhen People's Hospital from January 2015 to December 2016 were selected as an observation group. According to the width of the lateral ventricle, they were divided into a mild group (＞10 to ≤12 mm, 59 cases), moderate group (＞12 to ≤15 mm, 24 cases), and severe group ＞15 mm, 17 cases). The patients were also divided into an isolated ventriculomegaly (IVM) group (51 cases) or a non-isolated ventriculomegaly (NIVM) group (49 cases) according to whether or not they had other diseases. Another 141 consecutive singletons who had a width of the lateral ventricle of ＞8 mm to ≤10 mm were selected as a control group. The clinical, laboratory, and MRI data and pregnancy outcome were recorded. The χ² test was used to analyze the difference of pregnancy outcome and prognosis among the mild group, moderate group, severe group, and control group and the difference of abnormal pregnancy outcomes between the IVM and NIVM groups. The Kappa test was used to analyze the consistency of ultrasound and MRI in the diagnosis of lateral ventriculomegaly. ROC curve was used to analyze the cut-off value of the ultrasound lateral ventricle.

The positive rates at birth in the mild group, moderate group, severe group, and control group were 6.5% (3/46) ,22.2% (2/9), 60.0% (3/5), and 5.5% (7/128), respectively, with a statistically significant difference ( χ²=22.148, P=0.001). The rate of abnormal pregnancy outcomes in the IVM and NIVM groups were 33.3% (17/51) and 63.3% (31/49), respectively, with a statistically significant difference (χ²=8.970, P=0.005). A total of 36 cases underwent prenatal and/or postnatal MRI examination. The coincidence rate of ultrasound was 77.8% (28/36), and the supplementary diagnosis rate of MRI was 19.4% (7/36). Ultrasound is generally consistent with MRI in the diagnosis of lateral ventriculomegaly (Kappa=0.543, P=0.001). The ROC curve analysis showed that the diagnostic cut-off value of the lateral ventricle suggested by ultrasound was 9.7 mm.

The more severe the lateral ventriculomegaly, the worse the prognosis of the fetus. The prognosis of NIVM is worse than that of IVM. Ultrasound is generally consistent with MRI in the diagnosis of fetal lateral ventriculomegaly, and MRI has a higher detection rate for some types of abnormalities (such as cortex, white matter, and intracranial hemorrhage). Prenatal ultrasound is an important method for the diagnosis of lateral ventriculomegaly. Further prenatal consultation should be given when the width of the lateral ventricle measured by ultrasound is greater than 9.7 mm.