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Manual Segmentation of the Human Choroid Plexus Using Brain MRI
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Bifid choroid plexus: always a normal fetal brain structure variant?

Giovanni Centini1, Alberto Imperatore, Michele Morelli

  • 1Prenatal Diagnosis Center, University of Siena, Le Scotte Hospital, Siena, Italy.

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Summary

Bifid choroid plexus (BCP) detected during routine ultrasounds is linked to enlarged lateral ventricles in fetuses. Associated malformations significantly impact pregnancy outcomes, warranting further investigation.

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Area of Science:

  • Fetal Medicine
  • Neurodevelopmental Biology
  • Medical Imaging

Background:

  • The choroid plexus is crucial for fetal brain development.
  • Little is known about how choroid plexus structure anomalies affect brain function.
  • Bifid choroid plexus (BCP) is a structural anomaly requiring further investigation.

Purpose of the Study:

  • To examine bifid choroid plexus (BCP) cases.
  • To assess the association of BCP with lateral ventriculomegaly and other ultrasound findings.
  • To evaluate BCP's potential as a marker for fetal chromosomal abnormalities.

Main Methods:

  • Described 23 cases of fetal BCP from 2145 second-trimester ultrasounds.
  • Acquired 2D and 3D ultrasound volumes for each patient.
  • Defined BCP based on the division and orientation of the choroid plexus in relation to the lateral ventricle.

Main Results:

  • BCP was identified in a low-risk pregnant population.
  • Fetuses with BCP showed significantly enlarged lateral ventricles.
  • Four of 23 fetuses with BCP had associated malformations, with only one favorable outcome.

Conclusions:

  • BCP, especially when isolated, necessitates careful fetal brain and extra-cranial structure evaluation.
  • Serial sonographic follow-up is recommended for isolated BCP cases.
  • Concomitant abnormal findings with BCP warrant genetic counseling, karyotyping, and potentially MRI.