Can callosal angle (CA), anterior callosal angle (ACA), and Evans index be used as parameters to predict postnatal...

This study aims to evaluate the efficacy of the callosal angle (CA), the anterior callosal angle (ACA) and the Evans Index in predicting poor prognosis in fetuses with cranial ventriculomegaly (VM) and contribute these parameters to the current literature.

This study is a retrospective cross-sectional analysis of patients with fetal cranial VM. Fetal MRI was used to determine axial and coronal VP (posterior diameter of the lateral ventricle), ACA, CA, and Evans Index values. The antenatal and postnatal outcomes of VM were determined. The factors that predict a poor prognosis were calculated.

The analysis included 39 cases of fetal VM. The fetuses were divided into the following categories: mild VM (59 %), moderate VM (18 %), and severe VM (23 %). Severe VM (p = 0.042; OR: 6.04 (95 % CI: 1.06-34.37)) and additional anomalies (p < 0.001; OR: 33.25 (95 % CI:5.32-207.77)) most significantly elevate the risk of a poor prognosis. A moderately significant correlation was observed between VP length and Evans Index (r = 0.471, p = 0.002), but not with CA and ACA (p = 0.967, p = 0.448, respectively). In predicting postnatal ventriculo-peritoneal shunt, severe VM, additional anomalies, and an increased Evans index antenatally were statistically significant (p < 0.001, p = 0.018, p = 0.041). There is no effect for ACA and CA (p = 0.1, p = 0.5, respectively).

The detection of fetal VM during antenatal ultrasonography can give rise to conflicts in informing parents. The most important factor in prognosis is determining the stage of VM and associated anomalies. Although our study demonstrated a significant effect of the Evans Index in predicting the requirement for postnatal shunt surgery, further large-scale prospective studies are needed to investigate the relationship between ACA, CA, and the Evans Index and poor prognosis, as well as the necessity for postnatal shunt surgery.