{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T16:29:10Z","timestamp":1759336150158,"version":"3.40.5"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,1,31]],"date-time":"2019-01-31T00:00:00Z","timestamp":1548892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Prenatal diagnosis of midbrain\u2010hindbrain (MB\u2010HB) malformations relies primarily on abnormal size and shape of the cerebellum and retrocerebellar space, particularly \u2018open fourth ventricle\u2019 (4V), the most common indicator of MB\u2010HB malformations. The aim of this study was to present the fourth ventricle index (4VI), and to evaluate its role as a marker for severe vermian dysgenesis\/agenesis in cases without open 4V.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective cross\u2010sectional study of patients with singleton low\u2010risk pregnancy at 14\u2009+\u20091 to 36\u2009+\u20096 gestational weeks presenting between May 2016 and November 2017 for routine ultrasound examination. Axial images of the fetal 4V were obtained and the 4VI was calculated as the ratio between the laterolateral and the anteroposterior diameters. Reference ranges were constructed and retrospectively collected values from 44 fetuses with confirmed anomalies involving severe vermian dysgenesis\/agenesis (Joubert syndrome and related disorders, rhombencephalosynapsis, cobblestone malformations and cerebellar hypoplasia) but without open 4V were compared with the normal values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 384 healthy fetuses were enrolled into the study, from which reference ranges were produced, and 44 cases were collected retrospectively. The 4VI in the normal fetuses was always &gt;\u20091. In affected fetuses, it was always below mean\u2009\u22122\u2009SD and\u2009&lt;\u20091.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The 4VI is a sonographic marker for severe fetal vermian dysgenesis\/agenesis in the absence of an open 4V. It may be incorporated easily into the routine brain scan; 4VI\u2009&lt;\u20091 indicates a need for dedicated fetal neuroimaging for diagnosis and prenatal counseling. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.19034","type":"journal-article","created":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T03:12:35Z","timestamp":1519701155000},"page":"390-395","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Fourth ventricle index: sonographic marker for severe fetal vermian dysgenesis\/agenesis"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9868-3548","authenticated-orcid":false,"given":"K. K.","family":"Haratz","sequence":"first","affiliation":[{"name":"Fetal Neurology Clinic, Ultrasound in ObGyn Unit Wolfson Medical Center  Holon Israel"},{"name":"Affiliated to the Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Lis Maternity Hospital Tel Aviv Medical Center  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. L.","family":"Shulevitz","sequence":"additional","affiliation":[{"name":"Fetal Neurology Clinic, Ultrasound in ObGyn Unit Wolfson Medical Center  Holon Israel"},{"name":"Affiliated to the Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z.","family":"Leibovitz","sequence":"additional","affiliation":[{"name":"Fetal Neurology Clinic, Ultrasound in ObGyn Unit Wolfson Medical Center  Holon Israel"},{"name":"Ultrasound in ObGyn Unit Department of ObGyn, Bnai Zion Medical Center  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Lev","sequence":"additional","affiliation":[{"name":"Fetal Neurology Clinic, Ultrasound in ObGyn Unit Wolfson Medical Center  Holon Israel"},{"name":"Affiliated to the Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Institute of Genetics Wolfson Medical Center  Holon Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Shalev","sequence":"additional","affiliation":[{"name":"Fetal Neurology Clinic, Ultrasound in ObGyn Unit Wolfson Medical Center  Holon Israel"},{"name":"Affiliated to the Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Tomarkin","sequence":"additional","affiliation":[{"name":"Fetal Neurology Clinic, Ultrasound in ObGyn Unit Wolfson Medical Center  Holon Israel"},{"name":"Affiliated to the Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0864-206X","authenticated-orcid":false,"given":"G.","family":"Malinger","sequence":"additional","affiliation":[{"name":"Affiliated to the Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Lis Maternity Hospital Tel Aviv Medical Center  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Lerman\u2010Sagie","sequence":"additional","affiliation":[{"name":"Fetal Neurology Clinic, Ultrasound in ObGyn Unit Wolfson Medical Center  Holon Israel"},{"name":"Affiliated to the Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Pediatric Neurology Unit Wolfson Medical Center  Holon Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7827-1922","authenticated-orcid":false,"given":"L.","family":"Gindes","sequence":"additional","affiliation":[{"name":"Fetal Neurology Clinic, Ultrasound in ObGyn Unit Wolfson Medical Center  Holon Israel"},{"name":"Affiliated to the Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,31]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2002.21.8.849"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13227"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13312"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13308"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12508"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3909"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6245"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2777"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2196"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12567"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2517"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.c.31398"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(1998100)18:10<997::AID-PD392>3.0.CO;2-O"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.192.2.8029392"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1201\/9780203507483"},{"key":"e_1_2_5_17_1","first-page":"1","volume-title":"Radiology: Diagnosis \u2010 Imaging \u2010 Intervention","author":"Naidich T","year":"1991"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12311-013-0470-2"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70024-3"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-006-0146-x"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410420110"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-6-50"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nic.2016.03.005"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.166.2.8553961"}],"container-title":["Ultrasound in Obstetrics &amp; 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