{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T09:20:38Z","timestamp":1770888038857,"version":"3.50.1"},"reference-count":18,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Fetal ventriculomegaly (FV), or enlarged cerebral ventricles in utero, is defined in fetal studies as an atrial diameter (AD) greater than 10 mm. In postnatal studies, the frontooccipital horn ratio (FOHR) is commonly used as a proxy for ventricle size (VS); however, its role in FV has not been assessed. Using image analysis techniques to quantify VS on fetal MR images, authors of the present study examined correlations between linear measures (AD and FOHR) and VS in patients with FV.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors performed a cross-sectional study using fetal MR images to measure AD in the axial plane at the level of the atria of the lateral ventricles and to calculate FOHR as the average of the frontal and occipital horn diameters divided by the biparietal distance. Computer software was used to separately segment and measure the area of the ventricle and the ventricle plus the subarachnoid space in 2 dimensions. Segmentation was performed on axial slices 3 above and 3 below the slice used to measure AD, and measurements for each slice were combined to yield a volume, or 3D VS. The VS was expressed as the absolute number of voxels (non-normalized) and as the number of voxels divided by intracranial size (normalized). A Pearson correlation coefficient was used to measure the strength of the relationships between the linear measures and the size of segmented regions in 2 and 3 dimensions and over various gestational ages (GAs). Differences between correlations were compared using Steiger's z-test.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Fifty FV patients who had undergone fetal MRI between 2008 and 2014 were included in the study. The mean GA was 26.3 \u00b1 5.4 weeks. The mean AD was 18.1 \u00b1 8.3 mm, and the mean FOHR was 0.49 \u00b1 0.11. When using absolute VS, the correlation between AD and 3D VS (r = 0.844, p &lt; 0.0001) was significantly higher than that between FOHR and 3D VS (r = 0.668, p &lt; 0.0001; p = 0.0004, Steiger's z-test). However, when VS was normalized, correlations were not significantly different between AD and 3D VS (r = 0.830, p &lt; 0.0001) or FOHR and 3D VS (r = 0.842, p &lt; 0.0001; p = 0.8, Steiger's z-test). For GAs of 24 weeks or earlier, AD correlated more strongly with normalized 3D VS (r = 0.902, p &lt; 0.0001) than with FOHR (r = 0.674, p &lt; 0.0001; p &lt; 0.0001, Steiger's z-test). After 24 weeks, there was no difference in correlations between linear measures (AD or FOHR) and 3D VS (r &gt; 0.9). Correlations of linear measures with VS in 2 and 3 dimensions were similar, and inclusion of the subarachnoid space did not significantly alter results.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Findings in the study support the use of AD as a measure of VS in fetal studies as it correlates highly with both absolute and relative VS, especially at early GAs, and captures the preferential dilation of the occipital horns in patients with FV. Compared with AD, FOHR similarly correlates with normalized VS and, after a GA of 24 weeks, can be reported in fetal studies to provide continuity with postnatal monitoring.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.9.peds16210","type":"journal-article","created":{"date-parts":[[2017,1,6]],"date-time":"2017-01-06T14:56:31Z","timestamp":1483714591000},"page":"300-306","source":"Crossref","is-referenced-by-count":15,"title":["Correlations of atrial diameter and frontooccipital horn ratio with ventricle size in fetal ventriculomegaly"],"prefix":"10.3171","volume":"19","author":[{"given":"Jared M.","family":"Pisapia","sequence":"first","affiliation":[{"name":"Department of Neurosurgery;"},{"name":"Center for Biomedical Image Computing and Analytics, University of Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Rozycki","sequence":"additional","affiliation":[{"name":"Center for Biomedical Image Computing and Analytics, University of Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamed","family":"Akbari","sequence":"additional","affiliation":[{"name":"Center for Biomedical Image Computing and Analytics, University of Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spyridon","family":"Bakas","sequence":"additional","affiliation":[{"name":"Center for Biomedical Image Computing and Analytics, University of Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayesh P.","family":"Thawani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie S.","family":"Moldenhauer","sequence":"additional","affiliation":[{"name":"Center for Fetal Diagnosis and Treatment, Special Delivery Unit; and\u00a0"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip B.","family":"Storm","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery;"},{"name":"Divisions of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah M.","family":"Zarnow","sequence":"additional","affiliation":[{"name":"Neuroradiology, Children's Hospital of Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christos","family":"Davatzikos","sequence":"additional","affiliation":[{"name":"Center for Biomedical Image Computing and Analytics, University of Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory G.","family":"Heuer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery;"},{"name":"Divisions of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-peds16210","series-title":"J Ultrasound Med","doi-asserted-by":"publisher","first-page":"39","DOI":"10.7863\/jum.2003.22.1.39","article-title":"Fetal lateral ventricular width: what should be its upper limit? A prospective cohort study and reanalysis of the current and previous data","volume":"22","author":"Almog B,","year":"2003","unstructured":"Almog B, Gamzu R, Achiron R, Fainaru O, Zalel Y: Fetal lateral ventricular width: what should be its upper limit? A prospective cohort study and reanalysis of the current and previous data. J Ultrasound Med 22:39\u201343, 20031252360910.7863\/jum.2003.22.1.39"},{"key":"b2-peds16210","series-title":"Acta Neurochir Suppl","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1007\/978-3-7091-0956-4_44","article-title":"Frontal and temporal horn ratio: a valid and reliable index to determine ventricular size in paediatric hydrocephalus patients?","volume":"114","author":"Antes S,","year":"2012","unstructured":"Antes S, Kiefer M, Schmitt M, Lechtenfeld M, Geipel M, Eymann R: Frontal and temporal horn ratio: a valid and reliable index to determine ventricular size in paediatric hydrocephalus patients?. Acta Neurochir Suppl 114:227\u2013230, 201210.1007\/978-3-7091-0956-4_4422327698"},{"key":"b3-peds16210","series-title":"J Pediatr","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/S0022-3476(05)81859-1","article-title":"Asymmetric growth of the lateral cerebral ventricle in infants with post-hemorrhagic ventricular dilation","volume":"118","author":"Brann BS IV,","year":"1991","unstructured":"Brann BS IV, Qualls C, Wells L, Papile L: Asymmetric growth of the lateral cerebral ventricle in infants with post-hemorrhagic ventricular dilation. J Pediatr 118:108\u2013112, 199110.1016\/S0022-3476(05)81859-1"},{"key":"b4-peds16210","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1148\/radiology.169.3.3055034","article-title":"Exclusion of fetal ventriculomegaly with a single measurement: the width of the lateral ventricular atrium","volume":"169","author":"Cardoza JD,","year":"1988","unstructured":"Cardoza JD, Goldstein RB, Filly RA: Exclusion of fetal ventriculomegaly with a single measurement: the width of the lateral ventricular atrium. Radiology 169:711\u2013714, 1988305503410.1148\/radiology.169.3.3055034"},{"key":"b5-peds16210","series-title":"IEEE Trans Med Imaging","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1109\/TMI.2007.906087","article-title":"An optimized blockwise nonlocal means denoising filter for 3-D magnetic resonance images","volume":"27","author":"Coupe P,","year":"2008","unstructured":"Coupe P, Yger P, Prima S, Hellier P, Kervrann C, Barillot C: An optimized blockwise nonlocal means denoising filter for 3-D magnetic resonance images. IEEE Trans Med Imaging 27:425\u2013441, 20081839034110.1109\/TMI.2007.906087"},{"key":"b6-peds16210","series-title":"Br J Prev Soc Med","doi-asserted-by":"publisher","first-page":"115","DOI":"10.12891\/ceog16442014","article-title":"Congenital malformations of the central nervous system in Scotland","volume":"12","author":"Edwards JH:","year":"1958","unstructured":"Edwards JH: Congenital malformations of the central nervous system in Scotland. Br J Prev Soc Med 12:115\u2013130, 19581357278210.12891\/ceog16442014"},{"key":"b7-peds16210","series-title":"Clin Exp Obstet Gynecol","doi-asserted-by":"publisher","first-page":"67","DOI":"10.12891\/ceog16442014","article-title":"The criterion value of fetal cerebral lateral ventricular atrium width for diagnosis of ventriculomegaly","volume":"41","author":"Goynumer G,","year":"2014","unstructured":"Goynumer G, Yayla M, Arisoy R, Turkmen O: The criterion value of fetal cerebral lateral ventricular atrium width for diagnosis of ventriculomegaly. Clin Exp Obstet Gynecol 41:67\u201371, 20142470768710.12891\/ceog16442014"},{"key":"b8-peds16210","series-title":"Designing Clinical Research: An Epidemiologic Approach","author":"Hulley SB,","year":"2013","unstructured":"Hulley SB, Cummings SR, Browner WS, Grady DNT: Designing Clinical Research: An Epidemiologic Approach ed 4Philadelphia, Lippincott Williams & Wilkins, 2013"},{"key":"b9-peds16210","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1159\/000070874","article-title":"Frontal and occipital horn width ratio for the evaluation of small and asymmetrical ventricles","volume":"39","author":"Jamous M,","year":"2003","unstructured":"Jamous M, Sood S, Kumar R, Ham S: Frontal and occipital horn width ratio for the evaluation of small and asymmetrical ventricles. Pediatr Neurosurg 39:17\u201321, 20031278407210.1159\/000070874"},{"key":"b10-peds16210","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1159\/000028836","article-title":"Measurement of ventricular size: reliability of the frontal and occipital horn ratio compared to subjective assessment","volume":"31","author":"Kulkarni AV,","year":"1999","unstructured":"Kulkarni AV, Drake JM, Armstrong DC, Dirks PB: Measurement of ventricular size: reliability of the frontal and occipital horn ratio compared to subjective assessment. Pediatr Neurosurg 31:65\u201370, 199910.1159\/00002883610592474"},{"key":"b11-peds16210","series-title":"Br J Prev Soc Med","first-page":"146","article-title":"Major central nervous system malformations in South Wales. I. Incidence, local variations and geographical factors","volume":"22","author":"Laurence KM,","year":"1968","unstructured":"Laurence KM, Carter CO, David PA: Major central nervous system malformations in South Wales. I. Incidence, local variations and geographical factors. Br J Prev Soc Med 22:146\u2013160, 19684874476"},{"key":"b12-peds16210","series-title":"Semin Fetal Neonatal Med","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.siny.2012.06.001","article-title":"Neonatal outcome of congenital ventriculomegaly","volume":"17","author":"McKechnie L,","year":"2012","unstructured":"McKechnie L, Vasudevan C, Levene M: Neonatal outcome of congenital ventriculomegaly. Semin Fetal Neonatal Med 17:301\u2013307, 201210.1016\/j.siny.2012.06.00122819382"},{"key":"b13-peds16210","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1159\/000028730","article-title":"Frontal and occipital horn ratio: A linear estimate of ventricular size for multiple imaging modalities in pediatric hydrocephalus","volume":"29","author":"O'Hayon BB,","year":"1998","unstructured":"O'Hayon BB, Drake JM, Ossip MG, Tuli S, Clarke M: Frontal and occipital horn ratio: A linear estimate of ventricular size for multiple imaging modalities in pediatric hydrocephalus. Pediatr Neurosurg 29:245\u2013249, 199810.1159\/0000287309917541"},{"key":"b14-peds16210","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"547","DOI":"10.3171\/2014.10.PEDS14209","article-title":"The accuracy of linear indices of ventricular volume in pediatric hydrocephalus: technical note","volume":"15","author":"Ragan DK,","year":"2015","unstructured":"Ragan DK, Cerqua J, Nash T, McKinstry RC, Shimony JS, Jones BV, : The accuracy of linear indices of ventricular volume in pediatric hydrocephalus: technical note. J Neurosurg Pediatr 15:547\u2013551, 20152574595310.3171\/2014.10.PEDS14209"},{"key":"b15-peds16210","series-title":"Surg Neurol Int","doi-asserted-by":"publisher","first-page":"59","DOI":"10.4103\/2152-7806.154777","article-title":"Simple and reproducible linear measurements to determine ventricular enlargement in adults","volume":"6","author":"Reinard K,","year":"2015","unstructured":"Reinard K, Basheer A, Phillips S, Snyder A, Agarwal A, Jafari-Khouzani K, : Simple and reproducible linear measurements to determine ventricular enlargement in adults. Surg Neurol Int 6:59, 201510.4103\/2152-7806.15477725883851"},{"key":"b16-peds16210","series-title":"IEEE Trans Med Imaging","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1109\/42.668698","article-title":"A nonparametric method for automatic correction of intensity nonuniformity in MRI data","volume":"17","author":"Sled JG,","year":"1998","unstructured":"Sled JG, Zijdenbos AP, Evans AC: A nonparametric method for automatic correction of intensity nonuniformity in MRI data. IEEE Trans Med Imaging 17:87\u201397, 1998961791010.1109\/42.668698"},{"key":"b17-peds16210","series-title":"Int J Adv Res Comput Eng Technol","first-page":"387","article-title":"A review on Otsu image segmentation algorithm","volume":"2","author":"Vala HJ,","year":"2013","unstructured":"Vala HJ, Baxi PA: A review on Otsu image segmentation algorithm. Int J Adv Res Comput Eng Technol 2:387\u2013389, 2013"},{"key":"b18-peds16210","series-title":"Neuroimage","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1016\/j.neuroimage.2006.01.015","article-title":"User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability","volume":"31","author":"Yushkevich PA,","year":"2006","unstructured":"Yushkevich PA, Piven J, Hazlett HC, Smith RG, Ho S, Gee JC, : User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability. Neuroimage 31:1116\u20131128, 20061654596510.1016\/j.neuroimage.2006.01.015"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/19\/3\/article-p300.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/19\/3\/article-p300.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/19\/3\/article-p300.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T13:01:21Z","timestamp":1681563681000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/19\/3\/article-p300.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":18,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2016.9.peds16210","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3]]}}}