{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:06:28Z","timestamp":1790633188888,"version":"4.1.0"},"reference-count":43,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Colonel Robert R. McCormick Professorship of Diagnostic Imaging Fund at Rush University Medical Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objective: The accurate diagnosis of congenital central nervous system abnormalities is critical to pre- and postnatal prognostication and management. When an abnormality is found in the posterior fossa of the fetal brain, parental counseling is challenging because of the wide spectrum of clinical and neurodevelopmental outcomes in patients with Dandy\u2013Walker (DW) spectrum posterior malformations. The objective of this study was to evaluate the utility of biometric measurements obtained from fetal magnetic resonance imaging (MRI) to facilitate the prenatal differentiation of Dandy\u2013Walker (DW) spectrum malformations, including vermian hypoplasia (VH), Blake\u2019s pouch cyst (BPC), and classic Dandy\u2013Walker malformation (DWM). Methods: This retrospective single-center study evaluated 34 maternal\u2013infant dyads referred for fetal MRI evaluation of suspected DW spectrum malformations identified on antenatal ultrasound. Radiologists took posterior fossa measurements, including the vermis anteroposterior (AP) diameter, vermis height (VH), and tegmento\u2013vermian angle (TVA). The posterior fossa, fourth ventricle, and cisterna magna were classified as normal, large, or dilated. The postnatal imaging findings were evaluated for concordance. The acquired values were compared between the groups and with normative data. The genetic testing results are reported when available. Results: A total of 27 DW spectrum fetal MRI cases were identified, including 7 classic DWMs, 14 VHs, and 6 BPCs. The TVA was significantly higher in the DWM group compared with the VH and BPC groups (p &lt; 0.001). All three groups had reduced AP vermis measurements for gestational age compared with normal fetal brains, as well as differences in the means across the groups (p = 0.002). Conclusions: Biometric measurements derived from fetal MRI can effectively facilitate the prenatal differentiation of VH, BPC, and classic DWM when assessing DW spectrum posterior fossa lesions. Standardizing biometric measurements may increase the diagnostic utility of fetal MRI and facilitate improved antenatal counseling and clinical decision-making.<\/jats:p>","DOI":"10.3390\/diagnostics15101295","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T09:58:22Z","timestamp":1747821502000},"page":"1295","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Utility of Biometric Measurements from Fetal Magnetic Resonance Imaging for Improved Antenatal Diagnosis of Dandy\u2013Walker Spectrum Posterior Fossa Lesions"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3745-1908","authenticated-orcid":false,"given":"Rakhee M.","family":"Bowker","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, Rush University Children\u2019s Hospital, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kranthi K.","family":"Marathu","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa","family":"Pharel","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jubril O.","family":"Adepoju","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzan","family":"Vahedifard","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth","family":"Adler","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8283-4070","authenticated-orcid":false,"given":"Mehmet","family":"Kocak","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuchu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon E.","family":"Byrd","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Tan, A.G., Sethi, N., and Sulaiman, S. 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