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Background <p>Developmental venous anomalies are the most common cerebral vascular malformations but remain underrecognized in fetuses. Accurate prenatal identification is important for diagnosis and counseling.</p> Objective <p>This study aimed to describe the prevalence of developmental venous anomalies on fetal MRI and characterize their distinctive MRI patterns.</p> Materials and methods <p>A retrospective study of all fetal MRIs performed between January 2017 and June 2025. Cases with documented or suspected developmental venous anomalies were extracted, including a systematic re-evaluation of studies with susceptibility artifacts, to identify developmental venous anomalies not categorized initially as such. Two independent reviewers assessed the number, location, and drainage pattern (superficial, deep, or mixed) of developmental venous anomalies. Associated abnormalities, including varix thrombosis, parenchymal hemorrhage and volume loss, and vascular malformation, were recorded. Developmental venous anomalies with associated abnormalities or multiple developmental venous anomalies were classified as complicated developmental venous anomalies.</p> Results <p>Among 3,932 fetuses, 18 (0.46%) had developmental venous anomalies (median gestational age 33&#xa0;weeks (IQR, 32, 33); 13 males). Developmental venous anomalies were frontal in 10 (55.6%), parieto-occipital in 7 (38.9%), and parietal in 1 (5.6%); 14 (77.8%) were right-sided. Deep drainage occurred in 8/18 (44.4%), superficial in 4/18 (22.2%), and mixed in 6/18 (33.3%). Two reproducible MRI patterns were identified: the “fisherman’s-rope” sign in superficial frontal developmental venous anomalies, and ventricular-wall T2 hypointensity in developmental venous anomalies with deep drainage. Eight fetuses (44.4%) had a complicated developmental venous anomaly. Multiple developmental venous anomalies (3/18, 16.7%) were associated with varix thrombosis (2/3 vs 0/15, <i>P</i>=0.02).</p> Conclusion <p>Fetal developmental venous anomalies demonstrate two reproducible MRI patterns that enable confident diagnosis and help in differentiating from hemorrhage and other vascular malformations.</p> Graphical abstract <p></p>

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Developmental venous anomalies on fetal magnetic resonance imaging: prevalence and reproducible radiological phenotypes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月13日

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  • Stephanie Libzon,
  • Moran Hausman-Kedem,
  • Nira Schneebaum-Sender,
  • Li-Tal Pratt,
  • Zvi Leibovitz,
  • Gustavo Malinger,
  • Karina Krajden Haratz,
  • Shelly I. Shiran,
  • Catherine Garel,
  • Liat Ben Sira

摘要

Background

Developmental venous anomalies are the most common cerebral vascular malformations but remain underrecognized in fetuses. Accurate prenatal identification is important for diagnosis and counseling.

Objective

This study aimed to describe the prevalence of developmental venous anomalies on fetal MRI and characterize their distinctive MRI patterns.

Materials and methods

A retrospective study of all fetal MRIs performed between January 2017 and June 2025. Cases with documented or suspected developmental venous anomalies were extracted, including a systematic re-evaluation of studies with susceptibility artifacts, to identify developmental venous anomalies not categorized initially as such. Two independent reviewers assessed the number, location, and drainage pattern (superficial, deep, or mixed) of developmental venous anomalies. Associated abnormalities, including varix thrombosis, parenchymal hemorrhage and volume loss, and vascular malformation, were recorded. Developmental venous anomalies with associated abnormalities or multiple developmental venous anomalies were classified as complicated developmental venous anomalies.

Results

Among 3,932 fetuses, 18 (0.46%) had developmental venous anomalies (median gestational age 33 weeks (IQR, 32, 33); 13 males). Developmental venous anomalies were frontal in 10 (55.6%), parieto-occipital in 7 (38.9%), and parietal in 1 (5.6%); 14 (77.8%) were right-sided. Deep drainage occurred in 8/18 (44.4%), superficial in 4/18 (22.2%), and mixed in 6/18 (33.3%). Two reproducible MRI patterns were identified: the “fisherman’s-rope” sign in superficial frontal developmental venous anomalies, and ventricular-wall T2 hypointensity in developmental venous anomalies with deep drainage. Eight fetuses (44.4%) had a complicated developmental venous anomaly. Multiple developmental venous anomalies (3/18, 16.7%) were associated with varix thrombosis (2/3 vs 0/15, P=0.02).

Conclusion

Fetal developmental venous anomalies demonstrate two reproducible MRI patterns that enable confident diagnosis and help in differentiating from hemorrhage and other vascular malformations.

Graphical abstract