Koroid pleksus kistlerinin değerlendirilmesi: 9244 gebe kadın üzerine kesitsel bir çalışma

Öz

Amaç: Rastgele popülasyonlar üzerinde yapılmış bir çok çalışmada koroid pleksus kistlerinin (KPK) boyut, bilateralite ve sayısının çeşitli derecelerde anöploidi riski ile ilişkili olduğu ortaya konulmuştur. Bu makale seçilmiş bir popülasyonda, KPK’ların sayı, boyut ve bilateralitesinin doğal seyri ve önemini ele almaktadır.
Yöntemler: Bu kesitsel çalışma Mart 2014 ve Mart 2018 arasında departmanımıza başvuran 9244 gebe kadın üzerinde yürütüldü. Dışlama kriterleri uyguladıktan sonra geriye izole KPK’li 87 hasta kaldı. Hastaların tüm kayıtları tarandı ve ihtiyaç duyulan veriler alındı.
Bulgular: Bu dönemde 9244 prenatal sonografi uygulanmıştı. 87 fetüste izole KPK tespit edildi. KPK’lar 83 (%95,4) vakada tek taraflı ve diğer 4 (%4,6) vakada çift taraflı olarak izlendi. Tek taraflı olan 83 vakanın 45’inin (%51,7) sol taraflı ve 38’inin (%43,7) sağ taraflı KPK’sı vardı. Kistlerin boyutu, 3,51 (0,06) mm lik bir ortalamayla, 3mm den 5,1mm ye uzanıyordu. İkili test (n=24) ve dörtlü testlerin (n=63) sırasıyla 2 ve 5 anormal sonucu vardı. Hepsi normal karyotipe sahipti. Dört vaka membranların prematür rüptürü (n=2) ve intrauterin fetal ölüm (n=2) nedeni ile çalışmadan çıkarıldı. Kalan tüm fetüslerin (n=83) akıbetinin normal olduğu bulundu ve doğuma kadar hiçbir anomali izlenmedi.
Sonuç: Tek bir koroid pleksusta çoğul KPK ve bilateralite anormal fetal karyotiple ilişkili değildi, bu yüzden izole KPK’ lerinin iyi bir prognoza sahip olduğunu düşünüyoruz. 

Anahtar Kelimeler

• Koroid pleksus kisti,Ultrasonografi,Fetüs

Review of fetal choroid plexus cysts: A cross-sectional study on 9244 pregnant women

Abstract

Aim: It was revealed in many studies conducted on unselected populations that the size, bilaterality and number of choroid plexus cysts (CPCs) are correlated with various degrees of aneuploidy risk. This article deals with the natural history and significance of numbers, sizes and bilaterality of CPCs in a selected population.
Methods: This cross-sectional study was conducted on 9244 pregnant women attending to our department between March 2014 and March 2018. After exclusion criteria was applied, 87 patients with isolated CPCs remained. All records of the patients were screened and needed data were recorded.
Results: A total of 9244 prenatal sonographies had been performed during this period. Isolated CPC was detected in 87 fetuses. CPCs were visualized unilaterally in 83 cases (95.4%) and bilaterally in 4 cases (4.6%). Among 83 unilateral cases, 45 had left sided (51.7%) and 38 had right sided CPCs (43.7%). The size of the cysts ranged between 3 mm to 5.1 mm with an average of 3.51 (0.06) mm. Double tests (n=24) and quadruple tests (n=63) had 2 and 5 abnormal results, respectively. All had normal karyotypes. Four samples were dropped out due to premature rupture of membranes (n=2) and intrauterine fetal death (n=2). It was found that the outcomes of all remaining fetuses (n=83) were normal and no anomalies were seen until birth.
Conclusion: Multiple CPCs in a single choroid plexus or bilaterality were not associated with abnormal fetal karyotype and therefore we think that isolated CPCs has a good prognosis.

Keywords

• Choroid plexus cyst,Ultrasonography,Fetus

References

1. 1. Chudleigh P, Pearce JM, Campbell S. The prenatal diagnosis of transient cysts of the fetal choroid plexus. Prenatal Diag. 1984;4:135-7.
2. 2. Camurri L, Ventura A. Prospective study on trisomy 18 and fetal choroid plexus cysts. Prenat Diagn. 1989;9:742.
3. 3. Gabrielli S, Reece A, Pilu G, Perolo A, Rizzo N, Bovicelli L, Hobbins JC. The clinical significance of prenatally diagnosed choroid plexus cysts. Am J Obstet Gynecol. 1989;160:1207–10.
4. 4. Landy HJ, Bannon P, Zalud I, Collea JV, Lewis KM, Bartholomew ML, et al. Association of sex of the fetus in isolated fetal choroid plexus cysts. J Ultrasound Med. 1999;18:769-71.
5. 5. Cristofalo E, Dipietro J, Costigan K, Nelson P, Crino J. Women's response to fetal choroid plexus cysts detected by prenatal ultrasound. J Perinatol. 2006;26:215-23.
6. 6. Nyberg DA, Kramer D, Resta R, Kapur R, Mahony BS, Luthy DA. Prenatal sonographic findings of trisomy 18: review of 47 cases. J Ultrasound Med. 1993;12:103-13.
7. 7. Shah, N. J Obstet Gynecol India. 2018;68:366. Doi:. 10.1007/s13224-017-1047-7.
8. 8. Demasio K, Canterino J, Ananth C, Fernandez C, Smulian J, Vintzileos A. Isolated choroid plexus cyst in low-risk women less than 35 years old. Am J Obestet Gynecol. 2002;187:1246-9.

9. 9. Chan L, Hixson JL, Laifer SA, Marchese SG, Martin JG, Hill LM. A sonographic and karyotypic study of second-trimester fetal choroid plexus cysts. Obstet Gynecol. 1989;73:703–5.
10. 10. Perpignano MC, Cohen HL, Klein VR, Mandel FS, Streltzoff J, Chervenak FA, Goldman MA. Fetal choroid plexus cysts: beware the smaller cyst. Radiology. 1992;182:715–7.
11. 11. Clark S, DeVore GR, Sabey P. Prenatal diagnosis of cysts of the fetal choroid plexus. Obstet Gynecol. 1988;72:4.
12. 12. Bronsteen R, Lee W, Vettraino IM, Huang R, Comstock CH. Second-trimester sonography and trisomy 18 the significance of isolated choroid plexus cysts after an examination that includes the fetal hands. J Ultrasound Med. 2004;23:241-5.
13. 13. DiPietro J, Costigan K, Cristofalo E, Lu Y, Bird CW, McShane CA, et al. Choroid plexus cysts do not affect fetal neurodevelopment. J Perinatol. 2006;26:622-7.
14. 14. Cheng PJ, Shaw SW, Soong YK. Association of fetal choroid plexus cysts with trisomy 18 in a population previously screened by nuchal translucency thickness measurement. J Soc Gynecol Investig. 2006;13:280-4.
15. 15. Lopez JA, Reich D. Choroid plexus cysts. J Am Board Fam Med. 2006;19:422-5.
16. 16. Sullivan A, Giudice T, Vavelidis F, Thiagarajah S. Choroid plexus cysts: Is biochemical testing a valuable adjunct to targeted ultrasonography? Am J Obestet Gynecol. 1999;181:260-5.
17. 17. Nicolaides KH. Nuchal translucency and other first-trimester sonographic markers of chromosomal abnormalities. Am J Obstet Gynecol. 2004;191:45–67.