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Comparison of Fetal Ultrasonography and Fetal Magnetic Resonance Imaging for the Detection of Additional Anomalies in Cases of Fetal Ventricolumegaly

Yıl 2018, Cilt: 49 Sayı: 2, 192 - 195, 27.06.2018
https://doi.org/10.16948/zktipb.417284

Öz

Objective: To compare fetal US and fetal MRI techniques for the detection of
additional findings in cases of fetal venticulomegaly diagnosed by antenatal
US.

 

Material
and Method:
46 Patients diagnosed with
ventriculomegaly by ultrasonography between May 2009 – April 2010 have been
included in the study. Gestational (FETAL age mi demek gerek, tam terimi
bilmiyorum?) age (GA) was between 21 and 35 weeks. MRI examination couldn’t be
performed in 4 patients due to clostrophoby and 2 patients didn’t give consent
for the procedure. Those 6 patients have been excluded from the study and the
examination was carried in 40 patients. The ventriculomegaly was graded in 2
groups as mild (10-14 mm) or as severe (15 mm or higher). MRI has been
performed in maximum 4 days following ultrasonography with a  1,5 T MRI unit (Sympony, Siemens, Erlangen,
Germany), using a “phased array” body coil. The fetal anatomy was evaluated
by  the 
“Half-Fourier acquisition single-shot turbo spin-echo" (HASTE)
sequence (TR: 4.4, TE: 64, flip angle: 150°, slice thickness: 6 mm, gap: 0.1
mm, matriks: 160x256, FOV: 350 mm) in three planes adjusted to the fetal
position. The frequency of the patients 
where MRI and US results were in concordance and teh frequency of the
patients where MRI provided additional diagnostic information were given  by a confidence interval of 95%. Chi-square
test (Yates) was used to compare the groups. The significance was evaluated at
p<0.05.

 

Findings: Mild ventirculomegaly (10-14 mm) was detected in 28 patients (Group
1), and severe ventriculomegaly (>15 mm) was detected in 12 patients
(Group II). MRI detected additional findings compared to ultrasonography in 7
of the 28 patients in Group I (25% [CI 95%; 0.11-0.45]) and 5 of the 12
patients in Group II (%42 [CI 95%; 0.15-0.72]), a total of 12 patients (30% [CI
95%; 0.16-0.46]). When 2 groups were compared for the additional findings
provided by MRI, MRI detected more abnormalities in severe ventriculomegaly
group (42%), however the difference with mild ventriculomegaly group (25%) was
not statistically significant ( x² yates: 0.459, p:0.498). MRI changed patient
management in 4 patients in Group I (14% [95% CI; 0.09-0.34]) and 3 patients in
Group II (25% [95% CI; 0.14-0.94]). In total, MRI changed patient management in
17% [95% CI; 0.13-0.41] of the patients.

 
































Conclusion:
Our study demonstrated that, while US has a high
accuracy in diagnosing ventriculomegaly, fetal MRI examination can provide
additional findings to US, especially in detecting co-existing CNS
abnormalities.

Kaynakça

  • Referans1-Karabulut N, Fetal MRG: Nasıl Yapılmalı? 30.Ulusal Radyoloji Kongresi, 4-9 Kasım 2009, AntalyaReferans2 -Weinreb JC, Lowe T, Cohen JM, Kutler M. Human fetal anatomy: MR imaging. Radiology 1985;157:715-720Referans3- Adaletli İ, Özer H, Fetal MR Görüntüleme, Body MRI (1. Baskı). Siegelman ES 2008;343-367Referans-4 Coakley FV, Glenn OA, Qayyum A, Barkovich AJ, Goldstein R, Filly RA. Fetal MRI: a developing technique for the developing patient. AJR. Am Roentgenol 2004;182:243-252 Referans-5 Clements H, Duncan KR, Fielding K, Gowland PA, Johnson IR, Baker PN. Infants exposed to MRI in utero have a normal paediatric assessment at 9 months of age. Br J Radiol. 2000 Feb;73(866):190-194.Referans-6 Kok RD, de Vries MM, Heerschap A, van den Berg PP. Absence of harmful effects of magnetic resonance exposure at 1.5 T in utero during the third trimester of pregnancy: a follow-up study. Magn Reson Imaging. 2004 Jul;22(6):851-4.Referans-7 Kanal E, Gillen J, Evans JA, Savitz DA, Shellock FG. Survey of reproductive health among female MR workers. Radiology. 1993 May;187(2):395-9.Referans-8 Levine D. Zio C, Faro CB, Chen Q. Potential heating effect in the gravid uterus during MR HASTE imaging. J.Magn Reson Imaging 2001;13:856-851 Referans-9 Coakley FV. Role of magnetic resonance imaging in fetal surgery. Top Magn Reson Imaging 2001;12:39-51Referans-10 Hertzberg BS, Kliewer MA, Bowie JD, Sonographic evaluation of fetal CNS: technical and interpretive pitfalls. AJR Am Roentgenol 1999;172:523-527Referans-11 Levine D, Barnes PD, Robertson RR, Wong G, Mehta TS. Fast MR imaging of fetal central nervous system abnormalities. Radiology 2003;229:51-61 Referans-12 Cardoza JD, Goldstein RB, Filly RA. Exclusion of fetal ventriculomegaly with a single measurement: the width of the lateral ventricular atrium. Radiology 1988;169: 711–14 Referans-13 Heiserman J, Filly RA, Goldstein RB. Effect of measurement errors on sonographic evaluation of ventriculomegaly. J Ultrasound Med 1991;10: 121–24 Referans-14 Twickler DM, Reichel T, McIntire DD, et al. Fetal CNS ventricle and cisterna magna measurements by magnetic resonance imaging. Am J Obstet Gynecol 2002;187: 927–31 Referans-15 Nicolaides KH, Gosden CM, Snijders RJM. Ultrasonographically detectable markers of fetal chromosomal defects. In: Nelson JP, Chambers SE eds. Obstetric Ultrasound: Volume 1. Oxford, UK: Oxford University Press; 1993: 41–82 Referans-16- Griffiths PD, Reeves MJ, Morris JE, Mason G, Russell SA, Paley MN, Whitby EH A prospective study of fetuses with isolated ventriculomegaly investigated by antenatal sonography and in utero MR imaging.. AJNR Am J Neuroradiol. 2010 Jan;31(1):106-11. Referans-17 Nicolaides KH, Berry S, Snijders RJ, et al. Fetal lateral cerebral ventriculomegaly: associated malformations and chromosomal defects. Fetal Diagn Ther 1990;5: 5–14 Referans-18 Nyberg DA, Mack LA, Hirsch J, et al. Fetal hydrocephalus: sonographic detection and clinical significance of associated abnormalities. Radiology 1987;163: 187–91 Referans-19 Gaglioti P, Danelon D, Bontempo S, et al. Fetal cerebral ventriculomegaly: outcome in 176 cases. Ultrasound Obstet Gynecol 2005;25: 372–77 Referans-20 Filly RA, Cardoza JD, Goldstein RB, et al. Detection of fetal CNS anomalies: a practical level of effort for a routine sonogram. Radiology 1989;172: 403–08 Referans-21 Bromley B, Frigoletto FD Jr, Benacerraf BR. Mild fetal lateral cerebral ventriculomegaly: clinical course and outcome. Am J Obstet Gynecol 1991;164:863–867.Referans- 22- Ouahba J, Luton D, Vuillard E, et al. Prenatal isolated mild ventriculomegaly: outcome in 167 cases. BJOG 2006;113:1072–1079. Referans-23 Graham E, Duhl A, Ural S, et al. The degree of antenatal ventriculomegaly is related to pediatric neurological morbidity. J Matern Fetal Med 2001;10: 258–63Referans-24- Glenn OA, Barkovich J. Magnetic resonance imaging of the fetal brain and spine: an increasingly important tool in prenatal diagnosis, part 2. AJNR Am J Neuroradiol 2006;27:1807–1814. Referans-25- Levine D, Trop I, Mehta TS, Barnes PD. MR imaging appearance of fetal cerebral ventricular morphology. Radiology 2002;223:652–660. Referans-26- Benacerraf BR, Shipp TD, Bromley B, Levine D.What does magnetic resonance imaging add to the prenatal sonographic diagnosis of ventriculomegaly? J Ultrasound Med. 2007 Nov;26(11):1513-22.Referans-27- Valsky DV, Ben-Sira L, Porat S, et al. The role of magnetic resonance imaging in the evaluation of isolated mild ventriculomegaly. J Ultrasound Med 2004;23:519–523. Referans-28- Morris JE, Rickard S, Paley MN, Griffiths PD, Rigby A, Whitby EH. The value of in-utero magnetic resonance imaging in ultrasound diagnosed foetal isolated cerebral ventriculomegaly. Clin Radiol. 2007 Feb;62(2):140-4.Referans-29- Bennett G, Bromley B, Benacerraf BR. Agenesis of the corpus callosum: prenatal detection not usually possible before twenty-two weeks of gestation. Radiology 1996;199:447–450.Referans-30- Glenn OA, Goldstein RB, Li KC, et al. Fetal magnetic resonance imaging in the evaluation of fetuses referred for sonographically suspected abnormalities of the corpus callosum. J Ultrasound Med 2005;24:791–804. Referans-31 - Malinger G, Kidron D, Schreiber L, et al. Prenatal diagnosis of malformations of cortical development by dedicated neurosonography. Ultrasound Obstet Gynecol 2007;29:178–191.Referans-32 - Righini A, Zirpoli S, Mrakic F, Parazzini C, Pogliani L, Triulzi F. Early prenatal MR imaging diagnosis of polymicrogyria. AJNR Am J Neuroradiol 2004;25:343–346. Referans-33 - Malinger G, Kidron D, Schreiber L, Ben-Sira L, Hoffmann C, Lev D, Lerman-Sagie T. Prenatal diagnosis of malformations of cortical development by dedicated neurosonography. Ultrasound Obstet Gynecol. 2007 Feb;29(2):178-91Referans-34- Malinger G, Ben-Sira L, Lev D, Ben-Aroya Z, Kidron D, Lerman-Sagie T. Fetal brain imaging: a comparison between magnetic resonance imaging and dedicated neurosonography. Ultrasound Obstet Gynecol 2004;23:333–340. Referans-35 - Monteagudo A, Timor-Tritsch IE, Mayberry P. Three-dimensional transvaginal neurosonography of the fetal brain: “navigating” in the volume scan. Ultrasound Obstet Gynecol 2000;16:307–313.

Fetal Ventrikülomegali Olgularında Ek Anomali Tanısında Fetal Ultrasonografiiel Manyetik Rezonans Görüntüleme Tetkiklerinin Değerlendirilmesi

Yıl 2018, Cilt: 49 Sayı: 2, 192 - 195, 27.06.2018
https://doi.org/10.16948/zktipb.417284

Öz

Amaç: Antenatal dönemde yapılan USG’de fetal
ventrikülomegali saptanan olgularda, ek bulgular açısından, fetal USG ile fetal
MRG  tetkiklerini karşılaştırmaktır.

 

Materyal ve Metod: Mayıs 2009 - Nisan 2010
tarihleri arasında USG
’de ventrikülomegali tanısı konan 46
hasta dahil edildi. Fetal yaş 21-35 gebelik haftası (GH), arasındaydı. 4
hastada klostrofobi nedeniyle, 2 hastada da onay vermedikleri için MRG tetkiki
yapılamadı. 40 hastaya MRG tetkiki yapıldı, diğer 6 hasta çalışmadan çıkarıldı.
Ventrikülomegali
derecesi hafif  (10-14 mm) ve belirgin
(15 mm ve üzeri) olarak 2’ye ayrılarak değerlendirildi.
USG
tetkiki sonrası en geç 4 gün içerisinde hastalara MRG tetkiki yapıldı. MR
görüntüleme, 1.5 T MR cihazında (Sympony, Siemens, Erlangen, Almanya),
"phased array" vücut sarmalı kullanılarak yapıldı. Fetal anatomiyi
belirlemek için fetal pozisyona uygun başlıca 3 planda "Half-Fourier
acquisition single-shot turbo spin-echo" (HASTE) sekansı (TR: 4.4, TE: 64,
sapma açısı: 150°, kesit kalınlığı: 6 mm, kesitler arası boşluk: 0.1 mm,
matriks: 160x256, FOV: 350 mm) kullanıldı. MRG ve USG tetkiklerinde tanısal
uyumu olan hasta sıklıkları ve MRG tetkiki ile ek tanısal bilgi elde edilen
hastaların sıklıkları, % 95 güven aralığı ile birlikte verildi. Grupların
karşılaştırılmasında ki-kare (yates) testi kullanıldı. Anlamlılık p<0.05
düzeyinde değerlendirildi.     

                                                                       
               

Bulgular:  28 hastada (Grup I) hafif
ventrikülümegali (10-14mm), 12 hastada (Grup II) belirgin ventrikülomegali
(>15 mm)  saptandı. I.gruptaki 28
hastanın 7’sinde (% 25 [% 95 GA; 0.11-0.45]) , II.gruptaki 12 hastanın 5’inde
(% 42 [% 95 GA; 0.15-0.72]) ve tüm olgular göz önüne alındığında toplam 12
hastada (% 30 [% 95 GA; 0.16-0.46])  MRG
tetkiki USG’ye ek bulgu saptadı. MRG tetkikinin sağladığı ek bulgular açısından
her iki grup karşılaştırıldığında, belirgin ventrikülomegali olan grupta MRG
tetkiki  daha fazla oranla ek bulgu (%
42) saptamasına rağmen istatistiksel olarak hafif ventrikülomegali olan grupla
( % 25) arasında anlamlı fark saptanmadı ( x² yates: 0.459, p:0.498). MRG
tetkiki I. grupta 4 olguda (% 14  [% 95
GA; 0.09-0.34]) II.Grupta ise 3 olguda (% 25 [% 95 GA; 0.14-0.94])  hasta yönetimini değiştirdi. Tüm hasta grubu
göz önüne alındığında  olguların %
17’sinde  [% 95 GA; 0.13-0.41] hasta
yönetimini değiştirdi.

 

 





































Sonuç:  Çalışmamız, her ne kadar USG tetkikinin ventrikülomegali olgularında
yüksek oranda doğru tanı koyabilsede, fetal MRG tetkikinin özellikle eşlik
edebilecek diğer SSS anomalilerini ortaya koymakta USG’ye ek bulgular
saptayabileceğini ortaya koymuştur.

Kaynakça

  • Referans1-Karabulut N, Fetal MRG: Nasıl Yapılmalı? 30.Ulusal Radyoloji Kongresi, 4-9 Kasım 2009, AntalyaReferans2 -Weinreb JC, Lowe T, Cohen JM, Kutler M. Human fetal anatomy: MR imaging. Radiology 1985;157:715-720Referans3- Adaletli İ, Özer H, Fetal MR Görüntüleme, Body MRI (1. Baskı). Siegelman ES 2008;343-367Referans-4 Coakley FV, Glenn OA, Qayyum A, Barkovich AJ, Goldstein R, Filly RA. Fetal MRI: a developing technique for the developing patient. AJR. Am Roentgenol 2004;182:243-252 Referans-5 Clements H, Duncan KR, Fielding K, Gowland PA, Johnson IR, Baker PN. Infants exposed to MRI in utero have a normal paediatric assessment at 9 months of age. Br J Radiol. 2000 Feb;73(866):190-194.Referans-6 Kok RD, de Vries MM, Heerschap A, van den Berg PP. Absence of harmful effects of magnetic resonance exposure at 1.5 T in utero during the third trimester of pregnancy: a follow-up study. Magn Reson Imaging. 2004 Jul;22(6):851-4.Referans-7 Kanal E, Gillen J, Evans JA, Savitz DA, Shellock FG. Survey of reproductive health among female MR workers. Radiology. 1993 May;187(2):395-9.Referans-8 Levine D. Zio C, Faro CB, Chen Q. Potential heating effect in the gravid uterus during MR HASTE imaging. J.Magn Reson Imaging 2001;13:856-851 Referans-9 Coakley FV. Role of magnetic resonance imaging in fetal surgery. Top Magn Reson Imaging 2001;12:39-51Referans-10 Hertzberg BS, Kliewer MA, Bowie JD, Sonographic evaluation of fetal CNS: technical and interpretive pitfalls. AJR Am Roentgenol 1999;172:523-527Referans-11 Levine D, Barnes PD, Robertson RR, Wong G, Mehta TS. Fast MR imaging of fetal central nervous system abnormalities. Radiology 2003;229:51-61 Referans-12 Cardoza JD, Goldstein RB, Filly RA. Exclusion of fetal ventriculomegaly with a single measurement: the width of the lateral ventricular atrium. Radiology 1988;169: 711–14 Referans-13 Heiserman J, Filly RA, Goldstein RB. Effect of measurement errors on sonographic evaluation of ventriculomegaly. J Ultrasound Med 1991;10: 121–24 Referans-14 Twickler DM, Reichel T, McIntire DD, et al. Fetal CNS ventricle and cisterna magna measurements by magnetic resonance imaging. Am J Obstet Gynecol 2002;187: 927–31 Referans-15 Nicolaides KH, Gosden CM, Snijders RJM. Ultrasonographically detectable markers of fetal chromosomal defects. In: Nelson JP, Chambers SE eds. Obstetric Ultrasound: Volume 1. Oxford, UK: Oxford University Press; 1993: 41–82 Referans-16- Griffiths PD, Reeves MJ, Morris JE, Mason G, Russell SA, Paley MN, Whitby EH A prospective study of fetuses with isolated ventriculomegaly investigated by antenatal sonography and in utero MR imaging.. AJNR Am J Neuroradiol. 2010 Jan;31(1):106-11. Referans-17 Nicolaides KH, Berry S, Snijders RJ, et al. Fetal lateral cerebral ventriculomegaly: associated malformations and chromosomal defects. Fetal Diagn Ther 1990;5: 5–14 Referans-18 Nyberg DA, Mack LA, Hirsch J, et al. Fetal hydrocephalus: sonographic detection and clinical significance of associated abnormalities. Radiology 1987;163: 187–91 Referans-19 Gaglioti P, Danelon D, Bontempo S, et al. Fetal cerebral ventriculomegaly: outcome in 176 cases. Ultrasound Obstet Gynecol 2005;25: 372–77 Referans-20 Filly RA, Cardoza JD, Goldstein RB, et al. Detection of fetal CNS anomalies: a practical level of effort for a routine sonogram. Radiology 1989;172: 403–08 Referans-21 Bromley B, Frigoletto FD Jr, Benacerraf BR. Mild fetal lateral cerebral ventriculomegaly: clinical course and outcome. Am J Obstet Gynecol 1991;164:863–867.Referans- 22- Ouahba J, Luton D, Vuillard E, et al. Prenatal isolated mild ventriculomegaly: outcome in 167 cases. BJOG 2006;113:1072–1079. Referans-23 Graham E, Duhl A, Ural S, et al. The degree of antenatal ventriculomegaly is related to pediatric neurological morbidity. J Matern Fetal Med 2001;10: 258–63Referans-24- Glenn OA, Barkovich J. Magnetic resonance imaging of the fetal brain and spine: an increasingly important tool in prenatal diagnosis, part 2. AJNR Am J Neuroradiol 2006;27:1807–1814. Referans-25- Levine D, Trop I, Mehta TS, Barnes PD. MR imaging appearance of fetal cerebral ventricular morphology. Radiology 2002;223:652–660. Referans-26- Benacerraf BR, Shipp TD, Bromley B, Levine D.What does magnetic resonance imaging add to the prenatal sonographic diagnosis of ventriculomegaly? J Ultrasound Med. 2007 Nov;26(11):1513-22.Referans-27- Valsky DV, Ben-Sira L, Porat S, et al. The role of magnetic resonance imaging in the evaluation of isolated mild ventriculomegaly. J Ultrasound Med 2004;23:519–523. Referans-28- Morris JE, Rickard S, Paley MN, Griffiths PD, Rigby A, Whitby EH. The value of in-utero magnetic resonance imaging in ultrasound diagnosed foetal isolated cerebral ventriculomegaly. Clin Radiol. 2007 Feb;62(2):140-4.Referans-29- Bennett G, Bromley B, Benacerraf BR. Agenesis of the corpus callosum: prenatal detection not usually possible before twenty-two weeks of gestation. Radiology 1996;199:447–450.Referans-30- Glenn OA, Goldstein RB, Li KC, et al. Fetal magnetic resonance imaging in the evaluation of fetuses referred for sonographically suspected abnormalities of the corpus callosum. J Ultrasound Med 2005;24:791–804. Referans-31 - Malinger G, Kidron D, Schreiber L, et al. Prenatal diagnosis of malformations of cortical development by dedicated neurosonography. Ultrasound Obstet Gynecol 2007;29:178–191.Referans-32 - Righini A, Zirpoli S, Mrakic F, Parazzini C, Pogliani L, Triulzi F. Early prenatal MR imaging diagnosis of polymicrogyria. AJNR Am J Neuroradiol 2004;25:343–346. Referans-33 - Malinger G, Kidron D, Schreiber L, Ben-Sira L, Hoffmann C, Lev D, Lerman-Sagie T. Prenatal diagnosis of malformations of cortical development by dedicated neurosonography. Ultrasound Obstet Gynecol. 2007 Feb;29(2):178-91Referans-34- Malinger G, Ben-Sira L, Lev D, Ben-Aroya Z, Kidron D, Lerman-Sagie T. Fetal brain imaging: a comparison between magnetic resonance imaging and dedicated neurosonography. Ultrasound Obstet Gynecol 2004;23:333–340. Referans-35 - Monteagudo A, Timor-Tritsch IE, Mayberry P. Three-dimensional transvaginal neurosonography of the fetal brain: “navigating” in the volume scan. Ultrasound Obstet Gynecol 2000;16:307–313.
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Vuslat Lale Bakır

A. Aktuğ Ertekin Bu kişi benim

Zeki Şahinoğlu

Nebiye Serra Sencer Bu kişi benim

Yayımlanma Tarihi 27 Haziran 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 49 Sayı: 2

Kaynak Göster

APA Bakır, V. L., Ertekin, A. A., Şahinoğlu, Z., Sencer, N. S. (2018). Fetal Ventrikülomegali Olgularında Ek Anomali Tanısında Fetal Ultrasonografiiel Manyetik Rezonans Görüntüleme Tetkiklerinin Değerlendirilmesi. Zeynep Kamil Tıp Bülteni, 49(2), 192-195. https://doi.org/10.16948/zktipb.417284
AMA Bakır VL, Ertekin AA, Şahinoğlu Z, Sencer NS. Fetal Ventrikülomegali Olgularında Ek Anomali Tanısında Fetal Ultrasonografiiel Manyetik Rezonans Görüntüleme Tetkiklerinin Değerlendirilmesi. Zeynep Kamil Tıp Bülteni. Haziran 2018;49(2):192-195. doi:10.16948/zktipb.417284
Chicago Bakır, Vuslat Lale, A. Aktuğ Ertekin, Zeki Şahinoğlu, ve Nebiye Serra Sencer. “Fetal Ventrikülomegali Olgularında Ek Anomali Tanısında Fetal Ultrasonografiiel Manyetik Rezonans Görüntüleme Tetkiklerinin Değerlendirilmesi”. Zeynep Kamil Tıp Bülteni 49, sy. 2 (Haziran 2018): 192-95. https://doi.org/10.16948/zktipb.417284.
EndNote Bakır VL, Ertekin AA, Şahinoğlu Z, Sencer NS (01 Haziran 2018) Fetal Ventrikülomegali Olgularında Ek Anomali Tanısında Fetal Ultrasonografiiel Manyetik Rezonans Görüntüleme Tetkiklerinin Değerlendirilmesi. Zeynep Kamil Tıp Bülteni 49 2 192–195.
IEEE V. L. Bakır, A. A. Ertekin, Z. Şahinoğlu, ve N. S. Sencer, “Fetal Ventrikülomegali Olgularında Ek Anomali Tanısında Fetal Ultrasonografiiel Manyetik Rezonans Görüntüleme Tetkiklerinin Değerlendirilmesi”, Zeynep Kamil Tıp Bülteni, c. 49, sy. 2, ss. 192–195, 2018, doi: 10.16948/zktipb.417284.
ISNAD Bakır, Vuslat Lale vd. “Fetal Ventrikülomegali Olgularında Ek Anomali Tanısında Fetal Ultrasonografiiel Manyetik Rezonans Görüntüleme Tetkiklerinin Değerlendirilmesi”. Zeynep Kamil Tıp Bülteni 49/2 (Haziran 2018), 192-195. https://doi.org/10.16948/zktipb.417284.
JAMA Bakır VL, Ertekin AA, Şahinoğlu Z, Sencer NS. Fetal Ventrikülomegali Olgularında Ek Anomali Tanısında Fetal Ultrasonografiiel Manyetik Rezonans Görüntüleme Tetkiklerinin Değerlendirilmesi. Zeynep Kamil Tıp Bülteni. 2018;49:192–195.
MLA Bakır, Vuslat Lale vd. “Fetal Ventrikülomegali Olgularında Ek Anomali Tanısında Fetal Ultrasonografiiel Manyetik Rezonans Görüntüleme Tetkiklerinin Değerlendirilmesi”. Zeynep Kamil Tıp Bülteni, c. 49, sy. 2, 2018, ss. 192-5, doi:10.16948/zktipb.417284.
Vancouver Bakır VL, Ertekin AA, Şahinoğlu Z, Sencer NS. Fetal Ventrikülomegali Olgularında Ek Anomali Tanısında Fetal Ultrasonografiiel Manyetik Rezonans Görüntüleme Tetkiklerinin Değerlendirilmesi. Zeynep Kamil Tıp Bülteni. 2018;49(2):192-5.