Prenatal diagnosis of arachnoid cysts: MRI features and neurodevelopmental outcome

Objective: Arachnoid cysts (AC) are congenital lesions comprising 1% of all intracranial mass lesions. The aim of this study was to characterize arachnoid cysts and their neurodevelopmental outcome and to compare it with the outcome of children without AC.

Methods: This is a retrospective cohort study of arachnoid cysts detected prenatally by fetal MRI in 29 fetuses compared to a control group of 59 fetuses without arachnoid cyst who were examined by MRI. The cohort was investigated from two different angles: anatomical and developmental. Anatomical analyzation, the cohort was divided into 2 groups by the arachnoid cyst anatomical location: group A (n = 9), which included cases with supratentorial cyst, and group B (n = 20), which included cases with infratentorial cyst. Developmental analyzation, the cohort was divided into 2 groups by the neurodevelopmental outcome: group γ (n = 5) which included cases that were affected by arachnoid cyst presence, and group δ (n = 17) which included cases that had neurodevelopmental outcome within the normal range. Data collected included prenatal history, MRI features, sonographic follow up, and neurodevelopmental outcome.

Results: In 22/29 cases we achieved a long-term follow up, by evaluation of children development in a range of ages from 6 months to 6 years. In group A (n = 9), 4 infants had normal outcome, 2 had abnormal outcome, 1 pregnancy was terminated, and 2 cases were not cooperative with the study. In group B (n = 20), 13 infants had normal outcome, 3 had abnormal outcome, and 4 cases were not cooperative with the study.

Conclusions: From all cases with AC detected by fetal MRI, 77.3% had normal neurodevelopmental outcome and 22.7% had abnormal neurodevelopment.