AI-Driven Clinical Decision Support System for Automated Ventriculomegaly Classification from Fetal Brain MRI

Fetal ventriculomegaly (VM) is a condition characterized by abnormal enlargement of the cerebral ventricles of the fetus brain that often causes developmental disorders in children. Manual segmentation and classification of ventricular structures from brain MRI scans are time-consuming and require clinical expertise. To address this challenge, we develop an automated pipeline for ventricle segmentation, ventricular width estimation, and VM severity classification using a publicly available dataset. An adaptive slice selection strategy converts 3D MRI volumes into the most informative 2D slices, which are then segmented to isolate the lateral ventricles and deep gray matter. Ventricular width is automatically estimated to assign severity levels based on clinical thresholds, generating labeled data for training a deep learning classifier. Finally, an explainability module using a large language model integrates the MRI slices, segmentation masks, and predicted severity to provide interpretable clinical reasoning. Experimental results demonstrate that the proposed decision support system delivers robust performance, achieving dice scores of 89% and 87.5% for the 2D and 3D segmentation models, respectively. Also, the classification network attains an accuracy of 86% and an F1-score of 0.84 in VM analysis.