1
|
Miller E, Orman G, Huisman TAGM. Fetal MRI assessment of posterior fossa anomalies: A review. J Neuroimaging 2021; 31:620-640. [PMID: 33964092 DOI: 10.1111/jon.12871] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 11/27/2022] Open
Abstract
Prenatal ultrasound (US) is the first prenatal imaging tool for screening and evaluation of posterior fossa malformations since it is noninvasive, widely available, and safe for both mother and child. Fetal MRI is a widely used secondary technique to confirm, correct, or complement questionable US findings and plays an essential role in evaluating fetuses with suspected US findings and /or positive family history. The main sequences of fetal MRI consist of T2-weighted (T2w) ultrafast, single-shot sequences. Axial, coronal, and sagittal images are typically acquired allowing for a detailed evaluation of the posterior fossa contents. Also, various complimentary sequences, such as T1w, T2*w gradient sequences, or advanced techniques, including diffusion-weighted imaging, diffusion tensor imaging, and magnetic resonance spectroscopy, may provide additional information based on the studied malformation. Inclusion of these techniques should be done with careful risk-benefit analysis. The use of fetal MRI also aims to evaluate for associated anomalies. In addition, prenatal diagnosis of posterior fossa malformations is still a challenge but advances in knowledge in human developmental anatomy, genetic, and imaging recognition patterns have enabled us to shed some light on prognostic information that will help with the counseling of families. Finally, high-resolution late third trimester fetal MRI offers a safe alternative to early postnatal MR imaging, basically taking advantage of the uterine environment as a kind of "maternal incubator." Our goal is to discuss the spectrum of prenatal posterior fossa pathologies that can be studied by fetal MRI and their key neuroimaging features.
Collapse
Affiliation(s)
- Elka Miller
- Department of Medical Imaging, CHEO, University of Ottawa, Ottawa, Ontario, Canada
| | - Gunes Orman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, Texas, USA
| | - Thierry A G M Huisman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, Texas, USA
| |
Collapse
|
2
|
Micalizzi A, Poretti A, Romani M, Ginevrino M, Mazza T, Aiello C, Zanni G, Baumgartner B, Borgatti R, Brockmann K, Camacho A, Cantalupo G, Haeusler M, Hikel C, Klein A, Mandrile G, Mercuri E, Rating D, Romaniello R, Santorelli FM, Schimmel M, Spaccini L, Teber S, von Moers A, Wente S, Ziegler A, Zonta A, Bertini E, Boltshauser E, Valente EM. Clinical, neuroradiological and molecular characterization of cerebellar dysplasia with cysts (Poretti-Boltshauser syndrome). Eur J Hum Genet 2016; 24:1262-7. [PMID: 26932191 DOI: 10.1038/ejhg.2016.19] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 01/14/2016] [Accepted: 02/01/2016] [Indexed: 12/11/2022] Open
Abstract
Cerebellar dysplasia with cysts and abnormal shape of the fourth ventricle, in the absence of significant supratentorial anomalies and of muscular involvement, defines recessively inherited Poretti-Boltshauser syndrome (PBS). Clinical features comprise non-progressive cerebellar ataxia, intellectual disability of variable degree, language impairment, ocular motor apraxia and frequent occurrence of myopia or retinopathy. Recently, loss-of-function variants in the LAMA1 gene were identified in six probands with PBS. Here we report the detailed clinical, neuroimaging and genetic characterization of 18 PBS patients from 15 unrelated families. Biallelic LAMA1 variants were identified in 14 families (93%). The only non-mutated proband presented atypical clinical and neuroimaging features, challenging the diagnosis of PBS. Sixteen distinct variants were identified, which were all novel. In particular, the frameshift variant c.[2935delA] recurred in six unrelated families on a shared haplotype, suggesting a founder effect. No LAMA1 variants could be detected in 27 probands with different cerebellar dysplasias or non-progressive cerebellar ataxia, confirming the strong correlate between LAMA1 variants and PBS.
Collapse
Affiliation(s)
- Alessia Micalizzi
- CSS-Mendel Institute, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.,Department of Biological and Environmental Sciences, University of Messina, Messina, Italy
| | - Andrea Poretti
- Department of Pediatric Neurology, University Children's Hospital, Zurich, Switzerland.,Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marta Romani
- CSS-Mendel Institute, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Monia Ginevrino
- CSS-Mendel Institute, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Tommaso Mazza
- CSS-Mendel Institute, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Chiara Aiello
- Laboratory of Molecular Medicine, Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ginevra Zanni
- Laboratory of Molecular Medicine, Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Renato Borgatti
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | - Knut Brockmann
- Interdisciplinary Pediatric Center for Children with Developmental Disabilities and Severe Chronic Disorders, Department of Pediatrics and Adolescent Medicine, University of Goettingen, Goettingen, Germany
| | - Ana Camacho
- Section of Pediatric Neurology, Hospital Universitario 12 de Octubre, Department of Medicine, Universidad Complutense, Madrid, Spain
| | - Gaetano Cantalupo
- Child Neuropsychiatry, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Martin Haeusler
- Department of Pediatrics, Division of Neuropediatrics and Social Pediatrics, University Hospital, RWTH Aachen, Aachen, Germany
| | - Christiane Hikel
- Social Pediatic Centrum (SPZ), St Vinzenz Hospital, Dinslaken, Germany
| | - Andrea Klein
- Department of Pediatric Neurology, University Children's Hospital, Zurich, Switzerland
| | - Giorgia Mandrile
- SCDU Medical Genetics, Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Dietz Rating
- Pediatrics, St Marien and St Anna Hospital, Ludwigshafen, Germany
| | - Romina Romaniello
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | | | - Mareike Schimmel
- Division of Pediatric Neurology, Children's Hospital, Klinikum Augsburg, Augsburg, Germany
| | - Luigina Spaccini
- Clinical Genetic Unit, Department of Women, Mother and Neonates, 'Vittore Buzzi' Children Hospital, Istituti Clinici di Perfezionamento, Milan, Italy
| | - Serap Teber
- Department of Pediatric Neurology, Ankara Pediatrics, Hematology-Oncology Training and Research Hospital, Ankara, Turkey
| | - Arpad von Moers
- Department of Pediatrics, DRK Kliniken Berlin Westend, Berlin, Germany
| | - Sarah Wente
- Interdisciplinary Pediatric Center for Children with Developmental Disabilities and Severe Chronic Disorders, Department of Pediatrics and Adolescent Medicine, University of Goettingen, Goettingen, Germany
| | - Andreas Ziegler
- Division of Pediatric Neurology, University Children's Hospital Heidelberg, Germany
| | - Andrea Zonta
- SCDU Medical Genetics, Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Enrico Bertini
- Laboratory of Molecular Medicine, Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Eugen Boltshauser
- Department of Pediatric Neurology, University Children's Hospital, Zurich, Switzerland
| | - Enza Maria Valente
- CSS-Mendel Institute, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.,Section of Neurosciences, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| |
Collapse
|
6
|
Abstract
The purpose of this article is to analyze the advantages and limitations of prenatal ultrasonography (US) and magnetic resonance imaging (MRI) in the evaluation of the fetal brain. These imaging modalities should not be seen as competitive but rather as complementary. There are wide variations in the world regarding screening policies, technology, skills, and legislation about termination of pregnancy, and these variations markedly impact on the way of using prenatal imaging. According to the contribution expected from each technique and to local working conditions, one should choose the most appropriate imaging modality on a case-by-case basis. The advantages and limitations of US and MRI in the setting of fetal brain imaging are displayed. Different anatomical regions (midline, ventricles, subependymal area, cerebral parenchyma, pericerebral space, posterior fossa) and pathological conditions are analyzed and illustrated in order to compare the respective contribution of each technique. An accurate prenatal diagnosis of cerebral abnormalities is of utmost importance for prenatal counseling.
Collapse
Affiliation(s)
- Eléonore Blondiaux
- Department of Radiology, Hôpital d'Enfants
Armand-Trousseau, Paris, France
| | - Catherine Garel
- Department of Radiology, Hôpital d'Enfants
Armand-Trousseau, Paris, France
| |
Collapse
|
9
|
Jimenez-Mallebrera C, Torelli S, Feng L, Kim J, Godfrey C, Clement E, Mein R, Abbs S, Brown SC, Campbell KP, Kröger S, Talim B, Topaloglu H, Quinlivan R, Roper H, Childs AM, Kinali M, Sewry CA, Muntoni F. A comparative study of alpha-dystroglycan glycosylation in dystroglycanopathies suggests that the hypoglycosylation of alpha-dystroglycan does not consistently correlate with clinical severity. Brain Pathol 2008; 19:596-611. [PMID: 18691338 PMCID: PMC2860390 DOI: 10.1111/j.1750-3639.2008.00198.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Hypoglycosylation of alpha-dystroglycan underpins a subgroup of muscular dystrophies ranging from congenital onset of weakness, severe brain malformations and death in the perinatal period to mild weakness in adulthood without brain involvement. Mutations in six genes have been identified in a proportion of patients. POMT1, POMT2 and POMGnT1 encode for glycosyltransferases involved in the mannosylation of alpha-dystroglycan but the function of fukutin, FKRP and LARGE is less clear. The pathological hallmark is reduced immunolabeling of skeletal muscle with antibodies recognizing glycosylated epitopes on alpha-dystroglycan. If the common pathway of these conditions is the hypoglycosyation of alpha-dystroglycan, one would expect a correlation between clinical severity and the extent of hypoglycosylation. By studying 24 patients with mutations in these genes, we found a good correlation between reduced alpha-dystroglycan staining and clinical course in patients with mutations in POMT1, POMT2 and POMGnT1. However, this was not always the case in patients with defects in fukutin and FKRP, as we identified patients with mild limb-girdle phenotypes without brain involvement with profound depletion of alpha-dystroglycan. These data indicate that it is not always possible to correlate clinical course and alpha-dystroglycan labeling and suggest that there might be differences in alpha-dystroglycan processing in these disorders.
Collapse
Affiliation(s)
- Cecilia Jimenez-Mallebrera
- Dubowitz Neuromuscular Centre, Institute of Child Health and Great Ormond Street Hospital for Children, UCL, London, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Lehle L, Strahl S, Tanner W. Protein Glycosylation, Conserved from Yeast to Man: A Model Organism Helps Elucidate Congenital Human Diseases. Angew Chem Int Ed Engl 2006; 45:6802-18. [PMID: 17024709 DOI: 10.1002/anie.200601645] [Citation(s) in RCA: 207] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Proteins can be modified by a large variety of covalently linked saccharides. The present review concentrates on two types, protein N-glycosylation and protein O-mannosylation, which, with only a few exceptions, are evolutionary conserved from yeast to man. They are also distinguished by some special features: The corresponding glycosylation processes start in the endoplasmatic reticulum, are continued in the Golgi apparatus, and require dolichol-activated precursors for the initial biosynthetic steps. With respect to the molecular biology of both types of protein glycosylation, the pathways and the genetic background of the reactions have most successfully been studied with the genetically easy-to-handle baker's yeast, Saccharomyces cerevisae. Many of the severe developmental disturbances in children are related to protein glycosylation, for example, the CDG syndrome (congenital disorders of glycosylation) as well as congenital muscular dystrophies with neuronal-cell-migration defects have been elucidated with the help of yeast.
Collapse
Affiliation(s)
- Ludwig Lehle
- Lehrstuhl für Zellbiologie und Pflanzenphysiologie, Universität Regensburg, Universitätstrasse 31, 93053 Regensburg, Germany.
| | | | | |
Collapse
|
13
|
Squier W, Cowan FM. The value of autopsy in determining the cause of failure to respond to resuscitation at birth. ACTA ACUST UNITED AC 2004; 9:331-45. [PMID: 15251149 DOI: 10.1016/j.siny.2004.01.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Autopsy is invaluable in identifying the causes of severe depression and very low Apgar score after birth and in assessing contributory conditions. Brain scans are increasingly used in the care of neonates who fail to respond to resuscitation at birth but their interpretation depends on the information gained from sound neuropathological studies. Asphyxia, both acute intrapartum asphyxia and chronic asphyxia, is an important cause of low Apgar scores. The gestational age and the nature of the asphyxial insult both have a profound influence on the ultimate pattern of injury. Asphyxia in the preterm brain tends to damage preferentially the white matter but some white matter damage is also seen in many infants who have an hypoxia-ischaemic insult at term though the predominant site of injury is to the central grey matter. The nature of the cellular damage and reactive change seen at autopsy is described. There is an association between low Apgar scores and intrauterine exposure to infection and maternal pyrexia. Detailed autopsy examination should include the search for infection. The placenta, cord and membranes should be examined in view of the mounting evidence of the association between intrauterine infection of the placenta and fetal membranes and prenatal brain damage. Additionally, the presence of placental thrombosis and infarction should be sought in relation to focal and global injury in the full term infant. Acquired prepartum lesions rarely cause the infant to present with a low Apgar score. The exception to this is severe damage to the brainstem and basal ganglia. Traumatic injury to the brain is now much less common than in previous decades. Subdural haemorrhage occurs more frequently than intraventricular or subarachnoid haemorrhage. Instrumental and assisted deliveries are associated with an increased incidence of subdural haemorrhage though these rarely cause significant long term damage. Careful autopsy, particularly of the neck and paravertebral tissues, spinal cord, brainstem and nerve roots is important where trauma is suspected. Tearing of nerve roots or fibre bundles in the spinal cord is readily demonstrated under the microscope using immunocytochemistry to beta-amyloid precursor protein. Disorders of the spinal cord, peripheral nerve and muscle as well as some metabolic diseases may cause a baby to be both floppy and weak. Metabolic disease, including peroxisomal disorders, non-ketotic hyperglycinaemia, lipid and glycogen storage disorders and mitochondrial diseases may cause profound hypotonia and respiratory failure at birth or shortly afterwards.
Collapse
MESH Headings
- Apgar Score
- Asphyxia Neonatorum/diagnosis
- Asphyxia Neonatorum/mortality
- Asphyxia Neonatorum/pathology
- Autopsy
- Birth Injuries/diagnosis
- Birth Injuries/mortality
- Birth Injuries/pathology
- Brain/abnormalities
- Brain/pathology
- Brain Diseases/diagnosis
- Brain Diseases/mortality
- Brain Diseases/pathology
- Cause of Death
- Cerebral Hemorrhage/diagnosis
- Cerebral Hemorrhage/mortality
- Cerebral Hemorrhage/pathology
- Humans
- Hypoxia-Ischemia, Brain/diagnosis
- Hypoxia-Ischemia, Brain/mortality
- Hypoxia-Ischemia, Brain/pathology
- Infant, Newborn
- Infant, Newborn, Diseases/diagnosis
- Infant, Newborn, Diseases/mortality
- Infant, Newborn, Diseases/pathology
- Infections/diagnosis
- Infections/mortality
- Infections/pathology
- Magnetic Resonance Imaging
- Metabolism, Inborn Errors/diagnosis
- Metabolism, Inborn Errors/mortality
- Metabolism, Inborn Errors/pathology
- Neuromuscular Diseases/congenital
- Neuromuscular Diseases/diagnosis
- Neuromuscular Diseases/mortality
- Neuromuscular Diseases/pathology
- Resuscitation
- Treatment Failure
Collapse
Affiliation(s)
- Waney Squier
- Department of Neuropathology, Radcliffe Infirmary, Oxford OX2 6HE, UK.
| | | |
Collapse
|