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Faghihpirayesh R, Karimi D, Erdoğmuş D, Gholipour A. Fetal-BET: Brain Extraction Tool for Fetal MRI. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2024; 5:551-562. [PMID: 39157057 PMCID: PMC11329220 DOI: 10.1109/ojemb.2024.3426969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/09/2024] [Accepted: 07/07/2024] [Indexed: 08/20/2024] Open
Abstract
Goal: In this study, we address the critical challenge of fetal brain extraction from MRI sequences. Fetal MRI has played a crucial role in prenatal neurodevelopmental studies and in advancing our knowledge of fetal brain development in-utero. Fetal brain extraction is a necessary first step in most computational fetal brain MRI pipelines. However, it poses significant challenges due to 1) non-standard fetal head positioning, 2) fetal movements during examination, and 3) vastly heterogeneous appearance of the developing fetal brain and the neighboring fetal and maternal anatomy across gestation, and with various sequences and scanning conditions. Development of a machine learning method to effectively address this task requires a large and rich labeled dataset that has not been previously available. Currently, there is no method for accurate fetal brain extraction on various fetal MRI sequences. Methods: In this work, we first built a large annotated dataset of approximately 72,000 2D fetal brain MRI images. Our dataset covers the three common MRI sequences including T2-weighted, diffusion-weighted, and functional MRI acquired with different scanners. These data include images of normal and pathological brains. Using this dataset, we developed and validated deep learning methods, by exploiting the power of the U-Net style architectures, the attention mechanism, feature learning across multiple MRI modalities, and data augmentation for fast, accurate, and generalizable automatic fetal brain extraction. Results: Evaluations on independent test data, including data available from other centers, show that our method achieves accurate brain extraction on heterogeneous test data acquired with different scanners, on pathological brains, and at various gestational stages. Conclusions:By leveraging rich information from diverse multi-modality fetal MRI data, our proposed deep learning solution enables precise delineation of the fetal brain on various fetal MRI sequences. The robustness of our deep learning model underscores its potential utility for fetal brain imaging.
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Affiliation(s)
- Razieh Faghihpirayesh
- Electrical and Computer Engineering DepartmentNortheastern UniversityBostonMA02115USA
- Radiology DepartmentBoston Children's Hospital, and Harvard Medical SchoolBostonMA02115USA
| | - Davood Karimi
- Radiology DepartmentBoston Children's Hospital, and Harvard Medical SchoolBostonMA02115USA
| | - Deniz Erdoğmuş
- Electrical and Computer Engineering DepartmentNortheastern UniversityBostonMA02115USA
| | - Ali Gholipour
- Radiology DepartmentBoston Children's Hospital, and Harvard Medical SchoolBostonMA02115USA
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Proshchina A, Kharlamova A, Krivova Y, Godovalova O, Otlyga D, Gulimova V, Otlyga E, Junemann O, Sonin G, Saveliev S. Neuromorphological Atlas of Human Prenatal Brain Development: White Paper. Life (Basel) 2023; 13:life13051182. [PMID: 37240827 DOI: 10.3390/life13051182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/06/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Recent morphological data on human brain development are quite fragmentary. However, they are highly requested for a number of medical practices, educational programs, and fundamental research in the fields of embryology, cytology and histology, neurology, physiology, path anatomy, neonatology, and others. This paper provides the initial information on the new online Human Prenatal Brain Development Atlas (HBDA). The Atlas will start with forebrain annotated hemisphere maps, based on human fetal brain serial sections at the different stages of prenatal ontogenesis. Spatiotemporal changes in the regional-specific immunophenotype profiles will also be demonstrated on virtual serial sections. The HBDA can serve as a reference database for the neurological research, which provides opportunity to compare the data obtained by noninvasive techniques, such as neurosonography, X-ray computed tomography and magnetic resonance imaging, functional magnetic resonance imaging, 3D high-resolution phase-contrast computed tomography visualization techniques, as well as spatial transcriptomics data. It could also become a database for the qualitative and quantitative analysis of individual variability in the human brain. Systemized data on the mechanisms and pathways of prenatal human glio- and neurogenesis could also contribute to the search for new therapy methods for a large spectrum of neurological pathologies, including neurodegenerative and cancer diseases. The preliminary data are now accessible on the special HBDA website.
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Affiliation(s)
- Alexandra Proshchina
- Avtsyn Research Institute of Human Morphology of Federal State Budgetary Scientific Institution "Petrovsky National Research Centre of Surgery", Tsurupi Street, 3, 117418 Moscow, Russia
| | - Anastasia Kharlamova
- Avtsyn Research Institute of Human Morphology of Federal State Budgetary Scientific Institution "Petrovsky National Research Centre of Surgery", Tsurupi Street, 3, 117418 Moscow, Russia
| | - Yuliya Krivova
- Avtsyn Research Institute of Human Morphology of Federal State Budgetary Scientific Institution "Petrovsky National Research Centre of Surgery", Tsurupi Street, 3, 117418 Moscow, Russia
| | - Olga Godovalova
- Avtsyn Research Institute of Human Morphology of Federal State Budgetary Scientific Institution "Petrovsky National Research Centre of Surgery", Tsurupi Street, 3, 117418 Moscow, Russia
| | - Dmitriy Otlyga
- Avtsyn Research Institute of Human Morphology of Federal State Budgetary Scientific Institution "Petrovsky National Research Centre of Surgery", Tsurupi Street, 3, 117418 Moscow, Russia
| | - Victoria Gulimova
- Avtsyn Research Institute of Human Morphology of Federal State Budgetary Scientific Institution "Petrovsky National Research Centre of Surgery", Tsurupi Street, 3, 117418 Moscow, Russia
| | - Ekaterina Otlyga
- Avtsyn Research Institute of Human Morphology of Federal State Budgetary Scientific Institution "Petrovsky National Research Centre of Surgery", Tsurupi Street, 3, 117418 Moscow, Russia
| | - Olga Junemann
- Avtsyn Research Institute of Human Morphology of Federal State Budgetary Scientific Institution "Petrovsky National Research Centre of Surgery", Tsurupi Street, 3, 117418 Moscow, Russia
| | - Gleb Sonin
- Avtsyn Research Institute of Human Morphology of Federal State Budgetary Scientific Institution "Petrovsky National Research Centre of Surgery", Tsurupi Street, 3, 117418 Moscow, Russia
| | - Sergey Saveliev
- Avtsyn Research Institute of Human Morphology of Federal State Budgetary Scientific Institution "Petrovsky National Research Centre of Surgery", Tsurupi Street, 3, 117418 Moscow, Russia
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Uus AU, Kyriakopoulou V, Makropoulos A, Fukami-Gartner A, Cromb D, Davidson A, Cordero-Grande L, Price AN, Grigorescu I, Williams LZJ, Robinson EC, Lloyd D, Pushparajah K, Story L, Hutter J, Counsell SJ, Edwards AD, Rutherford MA, Hajnal JV, Deprez M. BOUNTI: Brain vOlumetry and aUtomated parcellatioN for 3D feTal MRI. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.18.537347. [PMID: 37131820 PMCID: PMC10153133 DOI: 10.1101/2023.04.18.537347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Fetal MRI is widely used for quantitative brain volumetry studies. However, currently, there is a lack of universally accepted protocols for fetal brain parcellation and segmentation. Published clinical studies tend to use different segmentation approaches that also reportedly require significant amounts of time-consuming manual refinement. In this work, we propose to address this challenge by developing a new robust deep learning-based fetal brain segmentation pipeline for 3D T2w motion corrected brain images. At first, we defined a new refined brain tissue parcellation protocol with 19 regions-of-interest using the new fetal brain MRI atlas from the Developing Human Connectome Project. This protocol design was based on evidence from histological brain atlases, clear visibility of the structures in individual subject 3D T2w images and the clinical relevance to quantitative studies. It was then used as a basis for developing an automated deep learning brain tissue parcellation pipeline trained on 360 fetal MRI datasets with different acquisition parameters using semi-supervised approach with manually refined labels propagated from the atlas. The pipeline demonstrated robust performance for different acquisition protocols and GA ranges. Analysis of tissue volumetry for 390 normal participants (21-38 weeks gestational age range), scanned with three different acquisition protocols, did not reveal significant differences for major structures in the growth charts. Only minor errors were present in < 15% of cases thus significantly reducing the need for manual refinement. In addition, quantitative comparison between 65 fetuses with ventriculomegaly and 60 normal control cases were in agreement with the findings reported in our earlier work based on manual segmentations. These preliminary results support the feasibility of the proposed atlas-based deep learning approach for large-scale volumetric analysis. The created fetal brain volumetry centiles and a docker with the proposed pipeline are publicly available online at https://hub.docker.com/r/fetalsvrtk/segmentation (tag brain_bounti_tissue).
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Affiliation(s)
- Alena U Uus
- School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | | | | | | | - Daniel Cromb
- Centre for the Developing Brain, King's College London, London, UK
| | - Alice Davidson
- Centre for the Developing Brain, King's College London, London, UK
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, King's College London, London, UK
- Biomedical Image Technologies, ETSI Telecomunicacion, Universidad Politécnica de Madrid and CIBER-BBN, ISCII, Madrid, Spain
| | - Anthony N Price
- Centre for the Developing Brain, King's College London, London, UK
| | - Irina Grigorescu
- School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Logan Z J Williams
- School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Emma C Robinson
- School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - David Lloyd
- School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
- Department of Congenital Heart Disease, Evelina London Children's Hospital, London, UK
| | - Kuberan Pushparajah
- School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
- Department of Congenital Heart Disease, Evelina London Children's Hospital, London, UK
| | - Lisa Story
- Centre for the Developing Brain, King's College London, London, UK
| | - Jana Hutter
- School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | | | - A David Edwards
- Centre for the Developing Brain, King's College London, London, UK
| | | | - Joseph V Hajnal
- School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
- Centre for the Developing Brain, King's College London, London, UK
| | - Maria Deprez
- School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
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Wang J, Nichols ES, Mueller ME, de Vrijer B, Eagleson R, McKenzie CA, de Ribaupierre S, Duerden EG. Semi-automatic segmentation of the fetal brain from magnetic resonance imaging. Front Neurosci 2022; 16:1027084. [PMID: 36440277 PMCID: PMC9692018 DOI: 10.3389/fnins.2022.1027084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/19/2022] [Indexed: 11/13/2023] Open
Abstract
BACKGROUND Volumetric measurements of fetal brain maturation in the third trimester of pregnancy are key predictors of developmental outcomes. Improved understanding of fetal brain development trajectories may aid in identifying and clinically managing at-risk fetuses. Currently, fetal brain structures in magnetic resonance images (MRI) are often manually segmented, which requires both time and expertise. To facilitate the targeting and measurement of brain structures in the fetus, we compared the results of five segmentation methods applied to fetal brain MRI data to gold-standard manual tracings. METHODS Adult women with singleton pregnancies (n = 21), of whom five were scanned twice, approximately 3 weeks apart, were recruited [26 total datasets, median gestational age (GA) = 34.8, IQR = 30.9-36.6]. T2-weighted single-shot fast spin echo images of the fetal brain were acquired on 1.5T and 3T MRI scanners. Images were first combined into a single 3D anatomical volume. Next, a trained tracer manually segmented the thalamus, cerebellum, and total cerebral volumes. The manual segmentations were compared with five automatic methods of segmentation available within Advanced Normalization Tools (ANTs) and FMRIB's Linear Image Registration Tool (FLIRT) toolboxes. The manual and automatic labels were compared using Dice similarity coefficients (DSCs). The DSC values were compared using Friedman's test for repeated measures. RESULTS Comparing cerebellum and thalamus masks against the manually segmented masks, the median DSC values for ANTs and FLIRT were 0.72 [interquartile range (IQR) = 0.6-0.8] and 0.54 (IQR = 0.4-0.6), respectively. A Friedman's test indicated that the ANTs registration methods, primarily nonlinear methods, performed better than FLIRT (p < 0.001). CONCLUSION Deformable registration methods provided the most accurate results relative to manual segmentation. Overall, this semi-automatic subcortical segmentation method provides reliable performance to segment subcortical volumes in fetal MR images. This method reduces the costs of manual segmentation, facilitating the measurement of typical and atypical fetal brain development.
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Affiliation(s)
- Jianan Wang
- Biomedical Engineering, Western University, London, ON, Canada
| | - Emily S. Nichols
- Applied Psychology, Faculty of Education, Western University, London, ON, Canada
- Western Institute for Neuroscience, Western University, London, ON, Canada
| | - Megan E. Mueller
- Applied Psychology, Faculty of Education, Western University, London, ON, Canada
| | - Barbra de Vrijer
- Department of Obstetrics and Gynaecology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Roy Eagleson
- Biomedical Engineering, Western University, London, ON, Canada
- Western Institute for Neuroscience, Western University, London, ON, Canada
- Department of Electrical and Computer Engineering, Western University, London, ON, Canada
| | - Charles A. McKenzie
- Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Sandrine de Ribaupierre
- Biomedical Engineering, Western University, London, ON, Canada
- Western Institute for Neuroscience, Western University, London, ON, Canada
- Department of Clinical Neurological Sciences, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Emma G. Duerden
- Biomedical Engineering, Western University, London, ON, Canada
- Applied Psychology, Faculty of Education, Western University, London, ON, Canada
- Western Institute for Neuroscience, Western University, London, ON, Canada
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Uus AU, Egloff Collado A, Roberts TA, Hajnal JV, Rutherford MA, Deprez M. Retrospective motion correction in foetal MRI for clinical applications: existing methods, applications and integration into clinical practice. Br J Radiol 2022:20220071. [PMID: 35834425 DOI: 10.1259/bjr.20220071] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Foetal MRI is a complementary imaging method to antenatal ultrasound. It provides advanced information for detection and characterisation of foetal brain and body anomalies. Even though modern single shot sequences allow fast acquisition of 2D slices with high in-plane image quality, foetal MRI is intrinsically corrupted by motion. Foetal motion leads to loss of structural continuity and corrupted 3D volumetric information in stacks of slices. Furthermore, the arbitrary and constantly changing position of the foetus requires dynamic readjustment of acquisition planes during scanning.
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Affiliation(s)
- Alena U Uus
- Department of Biomedical Engineering, School Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, London, United Kingdom
| | - Alexia Egloff Collado
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, London, United Kingdom
| | - Thomas A Roberts
- Department of Biomedical Engineering, School Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, London, United Kingdom.,Clinical Scientific Computing, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Joseph V Hajnal
- Department of Biomedical Engineering, School Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, London, United Kingdom.,Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, London, United Kingdom
| | - Mary A Rutherford
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, London, United Kingdom
| | - Maria Deprez
- Department of Biomedical Engineering, School Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, London, United Kingdom
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6
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Autoencoding Low-Resolution MRI for Semantically Smooth Interpolation of Anisotropic MRI. Med Image Anal 2022; 78:102393. [DOI: 10.1016/j.media.2022.102393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 11/20/2022]
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Early magnetic resonance imaging biomarkers of schizophrenia spectrum disorders: Toward a fetal imaging perspective. Dev Psychopathol 2021; 33:899-913. [PMID: 32489161 DOI: 10.1017/s0954579420000218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
There is mounting evidence to implicate the intrauterine environment as the initial pathogenic stage for neuropsychiatric disease. Recent developments in magnetic resonance imaging technology are making a multimodal analysis of the fetal central nervous system a reality, allowing analysis of structural and functional parameters. Exposures to a range of pertinent risk factors whether preconception or in utero can now be indexed using imaging techniques within the fetus' physiological environment. This approach may determine the first "hit" required for diseases that do not become clinically manifest until adulthood, and which only have subtle clinical markers during childhood and adolescence. A robust characterization of a "multi-hit" hypothesis may necessitate a longitudinal birth cohort; within this investigative paradigm, the full range of genetic and environmental risk factors can be assessed for their impact on the early developing brain. This will lay the foundation for the identification of novel biomarkers and the ability to devise methods for early risk stratification and disease prevention. However, these early markers must be followed over time: first, to account for neural plasticity, and second, to assess the effects of postnatal exposures that continue to drive the individual toward disease. We explore these issues using the schizophrenia spectrum disorders as an illustrative paradigm. However, given the potential richness of fetal magnetic resonance imaging, and the likely overlap of biomarkers, these concepts may extend to a range of neuropsychiatric conditions.
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8
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Tavares de Sousa M, Hecher K, Kording F, Yamamura J, Lenz A, Adam G, Bannas P, Schoennagel BP. Fetal dynamic magnetic resonance imaging using Doppler ultrasound gating for the assessment of the aortic isthmus: A feasibility study. Acta Obstet Gynecol Scand 2020; 100:67-73. [PMID: 32649773 DOI: 10.1111/aogs.13957] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Cardiovascular magnetic resonance imaging (MRI) is established in cardiac evaluation in postnatal life, but its application to the fetus has been hampered by technical limitations. We aimed to investigate the feasibility of dynamic MRI of the fetal aortic isthmus using a magnetic resonance-compatible Doppler ultrasound device for cardiac gating. MATERIAL AND METHODS This prospective study included 19 fetuses at a median gestational age of 32.3 weeks (range 26-38 weeks). Imaging of the fetal aortic isthmus was assessed by (a) dynamic steady-state free precession MRI using a magnetic resonance-compatible Doppler ultrasound device for cardiac gating and (b) echocardiography. Diameters of the aortic isthmus were compared by two blinded observers. Magnetic resonance image quality was assessed independently by two observers using a four-point scale (1 = low quality, 4 = high quality). Furthermore, we performed four-dimensional flow MRI of the fetal aorta in three of these fetuses. RESULTS The Doppler ultrasound device for cardiac gating allowed successful dynamic MRI examinations of the aortic isthmus in 18/19 (95%) fetuses. Evaluation of the fetal aortic isthmus was possible by both MRI (15/18, 83%) and echocardiography (16/18, 89%) (P < .05). Diameters of the aortic isthmus were concordant for MRI (3.8 ± 0.9 mm) and echocardiography (4.0 ± 1.1 mm), with a variability of 10.8% (bias -2.3%, 95% limits of agreement -23.9% to 19.3%). Overall magnetic resonance image quality was good (score 4 in 67% and score 3 in 23%) with good inter-observer agreement (κ = 0.75; 95% CI 0.5-1). Fetal four-dimensional flow MRI allowed visualization of aortic flow dynamics. CONCLUSIONS Doppler ultrasound-gating allows dynamic MRI of the fetal aorta with the potential to serve as a complementary imaging tool in cases where echocardiography is inconclusive.
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Affiliation(s)
- Manuela Tavares de Sousa
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kurt Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fabian Kording
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jin Yamamura
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Lenz
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Bannas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bjoern P Schoennagel
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Pishghadam M, Kazemi K, Nekooei S, Seilanian-Toosi F, Hoseini-Ghahfarokhi M, Zabizadeh M, Fatemi A. A new approach to automatic fetal brain extraction from MRI using a variational level set method. Med Phys 2019; 46:4983-4991. [PMID: 31419312 DOI: 10.1002/mp.13766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND AND PURPOSE Appropriate images extracted from the MRI of mothers' wombs can be of great help in the medical diagnosis of fetal abnormalities. As maternal tissue may appear in such images, affecting visualization of myelination of the fetal brain, it is not possible to use methods routinely used for extraction of adult brains for fetal brains. The aim of the present study was to use a variational level set approach to extract fetal brain from T2-weighted MR images of the womb. METHODS Coronal T2-weighted images were acquired using fast MRI protocols (to avoid artifacts). The database includes 105 MR images from eight subjects. After correcting the inhomogeneity of the images, the fetal eyes were located, and from that information, the location of the fetus brain was automatically determined. Then, the variational level set was used for fetus brain extraction. The results were analyzed by a clinical specialist (radiologist) and the similarity (Dice and Jaccard coefficients), sensitivity and specificity were calculated. RESULTS AND CONCLUSIONS The means of the statistical analysis for the Dice and Jaccard coefficients, sensitivity and specificity, were 99.56%, 96.89%, 95.71%, and 97.96%, respectively. Thus, extraction of fetal brain from MR images was confirmed, both statistically and visually through cross-validation.
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Affiliation(s)
- Morteza Pishghadam
- Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Kamran Kazemi
- Department of Electrical and Electronics Engineering, Shiraz University of Technology, Shiraz, Iran
| | - Sirous Nekooei
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farrokh Seilanian-Toosi
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Hoseini-Ghahfarokhi
- Department of Medical Physics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mansour Zabizadeh
- Department of Radiology and Nuclear Medicine, School of Para Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Fatemi
- Department of Radiation Oncology and Radiology, University of Mississippi Medical Center (UMMC), Jackson, MS, USA
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10
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Spinelli M, Wiest R, Di Meglio L, Baumann M, Raio L, Surbek D. The "vermian-crest angle": does it allow accurate categorisation of fetal upward rotation of cerebellar vermis on intrauterine MRI? A pilot study. Clin Radiol 2019; 74:489.e1-489.e7. [PMID: 30954236 DOI: 10.1016/j.crad.2019.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 02/21/2019] [Indexed: 12/23/2022]
Abstract
AIM To test a new parameter to assess the position of the fetal cerebellar vermis in the posterior fossa (PF) using intrauterine magnetic resonance imaging (MRI). MATERIALS AND METHODS The angle between the cerebellar vermis and the internal occipital crest (vermian-crest angle, VCA) was assessed retrospectively using MRI in fetuses with and without PF anomalies. Spearman's rank test was used to investigate correlation of the VCA with gestational age (GA). Groups were compared using Student's t-test and the one-way analysis of variance (ANOVA) with the Bonferroni adjustment. Box-and-whisker plots were also used. RESULTS One hundred and two normal cases were identified. Mean±SD GA at MRI was 26.5±2.8 weeks (range: 22-32 weeks). The VCA was 64.49±11.5° independently of GA (r=0.19; p=0.12). In addition, 30 fetuses at 19-28 weeks were identified with Blake's pouch cyst (BPC; n=5), Dandy-Walker malformation (DWM; n=12), mega cisterna magna (MCM; n=10), and vermian hypoplasia (VH; n=3). The VCA was significantly different in the DWM (p<0.001) and BPC (p<0.001) subgroups, but was not significantly different in cases of VH (p=0.84) and MCM (p=0.95) in comparison with controls. CONCLUSIONS A new method to assess vermian position within the PF using intrauterine MRI was assessed. In combination with the other existing parameters, it may be helpful for addressing the categorisation of upward rotation of the fetal cerebellar vermis; however, further studies are necessary to strengthen the present findings.
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Affiliation(s)
- M Spinelli
- Department of Clinical Research, University of Bern, Bern, Switzerland.
| | - R Wiest
- Department of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland
| | - L Di Meglio
- Private Centre "Diagnostica ecografica Aniello Di Meglio srl", Naples, Italy
| | - M Baumann
- Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland
| | - L Raio
- Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland
| | - D Surbek
- Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland
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11
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da Silva NA, Vassallo J, Sarian LO, Cognard C, Sevely A. Magnetic resonance imaging of the fetal brain at 3 Tesla: Preliminary experience from a single series. Medicine (Baltimore) 2018; 97:e12602. [PMID: 30290631 PMCID: PMC6200506 DOI: 10.1097/md.0000000000012602] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 09/02/2018] [Indexed: 11/30/2022] Open
Abstract
To report our preliminary experience with cerebral fetal magnetic resonance imaging (MRI) with a 3 Tesla (3T) scanner. We assessed feasibility, time of acquisition, and possibility to establish a diagnosis.Fifty-nine pregnant women had fetal MRI performed during the third trimester of pregnancy due to clinical or sonography concern of a central nervous system anomaly. No fetal or maternal sedation was used. The MRI protocol consisted of T2 turbo-spin-echo images in 3 planes of space. No T1-weighted images were performed. All images were analyzed by 2 pediatric neuroradiologists, who evaluated spatial resolution, artifacts, time of acquisition, and possibility to establish a diagnosis suspected by sonography.Examinations were performed safely for all patients. The images required longer time of acquisition (approximately 75 seconds for each plane in the space). The specific absorption rate was not exceeded in any fetus. Cerebral fetal MRI was normal in 22 cases. The spectrum of diagnostics included isolated ventriculomegaly, posterior fossa malformation, corpus callosum malformation, gyration anomalies, craniosynostosis, tuberous sclerosis, microcephaly, external hydrocephaly, midline arachnoid cyst, cerebral lesions, and persistent hyperplastic primitive vitreous.In our series, 3 T MRI of fetal brain was feasible and able to establish a diagnosis but required longer time of acquisition.
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Affiliation(s)
- Nivaldo Adolfo da Silva
- Department of Radiology, Faculty of Medical Sciences, State University of Campinas, Campinas (UNICAMP), Campinas-SP, Brazil
- Department of Diagnostic and Therapeutic Neuroradiology, Centre Hospitalier Universitaire (CHU) - Hôpital Pierre Paul Riquet, University of Toulouse, Toulouse, France
- Department of Neuroradiology, Diagnósticos da América (DASA Group), São Paulo
| | - José Vassallo
- Laboratory of Molecular and Investigative Pathology-LAPE, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP, Brazil
| | - Luis Otávio Sarian
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP, Brazil
| | - Christophe Cognard
- Department of Diagnostic and Therapeutic Neuroradiology, Centre Hospitalier Universitaire (CHU) - Hôpital Pierre Paul Riquet, University of Toulouse, Toulouse, France
| | - Annick Sevely
- Department of Diagnostic and Therapeutic Neuroradiology, Centre Hospitalier Universitaire (CHU) - Hôpital Pierre Paul Riquet, University of Toulouse, Toulouse, France
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12
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Hayat TTA, Rutherford MA. Neuroimaging perspectives on fetal motor behavior. Neurosci Biobehav Rev 2018; 92:390-401. [PMID: 29886176 DOI: 10.1016/j.neubiorev.2018.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/22/2018] [Accepted: 06/01/2018] [Indexed: 12/19/2022]
Abstract
We are entering a new era of understanding human development with the ability to perform studies at the earliest time points possible. There is a substantial body of evidence to support the concept that early motor behaviour originates from supraspinal motor centres, reflects neurological integrity, and that altered patterns of behaviour precede clinical manifestation of disease. Cine Magnetic Resonance Imaging (cineMRI) has established its value as a novel method to visualise motor behaviour in the human fetus, building on the wealth of knowledge gleaned from ultrasound based studies. This paper presents a state of the art review incorporating findings from human and preclinical models, the insights from which, we propose, can proceed a reconceptualisation of fetal motor behaviour using advanced imaging techniques. Foremost is the need to better understand the role of the intrauterine environment, and its inherent unique set of stimuli that activate sensorimotor pathways and shape early brain development. Finally, an improved model of early motor development, combined with multimodal imaging, will provide a novel source of in utero biomarkers predictive of neurodevelopmental disorders.
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Affiliation(s)
- Tayyib T A Hayat
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
| | - Mary A Rutherford
- Centre for the Developing Brain, Perinatal Imaging & Health, Imaging Sciences & Biomedical Engineering Division, King's College London, London, United Kingdom
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13
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Single-Shot Version of FLAIR Sequence in the Detection of Intraventricular Anomalies: Preliminary Experience in Fetal MR Imaging. J Comput Assist Tomogr 2018; 42:487-491. [PMID: 29287023 DOI: 10.1097/rct.0000000000000701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate single-shot (ss) FLAIR sequence in the detection of intraventricular anomalies in a series of fetuses showing mild-moderate ventriculomegaly at ultrasound. SUBJECTS AND METHODS Fetuses with mild-moderate isolated ventriculomegaly, which underwent MR imaging between 2003 and 2014 were considered eligible. Fetuses were examined by standard MR protocol and ss-FLAIR sequence, tailored for snapshot imaging. Two paediatric neuroradiologists evaluated MR images. RESULTS 542 cases were selected. MR imaging was performed at mean 26 weeks of gestation. ss-FLAIR sequence detected intraventricular findings, consistent with cysts in 10 cases. In 3/10 intraventricular cysts were also evident on ss-FSE T2 and FSE T1-weighted images. In no case diffusion weighted imaging was able to detect cyst. No cyst was highlighted on ss-FSE-T2 and FSE-T1-weighted images, without being visible also on ss-FLAIR. CONCLUSION ss-FLAIR sequence may be useful to detect intraventricular anomalies especially when fetal position or maternal obesity prevents adequate visualization by ultrasound.
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14
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Yadav BK, Krishnamurthy U, Buch S, Jella P, Hernandez-Andrade E, Yeo L, Korzeniewski SJ, Trifan A, Hassan SS, Haacke EM, Romero R, Neelavalli J. Imaging putative foetal cerebral blood oxygenation using susceptibility weighted imaging (SWI). Eur Radiol 2018; 28:1884-1890. [PMID: 29247352 PMCID: PMC5884705 DOI: 10.1007/s00330-017-5160-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/03/2017] [Accepted: 10/27/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the magnetic susceptibility, ∆χ v , as a surrogate marker of venous blood oxygen saturation, S v O 2, in second- and third-trimester normal human foetuses. METHODS Thirty-six pregnant women, having a mean gestational age (GA) of 31 2/7 weeks, underwent magnetic resonance imaging (MRI). Susceptibility-weighted imaging (SWI) data from the foetal brain were acquired. ∆χ v of the superior sagittal sinus (SSS) was quantified using MR susceptometry from the intra-vascular phase measurements. Assuming the magnetic property of foetal blood, ∆χ do , is the same as that of adult blood, S v O 2 was derived from the measured Δχ v . The variation of ∆χ v and S v O 2, as a function of GA, was statistically evaluated. RESULTS The mean ∆χ v in the SSS in the second-trimester (n = 8) and third-trimester foetuses (n = 28) was found to be 0.34± 0.06 ppm and 0.49 ±0.05 ppm, respectively. Correspondingly, the derived S v O 2 values were 69.4% ±3.27% and 62.6% ±3.25%. Although not statistically significant, an increasing trend (p = 0.08) in Δχ v and a decreasing trend (p = 0.22) in S v O 2 with respect to advancing gestation was observed. CONCLUSION We report cerebral venous blood magnetic susceptibility and putative oxygen saturation in healthy human foetuses. Cerebral oxygen saturation in healthy human foetuses, despite a slight decreasing trend, does not change significantly with advancing gestation. KEY POINTS • Cerebral venous magnetic susceptibility and oxygenation in human foetuses can be quantified. • Cerebral venous oxygenation was not different between second- and third-trimester foetuses. • Foetal cerebral venous oxygenation does not change significantly with advancing gestation.
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Affiliation(s)
- Brijesh Kumar Yadav
- Department of Radiology, Wayne State University School of Medicine, 4201 St. Antoine, Detroit, MI, 48201, USA
- Department of Biomedical Engineering, Wayne State University College of Engineering, Detroit, MI, USA
| | - Uday Krishnamurthy
- Department of Radiology, Wayne State University School of Medicine, 4201 St. Antoine, Detroit, MI, 48201, USA
- Department of Biomedical Engineering, Wayne State University College of Engineering, Detroit, MI, USA
| | - Sagar Buch
- The MRI Institute for Biomedical Research, Waterloo, ON, Canada
| | - Pavan Jella
- Department of Radiology, Wayne State University School of Medicine, 4201 St. Antoine, Detroit, MI, 48201, USA
| | - Edgar Hernandez-Andrade
- Perinatology Research Branch, NICHD/NIH/DHHS, Hutzel Women's Hospital, 3990 John R, 4 Brush, Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Lami Yeo
- Perinatology Research Branch, NICHD/NIH/DHHS, Hutzel Women's Hospital, 3990 John R, 4 Brush, Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Steven J Korzeniewski
- Perinatology Research Branch, NICHD/NIH/DHHS, Hutzel Women's Hospital, 3990 John R, 4 Brush, Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Anabela Trifan
- Department of Radiology, Wayne State University School of Medicine, 4201 St. Antoine, Detroit, MI, 48201, USA
| | - Sonia S Hassan
- Perinatology Research Branch, NICHD/NIH/DHHS, Hutzel Women's Hospital, 3990 John R, 4 Brush, Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - E Mark Haacke
- Department of Radiology, Wayne State University School of Medicine, 4201 St. Antoine, Detroit, MI, 48201, USA
- Department of Biomedical Engineering, Wayne State University College of Engineering, Detroit, MI, USA
- The MRI Institute for Biomedical Research, Waterloo, ON, Canada
| | - Roberto Romero
- Perinatology Research Branch, NICHD/NIH/DHHS, Hutzel Women's Hospital, 3990 John R, 4 Brush, Detroit, MI, 48201, USA.
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA.
| | - Jaladhar Neelavalli
- Department of Radiology, Wayne State University School of Medicine, 4201 St. Antoine, Detroit, MI, 48201, USA.
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15
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Batalle D, Edwards AD, O'Muircheartaigh J. Annual Research Review: Not just a small adult brain: understanding later neurodevelopment through imaging the neonatal brain. J Child Psychol Psychiatry 2018; 59:350-371. [PMID: 29105061 PMCID: PMC5900873 DOI: 10.1111/jcpp.12838] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND There has been a recent proliferation in neuroimaging research focusing on brain development in the prenatal, neonatal and very early childhood brain. Early brain injury and preterm birth are associated with increased risk of neurodevelopmental disorders, indicating the importance of this early period for later outcome. SCOPE AND METHODOLOGY Although using a wide range of different methodologies and investigating diverse samples, the common aim of many of these studies has been to both track normative development and investigate deviations in this development to predict behavioural, cognitive and neurological function in childhood. Here we review structural and functional neuroimaging studies investigating the developing brain. We focus on practical and technical complexities of studying this early age range and discuss how neuroimaging techniques have been successfully applied to investigate later neurodevelopmental outcome. CONCLUSIONS Neuroimaging markers of later outcome still have surprisingly low predictive power and their specificity to individual neurodevelopmental disorders is still under question. However, the field is still young, and substantial challenges to both acquiring and modeling neonatal data are being met.
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Affiliation(s)
- Dafnis Batalle
- Centre for the Developing BrainSchool of Imaging Sciences & Biomedical EngineeringKing's College LondonLondonUK
| | - A. David Edwards
- Centre for the Developing BrainSchool of Imaging Sciences & Biomedical EngineeringKing's College LondonLondonUK
| | - Jonathan O'Muircheartaigh
- Centre for the Developing BrainSchool of Imaging Sciences & Biomedical EngineeringKing's College LondonLondonUK
- Department of NeuroimagingInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
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16
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Kording F, Schoennagel BP, de Sousa MT, Fehrs K, Adam G, Yamamura J, Ruprecht C. Evaluation of a Portable Doppler Ultrasound Gating Device for Fetal Cardiac MR Imaging: Initial Results at 1.5T and 3T. Magn Reson Med Sci 2018; 17:308-317. [PMID: 29467359 PMCID: PMC6196307 DOI: 10.2463/mrms.mp.2017-0100] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose: Fetal cardiac MRI has the potential to play an important role in the assessment of fetal cardiac pathologies, but it is up to now not feasible due to a missing gating method. The purpose of this work was the evaluation of Doppler ultrasound (DUS) for external fetal cardiac gating with regard to compatibility, functionality, and reliability. Preliminary results were assessed performing fetal cardiac MRI. Methods: An MRI conditional DUS device was developed to obtain a gating signal from the fetal heart. The MRI compatibility was evaluated at 1.5T and 3T using B1 field maps and gradient echo images. The quality and sensitivity of the DUS device to detect the fetal heart motion for cardiac gating were evaluated outside the MRI room in 15 fetuses. A dynamic fetal cardiac phantom was employed to evaluate distortions of the DUS device and gating signal due to electromagnetic interferences at 1.5T and 3T. In the first in vivo experience, dynamic fetal cardiac images were acquired in four-chamber view at 1.5T and 3T in two fetuses. Results: The maximum change in the B1 field and signal intensity with and without the DUS device was <6.5% for 1.5T and 3T. The sensitivity of the DUS device to detect the fetal heartbeat was 99.1%. Validation of the DUS device using the fetal cardiac phantom revealed no electromagnetic interferences at 1.5T or 3T and a high correlation to the simulated heart frequencies. Fetal cardiac cine images were successfully applied and showed good image quality. Conclusion: An MR conditional DUS gating device was developed and evaluated revealing safety, compatibility, and reliability for different field strengths. In a preliminary experience, the DUS device was successfully applied for in vivo fetal cardiac imaging at 1.5T and 3T.
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Affiliation(s)
- Fabian Kording
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf.,northh medical GmbH
| | - Bjoern P Schoennagel
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf
| | | | - Kai Fehrs
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf.,northh medical GmbH
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf
| | - Jin Yamamura
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf
| | - Christian Ruprecht
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf.,northh medical GmbH
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17
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Benkarim OM, Sanroma G, Zimmer VA, Muñoz-Moreno E, Hahner N, Eixarch E, Camara O, González Ballester MA, Piella G. Toward the automatic quantification of in utero brain development in 3D structural MRI: A review. Hum Brain Mapp 2017; 38:2772-2787. [PMID: 28195417 DOI: 10.1002/hbm.23536] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 01/13/2017] [Accepted: 01/25/2017] [Indexed: 11/08/2022] Open
Abstract
Investigating the human brain in utero is important for researchers and clinicians seeking to understand early neurodevelopmental processes. With the advent of fast magnetic resonance imaging (MRI) techniques and the development of motion correction algorithms to obtain high-quality 3D images of the fetal brain, it is now possible to gain more insight into the ongoing maturational processes in the brain. In this article, we present a review of the major building blocks of the pipeline toward performing quantitative analysis of in vivo MRI of the developing brain and its potential applications in clinical settings. The review focuses on T1- and T2-weighted modalities, and covers state of the art methodologies involved in each step of the pipeline, in particular, 3D volume reconstruction, spatio-temporal modeling of the developing brain, segmentation, quantification techniques, and clinical applications. Hum Brain Mapp 38:2772-2787, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
| | | | | | - Emma Muñoz-Moreno
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, Spain.,Experimental 7T MRI Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Nadine Hahner
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, Spain
| | - Elisenda Eixarch
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, Spain
| | - Oscar Camara
- DTIC, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Gemma Piella
- DTIC, Universitat Pompeu Fabra, Barcelona, Spain
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18
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Lloyd DFA, van Amerom JFP, Pushparajah K, Simpson JM, Zidere V, Miller O, Sharland G, Allsop J, Fox M, Lohezic M, Murgasova M, Malamateniou C, Hajnal JV, Rutherford M, Razavi R. An exploration of the potential utility of fetal cardiovascular MRI as an adjunct to fetal echocardiography. Prenat Diagn 2016; 36:916-925. [PMID: 27521762 PMCID: PMC5082528 DOI: 10.1002/pd.4912] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 08/01/2016] [Accepted: 08/09/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Fetal cardiovascular magnetic resonance imaging (MRI) offers a potential alternative to echocardiography, although in practice, its use has been limited. We sought to explore the need for additional imaging in a tertiary fetal cardiology unit and the usefulness of standard MRI sequences. METHODS Cases where the diagnosis was not fully resolved using echocardiography were referred for MRI. Following a three-plane localiser, fetal movement was assessed with a balanced steady-state free precession (bSSFP) cine. Single-shot fast spin echo and bSSFP sequences were used for diagnostic imaging. RESULTS Twenty-two fetal cardiac MRIs were performed over 12 months, at mean gestation of 32 weeks (26-38 weeks). The majority of referrals were for suspected vascular abnormalities (17/22), particularly involving the aortic arch (n = 10) and pulmonary vessels (n = 4). Single-shot fast spin echo sequences produced 'black-blood' images, useful for examining the extracardiac vasculature in these cases. BSSFP sequences were more useful for intracardiac structures. Real-time SSFP allowed for dynamic assessment of structures such as cardiac masses, with enhancement patterns also allowing for tissue characterisation in these cases. CONCLUSIONS Fetal vascular abnormalities such as coarctation can be difficult to diagnose by using ultrasound. Fetal MRI may have an adjunctive role in the evaluation of the extracardiac vascular anatomy and tissue characterisation. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.
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Affiliation(s)
- David F A Lloyd
- Evelina Children's Hospital, London, UK. .,Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
| | - Joshua F P van Amerom
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Kuberan Pushparajah
- Evelina Children's Hospital, London, UK.,Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | | | | | | | | | - Joanna Allsop
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Matthew Fox
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Maelene Lohezic
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Maria Murgasova
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Christina Malamateniou
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Jo V Hajnal
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Mary Rutherford
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Reza Razavi
- Evelina Children's Hospital, London, UK.,Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
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19
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Abstract
Numerous events are involved in brain development, some of which are detected by neuroimaging. Major changes in brain morphology are depicted by brain imaging during the fetal period while changes in brain composition can be demonstrated in both pre- and postnatal periods. Although ultrasonography and computed tomography can show changes in brain morphology, these techniques are insensitive to myelination that is one of the most important events occurring during brain maturation. Magnetic resonance imaging (MRI) is therefore the method of choice to evaluate brain maturation. MRI also gives insight into the microstructure of brain tissue through diffusion-weighted imaging and diffusion tensor imaging. Metabolic changes are also part of brain maturation and are assessed by proton magnetic resonance spectroscopy. Understanding and knowledge of the different steps in brain development are required to be able to detect morphologic and structural changes on neuroimaging. Consequently alterations in normal development can be depicted.
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Affiliation(s)
- Nadine Girard
- Neuroradiology Service, Hôpital la Timone, Marseille, France; Aix Marseille Université, Marseille, France.
| | - Meriam Koob
- Pediatric Radiology Imaging Service, Centre Hospitalier Universitaire de Strasbourg, Hôpital de Hautepierre and Laboratoire ICube, Université de Strasbourg-CNRS, Strasbourg, France
| | - Herv Brunel
- Neuroradiology Service, Hôpital la Timone, Marseille, France
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20
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Kainz B, Steinberger M, Wein W, Kuklisova-Murgasova M, Malamateniou C, Keraudren K, Torsney-Weir T, Rutherford M, Aljabar P, Hajnal JV, Rueckert D. Fast Volume Reconstruction From Motion Corrupted Stacks of 2D Slices. IEEE TRANSACTIONS ON MEDICAL IMAGING 2015; 34:1901-13. [PMID: 25807565 PMCID: PMC7115883 DOI: 10.1109/tmi.2015.2415453] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Capturing an enclosing volume of moving subjects and organs using fast individual image slice acquisition has shown promise in dealing with motion artefacts. Motion between slice acquisitions results in spatial inconsistencies that can be resolved by slice-to-volume reconstruction (SVR) methods to provide high quality 3D image data. Existing algorithms are, however, typically very slow, specialised to specific applications and rely on approximations, which impedes their potential clinical use. In this paper, we present a fast multi-GPU accelerated framework for slice-to-volume reconstruction. It is based on optimised 2D/3D registration, super-resolution with automatic outlier rejection and an additional (optional) intensity bias correction. We introduce a novel and fully automatic procedure for selecting the image stack with least motion to serve as an initial registration target. We evaluate the proposed method using artificial motion corrupted phantom data as well as clinical data, including tracked freehand ultrasound of the liver and fetal Magnetic Resonance Imaging. We achieve speed-up factors greater than 30 compared to a single CPU system and greater than 10 compared to currently available state-of-the-art multi-core CPU methods. We ensure high reconstruction accuracy by exact computation of the point-spread function for every input data point, which has not previously been possible due to computational limitations. Our framework and its implementation is scalable for available computational infrastructures and tests show a speed-up factor of 1.70 for each additional GPU. This paves the way for the online application of image based reconstruction methods during clinical examinations. The source code for the proposed approach is publicly available.
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Affiliation(s)
| | - Markus Steinberger
- Institute for Computer Graphics and Vision at Graz University of Technology, Inffeldgasse 16, 8010 Graz, Austria
| | - Wolfgang Wein
- ImFusion GmbH and the Chair for Computer Aided Medical Procedures & Augmented Reality at TU Munich, Agnes-Pockels-Bogen 1, 80992 Munich, Germany
| | - Maria Kuklisova-Murgasova
- Department of Perinatal Imaging and Health within the Division of Imaging Sciences and Biomedical Engineering at King's College London, Strand, London WC2R 2LS, UK
| | - Christina Malamateniou
- Department of Perinatal Imaging and Health within the Division of Imaging Sciences and Biomedical Engineering at King's College London, Strand, London WC2R 2LS, UK
| | - Kevin Keraudren
- Department of Computing, Imperial College London, 180 Queen's Gate, London SW7 2AZ, UK
| | - Thomas Torsney-Weir
- Visualization and Data Analysis group within the Faculty of Computer Science at the University of Vienna, Waehringer Strae 29, 1090 Vienna, Austria
| | - Mary Rutherford
- Department of Perinatal Imaging and Health within the Division of Imaging Sciences and Biomedical Engineering at King's College London, Strand, London WC2R 2LS, UK
| | - Paul Aljabar
- Department of Perinatal Imaging and Health within the Division of Imaging Sciences and Biomedical Engineering at King's College London, Strand, London WC2R 2LS, UK
| | - Joseph V. Hajnal
- Department of Perinatal Imaging and Health within the Division of Imaging Sciences and Biomedical Engineering at King's College London, Strand, London WC2R 2LS, UK
| | - Daniel Rueckert
- Department of Computing, Imperial College London, 180 Queen's Gate, London SW7 2AZ, UK
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21
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Story L, Rutherford M. Advances and applications in fetal magnetic resonance imaging. ACTA ACUST UNITED AC 2015. [DOI: 10.1111/tog.12203] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Lisa Story
- London Deanery; Darent Valley Hospital; Darenth Wood Road Dartford Kent DA2 8DA UK
| | - Mary Rutherford
- King's College London; Perinatal Imaging Unit; St Thomas's Hospital; Westminster Bridge Road London SE1 7EH UK
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22
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Verburg B, Fink AM, Reidy K, Palma-Dias R. The Contribution of MRI after Fetal Anomalies Have Been Diagnosed by Ultrasound: Correlation with Postnatal Outcomes. Fetal Diagn Ther 2015; 38:186-94. [DOI: 10.1159/000380821] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 02/09/2015] [Indexed: 11/19/2022]
Abstract
Objective: The aim of this study was to investigate the additional value of fetal magnetic resonance imaging (MRI) in the assessment and management of fetuses with abnormal findings on ultrasound. Methods: A total of 257 patients who had fetal MRI following the ultrasound diagnosis of a fetal anomaly, or were at high risk, were included. The patients were grouped by referral category for fetal MRI. Fetal MRI was compared to ultrasound in the detection of anomalies, i.e. whether additional findings were identified and if this changed diagnosis, prognosis and management during pregnancy. Results: Ultrasound findings were confirmed on fetal MRI in 89% of the cases. Additional findings were seen with MRI in 28% of all patients. The diagnosis changed in 21% and the prognosis in 19% of the cases. Perinatal management changed in 8%. The antenatal findings were confirmed in all cases that had a postmortem examination following termination of pregnancy. In all the pregnancies that continued to delivery and for which the postnatal outcome is known, the findings correlated in 97% of the cases. Conclusion: Fetal MRI provided additional detection of fetal anomalies, leading to a change in diagnosis and prognosis in 19% of the cases. Neonatal and postmortem findings mostly confirmed the fetal MRI diagnosis, suggesting it to be a useful tool for clinical decision making in perinatal management.
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23
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Abstract
Advances in methodology have led to expanded application of resting-state functional MRI (rs-fMRI) to the study of term and prematurely born infants during the first years of life, providing fresh insight into the earliest forms of functional cerebral development. In this review, we detail our evolving understanding of the use of rs-fMRI for studying neonates. We initially focus on the biological processes of cortical development related to resting-state network development. We then review technical issues principally affecting neonatal investigations, including the effects of subject motion during acquisition and image distortions related to magnetic susceptibility effects. We next summarize the literature in which rs-fMRI is used to study normal brain development during the early postnatal period, the effects of prematurity, and the effects of cerebral injury. Finally, we review potential future directions for the field, such as the use of complementary imaging modalities and advanced analysis techniques.
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Affiliation(s)
- Christopher D. Smyser
- Division of Pediatric Neurology, Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Jeffrey J. Neil
- Department of Neurology, Boston Children’s Hospital, Boston, MA,Corresponding author. Jeff Neil, MD, PhD, Neurology, Boston Children's Hospital, 333 Longwood Avenue, LO 450, Boston, MA 02115, phone (617) 355-6388, fax (617) 730-0284,
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24
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Automated fetal brain segmentation from 2D MRI slices for motion correction. Neuroimage 2014; 101:633-43. [PMID: 25058899 DOI: 10.1016/j.neuroimage.2014.07.023] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 06/05/2014] [Accepted: 07/15/2014] [Indexed: 01/18/2023] Open
Abstract
Motion correction is a key element for imaging the fetal brain in-utero using Magnetic Resonance Imaging (MRI). Maternal breathing can introduce motion, but a larger effect is frequently due to fetal movement within the womb. Consequently, imaging is frequently performed slice-by-slice using single shot techniques, which are then combined into volumetric images using slice-to-volume reconstruction methods (SVR). For successful SVR, a key preprocessing step is to isolate fetal brain tissues from maternal anatomy before correcting for the motion of the fetal head. This has hitherto been a manual or semi-automatic procedure. We propose an automatic method to localize and segment the brain of the fetus when the image data is acquired as stacks of 2D slices with anatomy misaligned due to fetal motion. We combine this segmentation process with a robust motion correction method, enabling the segmentation to be refined as the reconstruction proceeds. The fetal brain localization process uses Maximally Stable Extremal Regions (MSER), which are classified using a Bag-of-Words model with Scale-Invariant Feature Transform (SIFT) features. The segmentation process is a patch-based propagation of the MSER regions selected during detection, combined with a Conditional Random Field (CRF). The gestational age (GA) is used to incorporate prior knowledge about the size and volume of the fetal brain into the detection and segmentation process. The method was tested in a ten-fold cross-validation experiment on 66 datasets of healthy fetuses whose GA ranged from 22 to 39 weeks. In 85% of the tested cases, our proposed method produced a motion corrected volume of a relevant quality for clinical diagnosis, thus removing the need for manually delineating the contours of the brain before motion correction. Our method automatically generated as a side-product a segmentation of the reconstructed fetal brain with a mean Dice score of 93%, which can be used for further processing.
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Multidimensional analysis of fetal posterior fossa in health and disease. THE CEREBELLUM 2014; 12:632-44. [PMID: 23553467 DOI: 10.1007/s12311-013-0470-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Fetal magnetic resonance imaging (MRI) is now routinely used to further investigate cerebellar malformations detected with ultrasound. However, the lack of 2D and 3D biometrics in the current literature hinders the detailed characterisation and classification of cerebellar anomalies. The main objectives of this fetal neuroimaging study were to provide normal posterior fossa growth trajectories during the second and third trimesters of pregnancy via semi-automatic segmentation of reconstructed fetal brain MR images and to assess common cerebellar malformations in comparison with the reference data. Using a 1.5-T MRI scanner, 143 MR images were obtained from 79 normal control and 53 fetuses with posterior fossa abnormalities that were grouped according to the severity of diagnosis on visual MRI inspections. All quantifications were performed on volumetric datasets, and supplemental outcome information was collected from the surviving infants. Normal growth trajectories of total brain, cerebellar, vermis, pons and fourth ventricle volumes showed significant correlations with 2D measurements and increased in second-order polynomial trends across gestation (Pearson r, p < 0.05). Comparison of normal controls to five abnormal cerebellum subgroups depicted significant alterations in volumes that could not be detected exclusively with 2D analysis (MANCOVA, p < 0.05). There were 15 terminations of pregnancy, 8 neonatal deaths, and a spectrum of genetic and neurodevelopmental outcomes in the assessed 24 children with cerebellar abnormalities. The given posterior fossa biometrics enhance the delineation of normal and abnormal cerebellar phenotypes on fetal MRI and confirm the advantages of utilizing advanced neuroimaging tools in clinical fetal research.
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Jovanov Milošević N, Judaš M, Aronica E, Kostovic I. Neural ECM in laminar organization and connectivity development in healthy and diseased human brain. PROGRESS IN BRAIN RESEARCH 2014; 214:159-78. [DOI: 10.1016/b978-0-444-63486-3.00007-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Abstract
Magnetic resonance imaging has become an important noninvasive technique to gain insight into fetal brain development. Its capabilities go beyond ultrasound when diagnosing high-risk pregnancies. To summarize observations across a population in magnetic resonance imaging studies, reference systems such as atlases that establish correspondences across a cohort are key. In this article, we review the evolution of atlas-building methods in light of their relevance, limitations, and benefits for the modeling of human brain development. Starting with single anatomical templates to which brain scans where mapped to such as Talairach and Montreal Neurological Institute space, we explore the uses of atlases as a means to establish correspondences across a cohort and as a model that captures the population characteristics of the cases the atlas is built from. We discuss methods that capture features of increasingly heterogeneous populations and approaches that are able to generalize with only minimal annotation. The main focus of this review are methods that explicitly model the variability in the population with regard to time, such as in the modeling of disease progression and brain development. We highlight the applicability and limitations of state-of-the art approaches, how insights from the study of disease progression are helpful in developmental studies, and point to the directions of future research that is still necessary.
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Zhan J, Dinov ID, Li J, Zhang Z, Hobel S, Shi Y, Lin X, Zamanyan A, Feng L, Teng G, Fang F, Tang Y, Zang F, Toga AW, Liu S. Spatial-temporal atlas of human fetal brain development during the early second trimester. Neuroimage 2013; 82:115-26. [PMID: 23727529 DOI: 10.1016/j.neuroimage.2013.05.063] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 05/15/2013] [Accepted: 05/16/2013] [Indexed: 01/29/2023] Open
Abstract
During the second trimester, the human fetal brain undergoes numerous changes that lead to substantial variation in the neonatal in terms of its morphology and tissue types. As fetal MRI is more and more widely used for studying the human brain development during this period, a spatiotemporal atlas becomes necessary for characterizing the dynamic structural changes. In this study, 34 postmortem human fetal brains with gestational ages ranging from 15 to 22 weeks were scanned using 7.0 T MR. We used automated morphometrics, tensor-based morphometry and surface modeling techniques to analyze the data. Spatiotemporal atlases of each week and the overall atlas covering the whole period with high resolution and contrast were created. These atlases were used for the analysis of age-specific shape changes during this period, including development of the cerebral wall, lateral ventricles, Sylvian fissure, and growth direction based on local surface measurements. Our findings indicate that growth of the subplate zone is especially striking and is the main cause for the lamination pattern changes. Changes in the cortex around Sylvian fissure demonstrate that cortical growth may be one of the mechanisms for gyration. Surface deformation mapping, revealed by local shape analysis, indicates that there is global anterior-posterior growth pattern, with frontal and temporal lobes developing relatively quickly during this period. Our results are valuable for understanding the normal brain development trajectories and anatomical characteristics. These week-by-week fetal brain atlases can be used as reference in in vivo studies, and may facilitate the quantification of fetal brain development across space and time.
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Affiliation(s)
- Jinfeng Zhan
- Research Center for Sectional and Imaging Anatomy, Shandong University School of Medicine, 44 Wen-hua Xi Road, 250012 Jinan, Shandong, China
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Vossough A, Limperopoulos C, Putt ME, du Plessis AJ, Schwab PJ, Wu J, Gee JC, Licht DJ. Development and validation of a semiquantitative brain maturation score on fetal MR images: initial results. Radiology 2013; 268:200-7. [PMID: 23440324 DOI: 10.1148/radiol.13111715] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To develop a valid, reliable, and simple-to-use semiquantitative visual scale of fetal brain maturation for use in clinical fetal MR imaging assessment and interpretation. MATERIALS AND METHODS This is a retrospective assessment of data from a previous study that was prospective, institutional review board approved, and HIPAA compliant. Forty-eight normal pregnancies with a gestational age (GA) of 25 to 35 weeks were studied. A fetal total maturation score (fTMS) was developed by utilizing six subscores that evaluated cortical sulcation, myelination, and the germinal matrix and provided a single combined numerical value to be evaluated as a marker of brain maturity. The fTMS was correlated with GA and segmented brain volume. A regression model that associated GA based on the visual fTMS scoring was determined. The model was validated with a leave-one-out cross validation procedure. RESULTS Mean GA was 29.3 weeks ± 2.9 (standard deviation) (range, 25.2-35.3 weeks) and mean fTMS was 8.6 ± 3.7 (range, 4-16). The intraclass correlation coefficient between the three readers (independent and blinded) was 0.948 (P < .001). The correlations were as follows: GA and brain volume, r = 0.964 (P < .001); fTMS and brain volume, r = 0.970 (P < .001); and GA and fTMS, r = 0.975 (P < .001). A regression model to calculate GA based on fTMS yielded the following equation: calculated GA (weeks) = 22.86 + 0.748 fTMS (P < .001; adjusted R(2) = 0.946). The standard error of the model for calculation of fetal GA from the visual fTMS scale was ± 4.8 days. CONCLUSION If validated further, the fTMS scale might be used to assess morphologic brain maturity of fetuses between 25 and 35 weeks GA on a single-case basis in a clinical setting.
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Affiliation(s)
- Arastoo Vossough
- Department of Radiology, Children's Hospital of Philadelphia, 324 S 34th St, Wood 2115, Philadelphia, PA 19004, USA.
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Girard NJ, Chaumoitre K. The brain in the belly: what and how of fetal neuroimaging? J Magn Reson Imaging 2013; 36:788-804. [PMID: 22987757 DOI: 10.1002/jmri.23596] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
This work reviews magnetic resonance imaging in the developing human brain. It focuses on fetal brain imaged in vivo and in utero with complementary sections on abnormalities seen in clinical settings, and on potential of diffusion tensor imaging and of proton magnetic resonance spectroscopy. The main purposes are to illustrate the normal fetal developing brain and its abnormalities commonly encountered in utero, and to emphasize the potential role of adjunct techniques such as diffusion imaging and spectroscopy that may help elucidate fetal brain maturation and its abnormalities.
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Affiliation(s)
- Nadine J Girard
- Department of Neuroradiology, Hopital Timone, Marseille, France.
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31
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Girard NJ, Dory-Lautrec P, Koob M, Dediu AM. MRI assessment of neonatal brain maturation. ACTA ACUST UNITED AC 2012. [DOI: 10.2217/iim.12.59] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Reconstruction of fetal brain MRI with intensity matching and complete outlier removal. Med Image Anal 2012; 16:1550-64. [PMID: 22939612 PMCID: PMC4067058 DOI: 10.1016/j.media.2012.07.004] [Citation(s) in RCA: 224] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 05/30/2012] [Accepted: 07/21/2012] [Indexed: 02/06/2023]
Abstract
We propose a method for the reconstruction of volumetric fetal MRI from 2D slices, comprising super-resolution reconstruction of the volume interleaved with slice-to-volume registration to correct for the motion. The method incorporates novel intensity matching of acquired 2D slices and robust statistics which completely excludes identified misregistered or corrupted voxels and slices. The reconstruction method is applied to motion-corrupted data simulated from MRI of a preterm neonate, as well as 10 clinically acquired thick-slice fetal MRI scans and three scan-sequence optimized thin-slice fetal datasets. The proposed method produced high quality reconstruction results from all the datasets to which it was applied. Quantitative analysis performed on simulated and clinical data shows that both intensity matching and robust statistics result in statistically significant improvement of super-resolution reconstruction. The proposed novel EM-based robust statistics also improves the reconstruction when compared to previously proposed Huber robust statistics. The best results are obtained when thin-slice data and the correct approximation of the point spread function is used. This paper addresses the need for a comprehensive reconstruction algorithm of 3D fetal MRI, so far lacking in the scientific literature.
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Malamateniou C, Malik SJ, Counsell SJ, Allsop JM, McGuinness AK, Hayat T, Broadhouse K, Nunes RG, Ederies AM, Hajnal JV, Rutherford MA. Motion-compensation techniques in neonatal and fetal MR imaging. AJNR Am J Neuroradiol 2012; 34:1124-36. [PMID: 22576885 DOI: 10.3174/ajnr.a3128] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARY Fetal and neonatal MR imaging is increasingly used as a complementary diagnostic tool to sonography. MR imaging is an ideal technique for imaging fetuses and neonates because of the absence of ionizing radiation, the superior contrast of soft tissues compared with sonography, the availability of different contrast options, and the increased FOV. Motion in the normally mobile fetus and the unsettled, sleeping, or sedated neonate during a long acquisition will decrease image quality in the form of motion artifacts, hamper image interpretation, and often necessitate a repeat MR imaging to establish a diagnosis. This article reviews current techniques of motion compensation in fetal and neonatal MR imaging, including the following: 1) motion-prevention strategies (such as adequate patient preparation, patient coaching, and sedation, when required), 2) motion-artifacts minimization methods (such as fast imaging protocols, data undersampling, and motion-resistant sequences), and 3) motion-detection/correction schemes (such as navigators and self-navigated sequences, external motion-tracking devices, and postprocessing approaches) and their application in fetal and neonatal brain MR imaging. Additionally some background on the repertoire of motion of the fetal and neonatal patient and the resulting artifacts will be presented, as well as insights into future developments and emerging techniques of motion compensation.
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Affiliation(s)
- C Malamateniou
- Robert Steiner MRI Unit, Imaging Sciences Department, Hammersmith Hospital Campus, Imperial College London, London, United Kingdom.
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Gholipour A, Akhondi-Asl A, Estroff JA, Warfield SK. Multi-atlas multi-shape segmentation of fetal brain MRI for volumetric and morphometric analysis of ventriculomegaly. Neuroimage 2012; 60:1819-31. [PMID: 22500924 PMCID: PMC3329183 DOI: 10.1016/j.neuroimage.2012.01.128] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Revised: 01/05/2012] [Accepted: 01/29/2012] [Indexed: 11/18/2022] Open
Abstract
The recent development of motion robust super-resolution fetal brain MRI holds out the potential for dramatic new advances in volumetric and morphometric analysis. Volumetric analysis based on volumetric and morphometric biomarkers of the developing fetal brain must include segmentation. Automatic segmentation of fetal brain MRI is challenging, however, due to the highly variable size and shape of the developing brain; possible structural abnormalities; and the relatively poor resolution of fetal MRI scans. To overcome these limitations, we present a novel, constrained, multi-atlas, multi-shape automatic segmentation method that specifically addresses the challenge of segmenting multiple structures with similar intensity values in subjects with strong anatomic variability. Accordingly, we have applied this method to shape segmentation of normal, dilated, or fused lateral ventricles for quantitative analysis of ventriculomegaly (VM), which is a pivotal finding in the earliest stages of fetal brain development, and warrants further investigation. Utilizing these innovative techniques, we introduce novel volumetric and morphometric biomarkers of VM comparing these values to those that are generated by standard methods of VM analysis, i.e., by measuring the ventricular atrial diameter (AD) on manually selected sections of 2D ultrasound or 2D MRI. To this end, we studied 25 normal and abnormal fetuses in the gestation age (GA) range of 19 to 39 weeks (mean=28.26, stdev=6.56). This heterogeneous dataset was essentially used to 1) validate our segmentation method for normal and abnormal ventricles; and 2) show that the proposed biomarkers may provide improved detection of VM as compared to the AD measurement.
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Affiliation(s)
- Ali Gholipour
- Computational Radiology Laboratory, Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
| | - Alireza Akhondi-Asl
- Computational Radiology Laboratory, Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
| | - Judy A. Estroff
- Advanced Fetal Care Center, Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
| | - Simon K. Warfield
- Computational Radiology Laboratory, Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
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Lin X, Zhang Z, Teng G, Meng H, Yu T, Hou Z, Fang F, Zang F, Liu S. Measurements using 7.0 T post-mortem magnetic resonance imaging of the scalar dimensions of the fetal brain between 12 and 20 weeks gestational age. Int J Dev Neurosci 2011; 29:885-9. [PMID: 21820045 DOI: 10.1016/j.ijdevneu.2011.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2011] [Revised: 07/13/2011] [Accepted: 07/14/2011] [Indexed: 11/25/2022] Open
Abstract
In this study, scalar values for the fetal brain from 12 to 20 weeks gestational age were obtained. Fifty-two fetal specimens of 12-20 weeks gestational age with an anatomically normal and developmentally appropriate central nervous system (CNS) were scanned using a 7.0 T magnetic resonance imaging (MRI) scanner. The linear biometric measurements of the brain were then determined. All the measurements (except for the interhemispheric distance) were found to increase linearly with gestational age, although each increased at a different growth rates. The 95% confidence interval for each value was obtained. These data may be considered to be a valuable reference for the assessment of normal fetal brain development in clinical settings and as a supplement to post-mortem MRI or anatomical investigations.
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Affiliation(s)
- Xiangtao Lin
- Research Center for Sectional and Imaging Anatomy, Shandong University School of Medicine, 250012 Jinan, Shandong, China
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Smyser CD, Snyder AZ, Neil JJ. Functional connectivity MRI in infants: exploration of the functional organization of the developing brain. Neuroimage 2011; 56:1437-52. [PMID: 21376813 PMCID: PMC3089442 DOI: 10.1016/j.neuroimage.2011.02.073] [Citation(s) in RCA: 147] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 01/22/2011] [Accepted: 02/27/2011] [Indexed: 12/15/2022] Open
Abstract
Advanced neuroimaging techniques have been increasingly applied to the study of preterm and term infants in an effort to further define the functional cerebral architecture of the developing brain. Despite improved understanding of the complex relationship between structure and function obtained through these investigations, significant questions remain regarding the nature, location, and timing of the maturational changes which occur during early development. Functional connectivity magnetic resonance imaging (fcMRI) utilizes spontaneous, low frequency (< 0.1 Hz), coherent fluctuations in blood oxygen level dependent (BOLD) signal to identify networks of functional cerebral connections. Due to the intrinsic characteristics of its image acquisition and analysis, fcMRI offers a novel neuroimaging approach well suited to investigation of infants. Recently, this methodology has been successfully applied to examine neonatal populations, defining normative patterns of large-scale neural network development in the maturing brain. The resting-state networks (RSNs) identified in these studies reflect the evolving cerebral structural architecture, presumably driven by varied genetic and environmental influences. Principal features of these investigations and their role in characterization of the tenets of neural network development during this critical developmental period are highlighted in this review. Despite these successes, optimal methods for fcMRI data acquisition and analysis for this population have not yet been defined. Further, appropriate schemes for interpretation and translation of fcMRI results remain unknown, a matter of increasing importance as functional neuroimaging findings are progressively applied in the clinical arena. Notwithstanding these concerns, fcMRI provides insight into the earliest forms of cerebral connectivity and therefore holds great promise for future neurodevelopmental investigations.
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Affiliation(s)
- Christopher D Smyser
- Department of Neurology, Washington University, Saint Louis, MO 63110-1093, USA.
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37
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Habas PA, Scott JA, Roosta A, Rajagopalan V, Kim K, Rousseau F, Barkovich AJ, Glenn OA, Studholme C. Early folding patterns and asymmetries of the normal human brain detected from in utero MRI. Cereb Cortex 2011; 22:13-25. [PMID: 21571694 DOI: 10.1093/cercor/bhr053] [Citation(s) in RCA: 158] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Early cortical folding and the emergence of structural brain asymmetries have been previously analyzed by neuropathology as well as qualitative analysis of magnetic resonance imaging (MRI) of fetuses and preterm neonates. In this study, we present a dedicated image analysis framework and its application for the detection of folding patterns during the critical period for the formation of many primary sulci (20-28 gestational weeks). Using structural information from in utero MRI, we perform morphometric analysis of cortical plate surface development and modeling of early folding in the normal fetal brain. First, we identify regions of the fetal brain surface that undergo significant folding changes during this developmental period and provide precise temporal staging of these changes for each region of interest. Then, we highlight the emergence of interhemispheric structural asymmetries that may be related to future functional specialization of cortical areas. Our findings complement previous descriptions of early sulcogenesis based on neuropathology and qualitative evaluation of 2D in utero MRI by accurate spatial and temporal mapping of the emergence of individual sulci as well as structural brain asymmetries. The study provides the missing starting point for their developmental trajectories and extends our understanding of normal cortical folding.
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Affiliation(s)
- Piotr A Habas
- Biomedical Image Computing Group, University of California San Francisco, San Francisco, CA 94143, USA.
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Vasung L, Huang H, Jovanov-Milošević N, Pletikos M, Mori S, Kostović I. Development of axonal pathways in the human fetal fronto-limbic brain: histochemical characterization and diffusion tensor imaging. J Anat 2011; 217:400-17. [PMID: 20609031 DOI: 10.1111/j.1469-7580.2010.01260.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The development of cortical axonal pathways in the human brain begins during the transition between the embryonic and fetal period, happens in a series of sequential events, and leads to the establishment of major long trajectories by the neonatal period. We have correlated histochemical markers (acetylcholinesterase (AChE) histochemistry, antibody against synaptic protein SNAP-25 (SNAP-25-immunoreactivity) and neurofilament 200) with the diffusion tensor imaging (DTI) database in order to make a reconstruction of the origin, growth pattern and termination of the pathways in the period between 8 and 34 postconceptual weeks (PCW). Histological sections revealed that the initial outgrowth and formation of joined trajectories of subcortico-frontal pathways (external capsule, cerebral stalk-internal capsule) and limbic bundles (fornix, stria terminalis, amygdaloid radiation) occur by 10 PCW. As early as 11 PCW, major afferent fibers invade the corticostriatal junction. At 13-14 PCW, axonal pathways from the thalamus and basal forebrain approach the deep moiety of the cortical plate, causing the first lamination. The period between 15 and 18 PCW is dominated by elaboration of the periventricular crossroads, sagittal strata and spread of fibers in the subplate and marginal zone. Tracing of fibers in the subplate with DTI is unsuccessful due to the isotropy of this zone. Penetration of the cortical plate occurs after 24-26 PCW. In conclusion, frontal axonal pathways form the periventricular crossroads, sagittal strata and 'waiting' compartments during the path-finding and penetration of the cortical plate. Histochemistry is advantageous in the demonstration of a growth pattern, whereas DTI is unique for demonstrating axonal trajectories. The complexity of fibers is the biological substrate of selective vulnerability of the fetal white matter.
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Affiliation(s)
- Lana Vasung
- Croatian Institute for Brain Research, University of Zagreb School of Medicine, Salata 12, Zagreb, Croatia.
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Abstract
Diffusion-weighted imaging has contributed to our understanding of fetal and neonatal brain development. This article will review the role of diffusion-weighted imaging and diffusion tensor imaging in fetuses and neonates, focusing primarily on normal brain developmental processes and then on pathologic processes that can be characterized using diffusion tensor imaging.
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Affiliation(s)
- Orit Glenn
- Neuroradiology Section, University of California, San Francisco, CA, USA.
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Habas PA, Kim K, Rousseau F, Glenn OA, Barkovich AJ, Studholme C. Atlas-based segmentation of developing tissues in the human brain with quantitative validation in young fetuses. Hum Brain Mapp 2011; 31:1348-58. [PMID: 20108226 DOI: 10.1002/hbm.20935] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Imaging of the human fetus using magnetic resonance (MR) is an essential tool for quantitative studies of normal as well as abnormal brain development in utero. However, because of fundamental differences in tissue types, tissue properties and tissue distribution between the fetal and adult brain, automated tissue segmentation techniques developed for adult brain anatomy are unsuitable for this data. In this paper, we describe methodology for automatic atlas-based segmentation of individual tissue types in motion-corrected 3D volumes reconstructed from clinical MR scans of the fetal brain. To generate anatomically correct automatic segmentations, we create a set of accurate manual delineations and build an in utero 3D statistical atlas of tissue distribution incorporating developing gray and white matter as well as transient tissue types such as the germinal matrix. The probabilistic atlas is associated with an unbiased average shape and intensity template for registration of new subject images to the space of the atlas. Quantitative whole brain 3D validation of tissue labeling performed on a set of 14 fetal MR scans (20.57-22.86 weeks gestational age) demonstrates that this atlas-based EM segmentation approach achieves consistently high DSC performance for the main tissue types in the fetal brain. This work indicates that reliable measures of brain development can be automatically derived from clinical MR imaging and opens up possibility of further 3D volumetric and morphometric studies with multiple fetal subjects.
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Affiliation(s)
- Piotr A Habas
- Biomedical Image Computing Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California 94143, USA.
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Malamateniou C, McGuinness AK, Allsop JM, O’Regan DP, Rutherford MA, Hajnal JV. Snapshot Inversion Recovery: An Optimized Single-Shot T1-weighted Inversion-Recovery Sequence for Improved Fetal Brain Anatomic Delineation. Radiology 2011; 258:229-35. [DOI: 10.1148/radiol.10100381] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Gholipour A, Estroff JA, Warfield SK. Robust super-resolution volume reconstruction from slice acquisitions: application to fetal brain MRI. IEEE TRANSACTIONS ON MEDICAL IMAGING 2010; 29:1739-58. [PMID: 20529730 PMCID: PMC3694441 DOI: 10.1109/tmi.2010.2051680] [Citation(s) in RCA: 189] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Fast magnetic resonance imaging slice acquisition techniques such as single shot fast spin echo are routinely used in the presence of uncontrollable motion. These techniques are widely used for fetal magnetic resonance imaging (MRI) and MRI of moving subjects and organs. Although high-quality slices are frequently acquired by these techniques, inter-slice motion leads to severe motion artifacts that are apparent in out-of-plane views. Slice sequential acquisitions do not enable 3-D volume representation. In this study, we have developed a novel technique based on a slice acquisition model, which enables the reconstruction of a volumetric image from multiple-scan slice acquisitions. The super-resolution volume reconstruction is formulated as an inverse problem of finding the underlying structure generating the acquired slices. We have developed a robust M-estimation solution which minimizes a robust error norm function between the model-generated slices and the acquired slices. The accuracy and robustness of this novel technique has been quantitatively assessed through simulations with digital brain phantom images as well as high-resolution newborn images. We also report here successful application of our new technique for the reconstruction of volumetric fetal brain MRI from clinically acquired data.
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Affiliation(s)
- Ali Gholipour
- Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
| | - Judy A. Estroff
- Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
| | - Simon K. Warfield
- Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
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Udagawa J, Yasuda A, Naito K, Otani H. Analysis of the harmonized growth pattern of fetal organs by multidimensional scaling and hierarchical clustering. Congenit Anom (Kyoto) 2010; 50:175-85. [PMID: 20584035 DOI: 10.1111/j.1741-4520.2010.00284.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The development of an organ may be affected by various growth and differentiation factors released from other organs. These factors are believed to have important effects on the development of multiple organs. To detect and analyze harmonized development among multiple organs, similarities in growth patterns among fetal organs were examined using multivariate analysis. Ninety human fetuses obtained from the Kyoto Collection of Human Embryos were dissected. Harmonized development of organs was evaluated by multidimensional scaling and cluster analysis using measurements (length, width, height, and weight) of the fetal organs. Similar growth patterns were observed between the brain, including cerebrum, diencephalon, and midbrain (cerebrum-to-midbrain [Cer-Mid]), and pituitary (crown-rump length [CRL] 95-155 mm). Further, similar growth patterns were observed between the liver and Cer-Mid and cerebellum (Cb; CRL 156-202 mm), and between Cer-Mid and Cb (CRL 203-253 mm). Similarities in growth patterns were also observed between right and left lungs (CRL 99-235 mm) and between the aorta and heart (CRL 139-187 mm), but not between the lung and pulmonary trunk. These findings revealed synchronized development among fetal organs and suggested a functional and structural relationship among different organs in the prenatal period. These relationships include the existence of common factors in organ development, such as cross-talk mediated by humoral factors, and the presence of an anatomical and functional relationship in the fetal circulatory system.
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Affiliation(s)
- Jun Udagawa
- Department of Developmental Biology, Faculty of Medicine, Shimane University, Izumo, Japan.
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Dubois J, Benders M, Lazeyras F, Borradori-Tolsa C, Leuchter RHV, Mangin J, Hüppi P. Structural asymmetries of perisylvian regions in the preterm newborn. Neuroimage 2010; 52:32-42. [DOI: 10.1016/j.neuroimage.2010.03.054] [Citation(s) in RCA: 119] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 03/16/2010] [Accepted: 03/19/2010] [Indexed: 11/28/2022] Open
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Dyet L. Fetal growth from mid- to late pregnancy: the Generation R Study. Dev Med Child Neurol 2010; 52:599. [PMID: 20059516 DOI: 10.1111/j.1469-8749.2009.03535.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Leigh Dyet
- University College London Hospital, London, UK
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Habas PA, Kim K, Corbett-Detig JM, Rousseau F, Glenn OA, Barkovich AJ, Studholme C. A spatiotemporal atlas of MR intensity, tissue probability and shape of the fetal brain with application to segmentation. Neuroimage 2010; 53:460-70. [PMID: 20600970 DOI: 10.1016/j.neuroimage.2010.06.054] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2010] [Revised: 06/18/2010] [Accepted: 06/21/2010] [Indexed: 11/27/2022] Open
Abstract
Modeling and analysis of MR images of the developing human brain is a challenge due to rapid changes in brain morphology and morphometry. We present an approach to the construction of a spatiotemporal atlas of the fetal brain with temporal models of MR intensity, tissue probability and shape changes. This spatiotemporal model is created from a set of reconstructed MR images of fetal subjects with different gestational ages. Groupwise registration of manual segmentations and voxelwise nonlinear modeling allow us to capture the appearance, disappearance and spatial variation of brain structures over time. Applying this model to atlas-based segmentation, we generate age-specific MR templates and tissue probability maps and use them to initialize automatic tissue delineation in new MR images. The choice of model parameters and the final performance are evaluated using clinical MR scans of young fetuses with gestational ages ranging from 20.57 to 24.71 weeks. Experimental results indicate that quadratic temporal models can correctly capture growth-related changes in the fetal brain anatomy and provide improvement in accuracy of atlas-based tissue segmentation.
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Affiliation(s)
- Piotr A Habas
- Biomedical Image Computing Group, University of California San Francisco, San Francisco, CA 94143, USA.
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Abstract
PURPOSE OF REVIEW Fetal magnetic resonance imaging (MRI) is a relatively new clinical application but is becoming increasingly used in fetal medicine in combination with the established technique of antenatal ultrasound. A review of the literature to date provides information for clinicians to help assess which patients they should be referring for fetal MRI and what additional information to ultrasound they can obtain. RECENT FINDINGS This review covers recent articles on practical aspects of imaging, MR findings in common disorders and comparisons with ultrasound. It includes information on current applications for fetal MRI, new sequence acquisitions and postprocessing techniques. Fetal motion is the single most important barrier to improving image data. SUMMARY Fetal MR has become an established tool for assessing the fetal brain. It provides complementary information to ultrasound. However, further optimization of this technique is still required to ensure it is exploited to the full in fetal medicine.
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Abstract
Recent technological advances in fetal magnetic resonance imaging (MRI) and increased reliability of MRI in depicting abnormalities and lesions, especially in the central nervous system, are increasingly bringing up challenging issues with regard to accurate diagnosis. There are also pitfalls not only attributable to image acquisition but also in clinical interpretation. The misinterpretation of findings because of insufficient knowledge about fetal brain development as visualized by MRI may also be regarded as an important limitation of fetal MRI. We provide an overview of the most common pitfalls experienced in fetal MRI in routine practice, demonstrate how to identify some of the factors that lead to imaging misinterpretation, and suggest ways to tackle these problems, with an emphasis on MR techniques and image calibration.
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Affiliation(s)
- Ali Al-Mukhtar
- Department of Radiology, Division of General and Pediatric Radiology, Medical University of Vienna, Vienna, Austria.
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Abstract
The fetal brain is a dynamic structure, which can now be imaged using magnetic resonance imaging (MRI). This article will review techniques of fetal MRI as well as several key aspects of brain development and their appearance on MRI. An understanding of normal fetal brain development is essential to correctly identifying developmental abnormalities.
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Affiliation(s)
- Orit A Glenn
- Department of Radiology, Neuroradiology Section, University of California, San Francisco, CA 94143, USA.
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Zubiaurre‐Elorza L, Soria‐Pastor S, Junqué C, Vendrell P, Padilla N, Rametti G, Bargalló N, Botet F. Magnetic resonance imaging study of cerebral sulci in low‐risk preterm children. Int J Dev Neurosci 2009; 27:559-65. [DOI: 10.1016/j.ijdevneu.2009.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2009] [Revised: 06/17/2009] [Accepted: 06/19/2009] [Indexed: 10/20/2022] Open
Affiliation(s)
- Leire Zubiaurre‐Elorza
- Department of Psychiatry and Clinical Psychobiology, Faculty of MedicineUniversity of BarcelonaC/Casanova 14308036BarcelonaSpain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)C/Villarroel 17008036BarcelonaSpain
| | - Sara Soria‐Pastor
- Department of Psychiatry and Clinical Psychobiology, Faculty of MedicineUniversity of BarcelonaC/Casanova 14308036BarcelonaSpain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)C/Villarroel 17008036BarcelonaSpain
| | - Carme Junqué
- Department of Psychiatry and Clinical Psychobiology, Faculty of MedicineUniversity of BarcelonaC/Casanova 14308036BarcelonaSpain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)C/Villarroel 17008036BarcelonaSpain
| | - Pere Vendrell
- Department of Psychiatry and Clinical Psychobiology, Faculty of MedicineUniversity of BarcelonaC/Casanova 14308036BarcelonaSpain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)C/Villarroel 17008036BarcelonaSpain
| | - Nelly Padilla
- Department of Maternal‐Fetal MedicineHospital Clinic‐IDIBAPSBarcelona08028Spain
- Centro de Investigación Biomédica en Enfermedades Raras (CIBERER)Spain
| | - Giuseppina Rametti
- Department of Psychiatry and Clinical Psychobiology, Faculty of MedicineUniversity of BarcelonaC/Casanova 14308036BarcelonaSpain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)C/Villarroel 17008036BarcelonaSpain
| | - Núria Bargalló
- Neuroradiology Section, Radiology DepartmentCentre de Diagnòstic per la Imatge (CDIC), Hospital ClínicC/Villarroel 17008036BarcelonaSpain
| | - Francesc Botet
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)C/Villarroel 17008036BarcelonaSpain
- Neonatological ServiceHospital Clínic de Barcelona, Universitat de BarcelonaC/Sabino Arana 108028BarcelonaSpain
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