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Sivera R, Clark AE, Dall'Asta A, Ghi T, Schievano S, Lees CC. Fetal face shape analysis from prenatal 3D ultrasound images. Sci Rep 2024; 14:4411. [PMID: 38388522 PMCID: PMC10884000 DOI: 10.1038/s41598-023-50386-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/19/2023] [Indexed: 02/24/2024] Open
Abstract
3D ultrasound imaging of fetal faces has been predominantly confined to qualitative assessment. Many genetic conditions evade diagnosis and identification could assist with parental counselling, pregnancy management and neonatal care planning. We describe a methodology to build a shape model of the third trimester fetal face from 3D ultrasound and show how it can objectively describe morphological features and gestational-age related changes of normal fetal faces. 135 fetal face 3D ultrasound volumes (117 appropriately grown, 18 growth-restricted) of 24-34 weeks gestation were included. A 3D surface model of each face was obtained using a semi-automatic segmentation workflow. Size normalisation and rescaling was performed using a growth model giving the average size at every gestation. The model demonstrated a similar growth rate to standard head circumference reference charts. A landmark-free morphometry model was estimated to characterize shape differences using non-linear deformations of an idealized template face. Advancing gestation is associated with widening/fullness of the cheeks, contraction of the chin and deepening of the eyes. Fetal growth restriction is associated with a smaller average facial size but no morphological differences. This model may eventually be used as a reference to assist in the prenatal diagnosis of congenital anomalies with characteristic facial dysmorphisms.
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Affiliation(s)
- Raphael Sivera
- Institute of Cardiovascular Science, University College London, London, UK
| | - Anna E Clark
- Institute of Reproductive and Development Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Andrea Dall'Asta
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Tullio Ghi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Silvia Schievano
- Institute of Cardiovascular Science, University College London, London, UK
| | - Christoph C Lees
- Institute of Reproductive and Development Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
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de Almeida CÁ, Nakamura R, Leverone A, Costa F, Estrada BD, Haui P, Luz F, Yamada AF, Werner H, Canella C. Imaging features for the evaluation of skin and nail infections. Skeletal Radiol 2024:10.1007/s00256-023-04557-4. [PMID: 38194095 DOI: 10.1007/s00256-023-04557-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024]
Abstract
Clinical manifestations of dermatological and musculoskeletal conditions can sometimes overlap, leading to confusion in diagnosis. Patients with nail and skin infections may undergo imaging examinations with suspicions of muscle, tendon, or joint injuries. Dermatological infections often involve soft tissues and musculoskeletal structures, and their etiology can range from fungi, bacteria, viruses, to protozoa. Relying solely on physical examination may not be sufficient for accurate diagnosis and treatment planning, necessitating the use of complementary imaging exams. The objective of this paper is to present and discuss imaging findings of the main infectious conditions affecting the nail apparatus and skin. The paper also highlights the importance of imaging in clarifying diagnostic uncertainties and guiding appropriate treatment for dermatological conditions.
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Affiliation(s)
- Carolina Ávila de Almeida
- Diagnósticos da América S/A, DASA, Avenida das Américas 4666, Sala 325, Rio de Janeiro, RJ, 22640-100, Brazil.
| | - Robertha Nakamura
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia Do Rio de Janeiro, Rio de Janeiro, Brazil
- Centro de Estudos das Unhas (CEU), Santa Casa de Misericórdia Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andreia Leverone
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia Do Rio de Janeiro, Rio de Janeiro, Brazil
- Centro de Estudos das Unhas (CEU), Santa Casa de Misericórdia Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávia Costa
- DASA, Clínica Alta Excelência Diagnóstica, Rio de Janeiro, Brazil
| | - Bruna Duque Estrada
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia Do Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Evidence-Based, Health of the Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Priscilla Haui
- Diagnósticos da América S/A, DASA, Avenida das Américas 4666, Sala 325, Rio de Janeiro, RJ, 22640-100, Brazil
| | - Flavio Luz
- Department of Dermatology, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil
| | - Andre Fukunishi Yamada
- Department of Radiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Hospital Do Coração, HCOR, São Paulo, Brazil
| | - Heron Werner
- Diagnósticos da América S/A, DASA, Avenida das Américas 4666, Sala 325, Rio de Janeiro, RJ, 22640-100, Brazil
- Bio Design Laboratory, Pontifícia Universidade Católica (PUC-Rio), Rio de Janeiro, Brazil
| | - Clarissa Canella
- DASA, Clínica Alta Excelência Diagnóstica, Rio de Janeiro, Brazil
- Bio Design Laboratory, Pontifícia Universidade Católica (PUC-Rio), Rio de Janeiro, Brazil
- Department of Radiology of Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil
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Wright R, Gomez A, Zimmer VA, Toussaint N, Khanal B, Matthew J, Skelton E, Kainz B, Rueckert D, Hajnal JV, Schnabel JA. Fast fetal head compounding from multi-view 3D ultrasound. Med Image Anal 2023; 89:102793. [PMID: 37482034 DOI: 10.1016/j.media.2023.102793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 02/26/2023] [Accepted: 03/06/2023] [Indexed: 07/25/2023]
Abstract
The diagnostic value of ultrasound images may be limited by the presence of artefacts, notably acoustic shadows, lack of contrast and localised signal dropout. Some of these artefacts are dependent on probe orientation and scan technique, with each image giving a distinct, partial view of the imaged anatomy. In this work, we propose a novel method to fuse the partially imaged fetal head anatomy, acquired from numerous views, into a single coherent 3D volume of the full anatomy. Firstly, a stream of freehand 3D US images is acquired using a single probe, capturing as many different views of the head as possible. The imaged anatomy at each time-point is then independently aligned to a canonical pose using a recurrent spatial transformer network, making our approach robust to fast fetal and probe motion. Secondly, images are fused by averaging only the most consistent and salient features from all images, producing a more detailed compounding, while minimising artefacts. We evaluated our method quantitatively and qualitatively, using image quality metrics and expert ratings, yielding state of the art performance in terms of image quality and robustness to misalignments. Being online, fast and fully automated, our method shows promise for clinical use and deployment as a real-time tool in the fetal screening clinic, where it may enable unparallelled insight into the shape and structure of the face, skull and brain.
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Affiliation(s)
- Robert Wright
- School of Biomedical Engineering & Imaging Sciences, King's College London, UK.
| | - Alberto Gomez
- School of Biomedical Engineering & Imaging Sciences, King's College London, UK
| | - Veronika A Zimmer
- School of Biomedical Engineering & Imaging Sciences, King's College London, UK; Department of Informatics, Technische Universität München, Germany
| | | | - Bishesh Khanal
- School of Biomedical Engineering & Imaging Sciences, King's College London, UK; Nepal Applied Mathematics and Informatics Institute for Research (NAAMII), Nepal
| | - Jacqueline Matthew
- School of Biomedical Engineering & Imaging Sciences, King's College London, UK
| | - Emily Skelton
- School of Biomedical Engineering & Imaging Sciences, King's College London, UK; School of Health Sciences, City, University of London, London, UK
| | | | - Daniel Rueckert
- Department of Computing, Imperial College London, UK; School of Medicine and Department of Informatics, Technische Universität München, Germany
| | - Joseph V Hajnal
- School of Biomedical Engineering & Imaging Sciences, King's College London, UK.
| | - Julia A Schnabel
- School of Biomedical Engineering & Imaging Sciences, King's College London, UK; Department of Informatics, Technische Universität München, Germany; Helmholtz Zentrum München - German Research Center for Environmental Health, Germany.
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Castro PT, Lopes J, Ribeiro G, Peixoto-Filho FM, Araujo Júnior E, Werner H. Prenatal diagnosis of Pallister-Hall syndrome: ultrasound, magnetic resonance imaging, and three-dimensional reconstructions of phenotypical findings. J Ultrasound 2023:10.1007/s40477-023-00782-8. [PMID: 37067730 DOI: 10.1007/s40477-023-00782-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/27/2023] [Indexed: 04/18/2023] Open
Abstract
Pallister - Hall syndrome is a rare malformation that involves the presence of a suprasellar hamartoma and associated malformations. Prenatal diagnosis is also rare, and few cases have been reported using magnetic resonance imaging (MRI). A 35-year-old G5P2A2 woman at the 35th week of gestation was referred to our service. Fetal MRI showed an isointense image in the suprasellar region, pushing the brainstem up and backward, and compressing the vermis and cerebellum on T2-weighted images. On T1-weighted images, the hypointense signal of the tumor was similar to that of the brain parenchyma. Ultrasound images showed a suprasellar mass, which was more echogenic than the normal cerebral parenchyma, posteriorly pushing the brain stem, with involvement of the vermis of the tumor and compression of the posterior fossa. Three-dimensional reconstruction using MRI scan data showed a space view of the tumor and its relationships with the other brain tissues allowing better understanding by parents and multidisciplinary team.
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Affiliation(s)
- Pedro Teixeira Castro
- Department of Fetal Medicine, Clínica de Diagnóstico por Imagem (CDPI - DASA), Rio de Janeiro, RJ, Brazil
| | - Jorge Lopes
- Biodesign Laboratory DASA/PUC, Rio de Janeiro, RJ, Brazil
| | - Gerson Ribeiro
- Biodesign Laboratory DASA/PUC, Rio de Janeiro, RJ, Brazil
| | | | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil, Rua Belchior de Azevedo, 156 apto. 111 Torre Vitória, 05089-030.
- Medical Course, Municipal University of São Caetano do Sul (USCS), Bela Vista Campus, São Paulo, SP, Brazil.
| | - Heron Werner
- Department of Fetal Medicine, Clínica de Diagnóstico por Imagem (CDPI - DASA), Rio de Janeiro, RJ, Brazil
- Biodesign Laboratory DASA/PUC, Rio de Janeiro, RJ, Brazil
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Diagnostic Value and Application of Prenatal MRI and Ultrasound in Fetal Cleft Lip and Palate. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:9410161. [PMID: 35655725 PMCID: PMC9132648 DOI: 10.1155/2022/9410161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/23/2022] [Indexed: 11/30/2022]
Abstract
Objective The purpose was to explore the diagnostic value and application of prenatal magnetic resonance imaging (MRI) and ultrasound (US) in fetal cleft lip and palate. Methods From January 2018 to December 2019, 39 pregnant women without normal fetal maxillofacial structure or with fetal maxillofacial deformity under US examination in our hospital were selected as the study subjects. Not knowing the clinical data of the pregnant women, MRI and US physicians performed diagnostic analysis on the MRI or US images of all the study subjects and analyzed the results of prenatal MRI and US diagnosis and postpartum follow-up to compare the diagnostic efficacy and confidence of MRI and US. Results The follow-up found that there were 20 cases of cleft lip, 15 cases of cheilopalatognathus, 3 cases of cleft palate, and 1 case of unilateral cleft lip with alveolar cleft, with a total of 39 cases having cleft lip and palate deformity. MRI and US had the same efficacy in the diagnosis of cleft lip. As for cleft palates, the diagnostic accuracy of MRI (94.87%) was significantly better than that of US (48.72%, P < 0.001). The diagnostic confidence of fetal cleft lip and palate by MRI (89.73%) was significantly better than that of US (43.59%, P < 0.001). The AUC of US (0.597) was significantly less than that of MRI (0.940), indicating that the diagnostic accuracy of US was not as good as that of MRI (P < 0.05). The sensitivity and 1 − specificity of MRI were significantly higher than those of US. Conclusion MRI is more accurate than US in the diagnosis of fetal cleft lip and palate, and MRI can be the preferred method for prenatal detection of cleft lip and palate, thus providing more accurate opinions and information for perinatal pregnant women.
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Hariastuti SM, Etika R, Utomo MT, Savitri QM. Female infant with apert syndrome and high imperforate anus without fistula. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2021.102064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Garel C, Vande Perre S, Guilbaud L, Soupre V, Blondiaux E, Ducou le Pointe H. Contribution of computed tomography and magnetic resonance imaging in the analysis of fetal craniofacial malformations. Pediatr Radiol 2021; 51:1917-1928. [PMID: 33852025 DOI: 10.1007/s00247-021-05033-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/15/2020] [Accepted: 02/21/2021] [Indexed: 11/26/2022]
Abstract
A wide range of craniofacial malformations can be diagnosed in utero using ultrasonography. However, even with highly experienced sonographers and diagnostic physicians and optimal conditions of examination, some anatomical structures cannot be properly analyzed by this technique. The aim of this pictorial essay is to show the additional value of fetal magnetic resonance imaging and computed tomography in this setting and to illustrate the role of these modalities in facial clefts; craniosynostosis; ear, eye and nose abnormalities; otomandibular dysplasias; and facial cephaloceles.
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Affiliation(s)
- Catherine Garel
- Service de Radiologie, Hôpital d´Enfants Armand-Trousseau APHP, 26 Avenue du Dr Arnold Netter, 75012, Paris, France.
| | - Saskia Vande Perre
- Service de Radiologie, Hôpital d´Enfants Armand-Trousseau APHP, 26 Avenue du Dr Arnold Netter, 75012, Paris, France
| | - Lucie Guilbaud
- Service de Médecine Fœtale, Hôpital d´Enfants Armand-Trousseau APHP, Sorbonne Université, Paris, France
| | - Véronique Soupre
- Service de Chirurgie Maxillo-faciale et Chirurgie Plastique, Hôpital Necker Enfants-Malades APHP, Paris, France
- Centre de référence Fentes et Malformations Faciales, APHP, Paris, France
| | - Eléonore Blondiaux
- Service de Radiologie, Hôpital d´Enfants Armand-Trousseau APHP, 26 Avenue du Dr Arnold Netter, 75012, Paris, France
| | - Hubert Ducou le Pointe
- Service de Radiologie, Hôpital d´Enfants Armand-Trousseau APHP, 26 Avenue du Dr Arnold Netter, 75012, Paris, France
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Magnetic resonance imaging of the fetal musculoskeletal system. Pediatr Radiol 2020; 50:2009-2027. [PMID: 33252766 DOI: 10.1007/s00247-020-04769-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/29/2020] [Accepted: 07/01/2020] [Indexed: 12/21/2022]
Abstract
Diagnosing musculoskeletal pathology requires understanding of the normal embryological development. Intrinsic errors of skeletal development are individually rare but are of paramount clinical importance because anomalies can greatly impact patients' lives. An accurate assessment of the fetal musculoskeletal system must be performed to provide optimal genetic counseling as well as to drive therapeutic management. This manuscript reviews the embryology of skeletal development and the appearance of the maturing musculoskeletal system on fetal MRI. In addition, it presents a comprehensive review of musculoskeletal fetal pathology along with postnatal imaging.
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Apert syndrome with congenital diaphragmatic hernia: another case report and review of the literature. Clin Dysmorphol 2019; 28:78-80. [DOI: 10.1097/mcd.0000000000000261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Katsube M, Yamada S, Yamaguchi Y, Takakuwa T, Yamamoto A, Imai H, Saito A, Shimizu A, Suzuki S. Critical Growth Processes for the Midfacial Morphogenesis in the Early Prenatal Period. Cleft Palate Craniofac J 2019; 56:1026-1037. [PMID: 30773047 DOI: 10.1177/1055665619827189] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Congenital midfacial hypoplasia often requires intensive treatments and is a typical condition for the Binder phenotype and syndromic craniosynostosis. The growth trait of the midfacial skeleton during the early fetal period has been assumed to be critical for such an anomaly. However, previous embryological studies using 2-dimensional analyses and specimens during the late fetal period have not been sufficient to reveal it. OBJECTIVE To understand the morphogenesis of the midfacial skeleton in the early fetal period via 3-dimensional quantification of the growth trait and investigation of the developmental association between the growth centers and midface. METHODS Magnetic resonance images were obtained from 60 human fetuses during the early fetal period. Three-dimensional shape changes in the craniofacial skeleton along growth were quantified and visualized using geometric morphometrics. Subsequently, the degree of development was computed. Furthermore, the developmental association between the growth centers and the midfacial skeleton was statistically investigated and visualized. RESULTS The zygoma expanded drastically in the anterolateral dimension, and the lateral part of the maxilla developed forward until approximately 13 weeks of gestation. The growth centers such as the nasal septum and anterior portion of the sphenoid were highly associated with the forward growth of the midfacial skeleton (RV = 0.589; P < .001). CONCLUSIONS The development of the midface, especially of the zygoma, before 13 weeks of gestation played an essential role in the midfacial development. Moreover, the growth centers had a strong association with midfacial forward growth before birth.
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Affiliation(s)
- Motoki Katsube
- 1 Department of Plastic and Reconstructive Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.,2 Congenital Anomaly Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shigehito Yamada
- 2 Congenital Anomaly Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.,3 Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yutaka Yamaguchi
- 2 Congenital Anomaly Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tetsuya Takakuwa
- 3 Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akira Yamamoto
- 4 Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hirohiko Imai
- 5 Department of Systems Science, Kyoto University Graduate School of Informatics, Kyoto, Japan
| | - Atsushi Saito
- 6 Institute of Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Akinobu Shimizu
- 6 Institute of Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Shigehiko Suzuki
- 1 Department of Plastic and Reconstructive Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Fetal brain MRI in Apert syndrome: early in vivo detection of temporal lobe malformation. Childs Nerv Syst 2018; 34:1617-1618. [PMID: 29955939 DOI: 10.1007/s00381-018-3882-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 06/22/2018] [Indexed: 10/28/2022]
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