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Eyring JB, Allen WP, Bayazid LO, Hemeyer BM, Walker S, Orb QT, Grimmer JF, Rampton J, Meier JD. Value of Imaging Measurements in Micrognathia-Related Fetal Airway Obstruction Within a Fetal Center. Laryngoscope 2024. [PMID: 39239829 DOI: 10.1002/lary.31747] [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: 05/13/2024] [Revised: 08/07/2024] [Accepted: 08/21/2024] [Indexed: 09/07/2024]
Abstract
OBJECTIVE Fetal imaging often identifies signs of upper airway obstruction due to micrognathia that may require airway intervention at delivery. This study investigated the role of quantitative fetal imaging measurements in predicting the need for otolaryngology consultation and intervention within a multidisciplinary Fetal Center. METHODS Data were retrospectively collected from expectant mothers attending a multidisciplinary Fetal Center from January 2017 to October 2023. Cases of fetal micrognathia associated with potential upper airway obstruction were analyzed, focusing on prenatal ultrasound and magnetic resonance imaging (MRI) findings, genetic testing results, and interventions at birth. RESULTS Among 25 pregnancies identified, diverse prenatal diagnoses were observed. Post hoc quantitative fetal ultrasound/MRI measurements included inferior facial angle, anteroposterior diameter, biparietal distance, and Jaw Index. Otolaryngology teams were present at delivery for a subset of cases, with various interventions performed, including tracheostomy and intubation. Lower gestational age at birth, rather than more severe quantitative measurements, was associated with the need for intervention. Intubation failure due to airway difficulty was also predicted by lower gestational age. CONCLUSION While certain quantitative fetal imaging measurements are often used for clinical decision-making regarding airway management at birth, they did not clearly predict the need for airway intervention in our sample. Gestational age is an important consideration in decision-making for fetal teams and should be considered in preterm fetuses to plan for airway difficulties. The findings highlight the complexity of fetal micrognathia management and highlight the need for further research to refine predictive models and optimize clinical decision-making in this challenging clinical scenario. LEVEL OF EVIDENCE Level 3 Laryngoscope, 2024.
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Affiliation(s)
- J B Eyring
- Department of Otolaryngology Head & Neck Surgery, Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT, USA
| | - Wesley P Allen
- Department of Otolaryngology Head & Neck Surgery, Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT, USA
| | - Leith O Bayazid
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT, USA
- Pediatric Otolaryngology Division, Intermountain Health, Primary Children's Hospital, Salt Lake City, UT, USA
| | - Brandon M Hemeyer
- Department of Otolaryngology Head & Neck Surgery, Spencer Fox Eccles School of Medicine, Salt Lake City, UT, USA
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT, USA
| | - Stephen Walker
- Department of Clinical Sciences, Rocky Vista University College of Medicine, Ivins, UT, USA
| | - Quinn T Orb
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT, USA
- Pediatric Otolaryngology Division, Intermountain Health, Primary Children's Hospital, Salt Lake City, UT, USA
| | - J Fredrik Grimmer
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT, USA
- Pediatric Otolaryngology Division, Intermountain Health, Primary Children's Hospital, Salt Lake City, UT, USA
| | - John Rampton
- Pediatric Radiology Division, Intermountain Health, Salt Lake City, UT, USA
| | - Jeremy D Meier
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT, USA
- Pediatric Otolaryngology Division, Intermountain Health, Primary Children's Hospital, Salt Lake City, UT, USA
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2
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Wang JT, Lee HJ, Chang TY. Prenatal Ultrasound and Magnetic Resonance Findings of Glutaric Acidemia Type 1 and Its Challenges in Prenatal Diagnosis. J Med Ultrasound 2024; 32:202-208. [PMID: 39310876 PMCID: PMC11414954 DOI: 10.4103/jmu.jmu_63_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 07/15/2024] [Indexed: 09/25/2024] Open
Abstract
Glutaric acidemia type 1 (GA1) presents unique challenges in prenatal diagnosis, especially in cases with no family history. This review article aims to review and present the prenatal ultrasound and magnetic resonance findings of GA1 and consolidate key insights into the difficulties associated with GA1 prenatal diagnosis and the neuroimaging features that require careful differentiation during the diagnostic process.
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Affiliation(s)
- Jo-Ting Wang
- Department of Fetal Medicine, Taiji Clinic, Taipei, Taiwan
| | - Han-Jui Lee
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Yao Chang
- Department of Fetal Medicine, Taiji Clinic, Taipei, Taiwan
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3
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Cederlund F, Axelsson O, Desmond S, Amini H, Wikström J. Magnetic resonance imaging in the second trimester as a complement to ultrasound for diagnosis of fetal anomalies. Acta Radiol Open 2024; 13:20584601241248820. [PMID: 38737558 PMCID: PMC11088812 DOI: 10.1177/20584601241248820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/07/2024] [Indexed: 05/14/2024] Open
Abstract
Background Fetal ultrasound has limitations, especially if the patient is obese or in cases with oligohydramnios. Magnetic resonance imaging (MRI) can then be used as a complement, but only few studies have focused on examinations in the second trimester. Purpose To validate MRI as a complement to diagnose fetal anomalies in the second trimester. Material and Methods This retrospective study retrieved data from January 2008 to July 2012 from the Fetal Medicine Unit and Department of Radiology at Uppsala University Hospital. Ultrasound and MRI findings were reviewed in 121 fetuses in relation to the final diagnosis, including postpartum follow-up and autopsy results. Results Of the 121 fetuses, 51 (42%) had a CNS anomaly and 70 (58%) a non-CNS anomaly diagnosed or suspected. MRI provided additional information in 21% of all cases without changing the management and revealed information that changed the management of the pregnancy in 13%. When a CNS anomaly was detected or suspected, the MRI provided additional information in 22% and changed the management in 10%. The corresponding figures for non-CNS cases were 21% and 16%, respectively. The proportion of cases with additional information that changed the management was especially high in patients with a BMI >30 kg/m2 (25%) and in patients with oligohydramnios (38%). In five cases in category III, false-positive ultrasound findings were identified. Conclusions MRI in the second trimester complements ultrasound and improves diagnosis of fetal CNS- and non-CNS anomalies especially when oligohydramnios or maternal obesity is present.
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Affiliation(s)
- Frida Cederlund
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Ove Axelsson
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Sara Desmond
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Hashem Amini
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Johan Wikström
- Department of Surgical Sciences, Neuroradiology, Uppsala University, Uppsala, Sweden
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Costanzo A, Ertl-Wagner B, Sussman D. AFNet Algorithm for Automatic Amniotic Fluid Segmentation from Fetal MRI. Bioengineering (Basel) 2023; 10:783. [PMID: 37508809 PMCID: PMC10376488 DOI: 10.3390/bioengineering10070783] [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: 05/24/2023] [Revised: 06/25/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
Amniotic Fluid Volume (AFV) is a crucial fetal biomarker when diagnosing specific fetal abnormalities. This study proposes a novel Convolutional Neural Network (CNN) model, AFNet, for segmenting amniotic fluid (AF) to facilitate clinical AFV evaluation. AFNet was trained and tested on a manually segmented and radiologist-validated AF dataset. AFNet outperforms ResUNet++ by using efficient feature mapping in the attention block and transposing convolutions in the decoder. Our experimental results show that AFNet achieved a mean Intersection over Union (mIoU) of 93.38% on our dataset, thereby outperforming other state-of-the-art models. While AFNet achieves performance scores similar to those of the UNet++ model, it does so while utilizing merely less than half the number of parameters. By creating a detailed AF dataset with an improved CNN architecture, we enable the quantification of AFV in clinical practice, which can aid in diagnosing AF disorders during gestation.
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Affiliation(s)
- Alejo Costanzo
- Department of Electrical, Computer and Biomedical Engineering, Faculty of Engineering and Architectural Sciences, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST), Toronto Metropolitan University and St. Michael's Hospital, Toronto, ON M5B 1T8, Canada
| | - Birgit Ertl-Wagner
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Department of Medical Imaging, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1W7, Canada
| | - Dafna Sussman
- Department of Electrical, Computer and Biomedical Engineering, Faculty of Engineering and Architectural Sciences, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST), Toronto Metropolitan University and St. Michael's Hospital, Toronto, ON M5B 1T8, Canada
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1E2, Canada
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5
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Pagliaccio D, Cao X, Sussman TJ. No Meta-analytic Evidence for Risks due to Prenatal Magnetic Resonance Imaging in Animal Models. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:592-598. [PMID: 36773800 PMCID: PMC10257767 DOI: 10.1016/j.bpsc.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is a powerful, noninvasive tool for both clinical practice and research. Though the safety of MRI has been endorsed by many professional societies and government bodies, some concerns have remained about potential risk from prenatal MRI. Case-control animal studies of MRI scanning during gestation and effects on offspring are the most direct test available for potential risks. We performed a meta-analysis of extant animal studies of prenatal MRI examining reproductive and offspring outcomes. METHODS Relevant articles were identified through PubMed search and citation searching of known articles and review papers. Eighteen relevant studies were identified with case-control designs of prenatal scanning conducted in vivo with mammalian species using MRI-relevant field strength. Standardized mean difference effect sizes were analyzed across k = 81 outcomes assessed across 649 unexposed dams, 622 exposed dams, 3024 unexposed offspring, and 3328 exposed offspring using a multilevel meta-analytic approach that clustered effect sizes within publications. RESULTS The meta-analysis indicated no significant evidence for a deleterious effects of prenatal MRI (standardized mean difference = 0.17, 95% CI [-0.19, 0.54], t80 = 0.94, p = .35) across outcomes. Similarly, no effects were observed when separately examining the 4 most commonly assessed outcomes: birth weight, litter size, fetal viability, and physical malformations (p > .05). CONCLUSIONS Case-control mammalian animal studies indicate no significant known risks of prenatal MRI to reproductive outcomes or offspring development. This finding is largely mirrored in human research, though the lack of randomized case-control designs limits direct comparison. The current findings provide additional support to the prevailing consensus that prenatal MRI poses no known risk to offspring.
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Affiliation(s)
- David Pagliaccio
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York; Department of Psychiatry, Columbia University, New York, New York.
| | - Xiaohe Cao
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York; Department of Psychiatry, Columbia University, New York, New York
| | - Tamara J Sussman
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York; Department of Psychiatry, Columbia University, New York, New York
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Deprest T, Fidon L, De Keyzer F, Ebner M, Deprest J, Demaerel P, De Catte L, Vercauteren T, Ourselin S, Dymarkowski S, Aertsen M. Application of Automatic Segmentation on Super-Resolution Reconstruction MR Images of the Abnormal Fetal Brain. AJNR Am J Neuroradiol 2023; 44:486-491. [PMID: 36863845 PMCID: PMC10084897 DOI: 10.3174/ajnr.a7808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 02/06/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND AND PURPOSE Fetal brain MR imaging is clinically used to characterize fetal brain abnormalities. Recently, algorithms have been proposed to reconstruct high-resolution 3D fetal brain volumes from 2D slices. By means of these reconstructions, convolutional neural networks have been developed for automatic image segmentation to avoid labor-intensive manual annotations, usually trained on data of normal fetal brains. Herein, we tested the performance of an algorithm specifically developed for segmentation of abnormal fetal brains. MATERIALS AND METHODS This was a single-center retrospective study on MR images of 16 fetuses with severe CNS anomalies (gestation, 21-39 weeks). T2-weighted 2D slices were converted to 3D volumes using a super-resolution reconstruction algorithm. The acquired volumetric data were then processed by a novel convolutional neural network to perform segmentations of white matter and the ventricular system and cerebellum. These were compared with manual segmentation using the Dice coefficient, Hausdorff distance (95th percentile), and volume difference. Using interquartile ranges, we identified outliers of these metrics and further analyzed them in detail. RESULTS The mean Dice coefficient was 96.2%, 93.7%, and 94.7% for white matter and the ventricular system and cerebellum, respectively. The Hausdorff distance was 1.1, 2.3, and 1.6 mm, respectively. The volume difference was 1.6, 1.4, and 0.3 mL, respectively. Of the 126 measurements, there were 16 outliers among 5 fetuses, discussed on a case-by-case basis. CONCLUSIONS Our novel segmentation algorithm obtained excellent results on MR images of fetuses with severe brain abnormalities. Analysis of the outliers shows the need to include pathologies underrepresented in the current data set. Quality control to prevent occasional errors is still needed.
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Affiliation(s)
- T Deprest
- From the Department of Radiology (T.D., F.D.K., P.D., S.D., M.A.)
| | - L Fidon
- School of Biomedical Engineering and Imaging Sciences (L.F., M.E., T.V., S.O.), King's College London, London, UK
| | - F De Keyzer
- From the Department of Radiology (T.D., F.D.K., P.D., S.D., M.A.)
| | - M Ebner
- School of Biomedical Engineering and Imaging Sciences (L.F., M.E., T.V., S.O.), King's College London, London, UK
- Department of Medical Physics and Biomedical Engineering (M.E., T.V.), University College London, London, UK
| | - J Deprest
- Gynaecology and Obstetrics (J.D., L.D.C., T.V.), University Hospitals Leuven, Belgium
- Institute for Women's Health (J.D.)
| | - P Demaerel
- From the Department of Radiology (T.D., F.D.K., P.D., S.D., M.A.)
| | - L De Catte
- Gynaecology and Obstetrics (J.D., L.D.C., T.V.), University Hospitals Leuven, Belgium
| | - T Vercauteren
- Gynaecology and Obstetrics (J.D., L.D.C., T.V.), University Hospitals Leuven, Belgium
- School of Biomedical Engineering and Imaging Sciences (L.F., M.E., T.V., S.O.), King's College London, London, UK
- Department of Medical Physics and Biomedical Engineering (M.E., T.V.), University College London, London, UK
| | - S Ourselin
- School of Biomedical Engineering and Imaging Sciences (L.F., M.E., T.V., S.O.), King's College London, London, UK
| | - S Dymarkowski
- From the Department of Radiology (T.D., F.D.K., P.D., S.D., M.A.)
| | - M Aertsen
- From the Department of Radiology (T.D., F.D.K., P.D., S.D., M.A.)
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7
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Tonni G, Peixoto AB, Werner H, Grisolia G, Ruano R, Sepulveda F, Sepulveda W, Araujo Júnior E. Ultrasound and fetal magnetic resonance imaging: Clinical performance in the prenatal diagnosis of orofacial clefts and mandibular abnormalities. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:346-361. [PMID: 36785498 DOI: 10.1002/jcu.23403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 06/18/2023]
Abstract
Cleft lip, with or without cleft palate, is the most common congenital craniofacial anomaly and the second most common birth defect worldwide. Micrognathia is a rare facial malformation characterized by small, underdeveloped mandible and frequently associated with retrognathia. Second- and third-trimester prenatal ultrasound is the standard modality for screening and identification of fetal orofacial abnormalities, with a detection rate in the low-risk population ranging from 0% to 73% for all types of cleft. The prenatal ultrasonography detection can also be performed during the first trimester of pregnancy. Given the potential limitations of obstetric ultrasound for examining the fetal face, such as suboptimal fetal position, shadowing from the surrounding bones, reduce amniotic fluid around the face, interposition of fetal limbs, umbilical cord and placenta, and maternal habitus/abdominal scars, the use of adjunct imaging modalities can enhance prenatal diagnosis of craniofacial anomalies in at-risk pregnancies. Fetal magnetic resonance imaging (MRI) is a potentially useful second-line investigation for the prenatal diagnosis of orofacial malformations with a pooled sensitivity of 97%. In this review, we discuss the role of ultrasound and fetal MRI in the prenatal assessment of abnormalities of the upper lip, palate, and mandible.
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Affiliation(s)
- Gabriele Tonni
- Prenatal Diagnostic Centre, Department of Obstetrics and Neonatology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), AUSL Reggio Emilia, Reggio Emilia, Italy
| | - Alberto Borges Peixoto
- Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba, Brazil
| | - Heron Werner
- Department of Fetal Medicine, Clínica de Diagnóstico por Imagem (CDPI - DASA), Rio de Janeiro, Brazil
| | - Gianpaolo Grisolia
- Department of Obstetrics and Gynecology, Carlo Poma Hospital, ASST Mantova, Mantova, Italy
| | - Rodrigo Ruano
- Division of Maternal-Fetal Medicine, UH Jackson Fetal Care, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Francisco Sepulveda
- FETALMED-Maternal-Fetal Diagnostic Center, Fetal Imaging Unit, Santiago, Chile
| | - Waldo Sepulveda
- FETALMED-Maternal-Fetal Diagnostic Center, Fetal Imaging Unit, Santiago, Chile
| | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
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Incidence of occult cleft palate on prenatal magnetic resonance images obtained for non-cleft indications. Int J Oral Maxillofac Surg 2022; 52:560-563. [PMID: 36150945 DOI: 10.1016/j.ijom.2022.09.006] [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: 06/01/2022] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 11/21/2022]
Abstract
Prenatal diagnosis of craniofacial anomalies has improved family education and preparedness. Isolated cleft palate, however, remains difficult to identify sonographically. The aim of this study was to investigate the rate of incidental cleft palate identified on fetal magnetic resonance imaging (MRI) following the ultrasound detection of non-cleft abnormalities. This was a retrospective study of pregnant women who had fetal MRI performed between 2003 and 2017. To be included, the woman had to have been referred for fetal imaging for a non-cleft indication, with subsequent identification of an isolated cleft palate on MRI. Fetuses with a postnatal diagnosis of Robin sequence were excluded. The study sample included 30 women. Mean gestational age at MRI was 24 weeks 4 days± 38 days. Most referrals (76.7%) were for non-cleft craniofacial anomalies, of which micrognathia was the most common (63.3%). The annual incidence of occult cleft palate diagnosis was 0.4%, and a genetic syndrome was suspected based on imaging findings in 76.7%. Although rare, isolated cleft palate found incidentally on fetal imaging led to concern for a genetic syndrome in a high percentage of cases. This suggests that early referral for fetal MRI may provide critical information when sonographic fetal anomalies have been identified.
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Liang J, Ma Q, Zhao X, Pan G, Zhang G, Zhu B, Xue Y, Li D, Lu B. Feasibility Analysis of 3D Printing With Prenatal Ultrasound for the Diagnosis of Fetal Abnormalities. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1385-1396. [PMID: 34510491 DOI: 10.1002/jum.15821] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/04/2021] [Accepted: 08/14/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To assess the feasibility and accuracy of 3D printing with prenatal three-dimensional ultrasound (3DUS) in the diagnosis of fetal abnormalities. METHODS Fetuses initially diagnosed with various abnormalities were included in this retrospective study. The fetuses were examined by 3DUS, modeled, and 3D printed, and the dimensional accuracy of the 3D prints was analyzed. The effectiveness, demand, necessity of 3D printing, and the diagnostic accuracy of different methods were analyzed based on questionnaire responses from 40 senior ultrasound doctors and 40 postgraduate students. RESULTS A total of 12 fetuses with cleft lip and palate, spinal, heart, or brain abnormalities were included for detailed assessment. All deviations (mean deviation: 0.1 mm) between the original images and the final 3D prints lay within the consistency boundary (-1.12, 1.31 mm) (P > .05). In the subsequent analyses, 90.8% of the doctors and 94.2% of the students strongly agreed that 3D printing could precisely represent and depict fetal abnormalities. The average misdiagnosis rate of the doctors decreased from 5% to 0.4% after the application of 3D printing combined with 3DUS in comparison with 3DUS alone, and the corresponding value for the students dropped from 17.9% to 5.2%. CONCLUSIONS The errors in modeling and 3D printing based on 3DUS were within acceptable limits, and 3D printing improved the diagnosis of various fetal abnormalities.
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Affiliation(s)
- Jixiang Liang
- The State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Shaanxi, China
- Institute of 3D Printing, Beijing City University, Beijing, China
| | - Qiang Ma
- Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, China
| | - Xin Zhao
- Institute of 3D Printing, Beijing City University, Beijing, China
| | - Guangyu Pan
- Department of Cardiovascular Surgery, Peking University International Hospital, Beijing, China
| | - Gen Zhang
- Department of Cardiovascular Surgery, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Sichuan, China
| | - Bin Zhu
- Department of Anesthesiology, Peking University International Hospital, Beijing, China
| | - Yanfang Xue
- Institute of 3D Printing, Beijing City University, Beijing, China
| | - Dianyuan Li
- Department of Cardiovascular Surgery, Peking University International Hospital, Beijing, China
- Nanjing Medical University Affiliated Suzhou Hospital, Jiangsu, China
| | - Bingheng Lu
- The State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Shaanxi, China
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Xia F, Guo Y, He H, Chen P, Shao J, Xia W. Reference biometry of foetal brain by prenatal MRI and the distribution of measurements in foetuses with ventricular septal defect. Ann Med 2021; 53:1428-1437. [PMID: 34414830 PMCID: PMC8381939 DOI: 10.1080/07853890.2021.1969590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/12/2021] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To provide the reference biometric measurements of the normal foetal brain by prenatal MRI and describe the distribution of measurements in the foetuses with ventricular septal defect (VSD). METHODS This retrospective study analysed the biometric measurements of 218 foetuses between 18 - 37 gestational weeks with normal MRI findings from July 2014 to August 2019, as well as 18 foetuses with VSD. The measurements included fronto-occipital diameter (FOD), biparietal diameter (BPD), and transverse cerebellar diameter (TCD). All the prenatal MRI examinations have been taken on the same 1.5 T MR unit with a standard protocol of the foetal brain. All the linear measurements of the foetal brain were obtained on the T2-weighted imaging. The distribution of measurements in 18 foetuses with VSD was plotted on centile curves. RESULTS The reference data were presented in mean, standard deviation, 95% predicted confidence intervals, and the 3rd, 10th, 25th, 50th, 75th, 90th, 97th centiles at each gestational age. The value of TCD in 56% (10/18 cases) foetuses with VSD was lower than the 3rd centile, and the rate for FOD and BPD was 33% (6/18 cases) and 22% (4/18 cases) separately. On the curves, most VSD cases with measurements lower than the 3rd centile were in relatively early gestational stage (≤28 weeks). CONCLUSIONS We have presented reference linear biometry of the foetal brain by prenatal MRI from 18 to 37 gestational weeks, which could help us to interpret and monitor the brain development for foetuses with VSD and other congenital heart diseases.Key messages:We have presented reference linear biometry of the foetal brain by prenatal MRI from 18 to 37 gestational weeks in multiple statistical methods: mean and standard deviation; 95% predicted confidence intervals and the 3rd, 10th, 25th, 50th, 75th, 90th, 97th centiles.Our data showed that the involvement of the brain in VSD may be not globally, but regionally, and the cerebellum may be more possible to be involved.We speculated that the earlier the VSD diagnosed the worse the brain involved, which might suggest a poor outcome and necessary follow-up.
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Affiliation(s)
- Feng Xia
- Department of Radiology, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Yu Guo
- Department of Imaging Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hua He
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Peiwen Chen
- Department of Ultrasound, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Jianbo Shao
- Department of Imaging Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Xia
- Department of Imaging Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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11
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Arechvo A, Lingman G, Thurn L, Jansson T, Jokubkiene L. Fusion imaging in brain structure measurements on a fetus phantom, combining real-time ultrasound with magnetic resonance imaging. Australas J Ultrasound Med 2021; 24:161-172. [PMID: 34765426 PMCID: PMC8409451 DOI: 10.1002/ajum.12246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 01/29/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives To assess synchronisation of MRI and US in measuring foetus phantom head structures; inter‐method, intra‐ and inter‐observer differences on biparietal diameter (BPD), head diameter, anterio‐posterior head diameter (HAP) and lateral ventricle structures (VS). Methods Fusion Imaging (FI) has been performed by combining MRI and US simultaneously. Axial scans of 1.5 Tesla MRI on a foetus phantom were acquired and uploaded on a US machine (EPIQ 7G, Philips). A PercuNav US tracker allowed the system to recognise and display the position of the transducer. A fetal phantom tracker was used as a phantom reference. Real‐time US of the phantom head was performed by synchronising the uploaded MRI images using different landmarks. Synchronisation has been assessed by taking measurements after rotating the US probe by 90. Measurements were taken by three different observers twice. Differences in measurements between MRI and US, inter‐, intra‐observer differences in all measurements were assessed. Results BPD, HAP and VS measurements before rotation were 0.13 ± 0.06 cm, 0.46 ± 0.09 cm and 0.4 ± 0.23 cm (width) and mean 0.6 ± 0.25 cm (length) larger at MRI than at US using any number of landmarks. After US probe rotation VS were 0.3 ± 0.24 cm in width and 0.3 ± 0.27 cm in length. Intra‐ and inter‐observer differences in all measurements were small. Conclusions FI showed good synchronisation in measurements. BPD, HAP and VS were larger at MRI than US, likely a result of the way images are generated. Intra‐, inter‐observer differences between measurements were small. This can be important when reporting geometric measures from FI.
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Affiliation(s)
- Anastasija Arechvo
- Department of Obstetrics and Gynecology Skåne University Hospital Lund University Lund Sweden
| | - Göran Lingman
- Department Obstetrics and Gynecology IKVL Medical Faculty Lund University Lund Sweden
| | - Lars Thurn
- Department of Obstetrics and Gynecology Skåne University Hospital Lund University Lund Sweden
| | - Tomas Jansson
- Department of Clinical Sciences Lund Biomedical Engineering Lund University Lund Sweden.,Clinical Engineering Skåne Medical Services Lund Sweden
| | - Ligita Jokubkiene
- Department of Obstetrics and Gynecology Skåne University Hospital Lund University Lund Sweden
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Peng SW, Peng KP, Tian GX, Cao XY, Liu MH, Dong QY. Ultrasonic Diagnosis of Lissencephaly: Literature Review and A Case Report. JOURNAL OF FETAL MEDICINE 2021. [DOI: 10.1007/s40556-021-00313-7] [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]
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13
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Hoffmann M, Abaci Turk E, Gagoski B, Morgan L, Wighton P, Tisdall MD, Reuter M, Adalsteinsson E, Grant PE, Wald LL, van der Kouwe AJW. Rapid head-pose detection for automated slice prescription of fetal-brain MRI. INTERNATIONAL JOURNAL OF IMAGING SYSTEMS AND TECHNOLOGY 2021; 31:1136-1154. [PMID: 34421216 PMCID: PMC8372849 DOI: 10.1002/ima.22563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/29/2021] [Accepted: 02/09/2021] [Indexed: 06/13/2023]
Abstract
In fetal-brain MRI, head-pose changes between prescription and acquisition present a challenge to obtaining the standard sagittal, coronal and axial views essential to clinical assessment. As motion limits acquisitions to thick slices that preclude retrospective resampling, technologists repeat ~55-second stack-of-slices scans (HASTE) with incrementally reoriented field of view numerous times, deducing the head pose from previous stacks. To address this inefficient workflow, we propose a robust head-pose detection algorithm using full-uterus scout scans (EPI) which take ~5 seconds to acquire. Our ~2-second procedure automatically locates the fetal brain and eyes, which we derive from maximally stable extremal regions (MSERs). The success rate of the method exceeds 94% in the third trimester, outperforming a trained technologist by up to 20%. The pipeline may be used to automatically orient the anatomical sequence, removing the need to estimate the head pose from 2D views and reducing delays during which motion can occur.
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Affiliation(s)
- Malte Hoffmann
- Department of Radiology, Massachusetts General HospitalBostonMassachusettsUSA
- Department of RadiologyHarvard Medical SchoolBostonMassachusettsUSA
| | - Esra Abaci Turk
- Fetal‐Neonatal Neuroimaging and Developmental Science Center, Boston Children's HospitalBostonMassachusettsUSA
- Electrical Engineering and Computer ScienceMassachusetts Institute of TechnologyCambridgeMassachusettsUSA
| | - Borjan Gagoski
- Department of RadiologyHarvard Medical SchoolBostonMassachusettsUSA
- Fetal‐Neonatal Neuroimaging and Developmental Science Center, Boston Children's HospitalBostonMassachusettsUSA
| | - Leah Morgan
- Department of Radiology, Massachusetts General HospitalBostonMassachusettsUSA
| | - Paul Wighton
- Department of Radiology, Massachusetts General HospitalBostonMassachusettsUSA
| | - Matthew Dylan Tisdall
- Radiology, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Martin Reuter
- Department of Radiology, Massachusetts General HospitalBostonMassachusettsUSA
- Department of RadiologyHarvard Medical SchoolBostonMassachusettsUSA
- German Center for Neurodegenerative DiseasesBonnGermany
| | - Elfar Adalsteinsson
- Electrical Engineering and Computer ScienceMassachusetts Institute of TechnologyCambridgeMassachusettsUSA
- Institute for Medical Engineering and ScienceMassachusetts Institute of TechnologyCambridgeMassachusettsUSA
| | - Patricia Ellen Grant
- Department of RadiologyHarvard Medical SchoolBostonMassachusettsUSA
- Fetal‐Neonatal Neuroimaging and Developmental Science Center, Boston Children's HospitalBostonMassachusettsUSA
| | - Lawrence L. Wald
- Department of Radiology, Massachusetts General HospitalBostonMassachusettsUSA
- Department of RadiologyHarvard Medical SchoolBostonMassachusettsUSA
| | - André J. W. van der Kouwe
- Department of Radiology, Massachusetts General HospitalBostonMassachusettsUSA
- Department of RadiologyHarvard Medical SchoolBostonMassachusettsUSA
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14
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Magnetic resonance imaging evaluation of foetal intracranial haemorrhage and the correlation with ultrasound findings and postnatal outcomes. Arch Gynecol Obstet 2021; 305:877-884. [PMID: 34459969 DOI: 10.1007/s00404-021-06210-8] [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: 02/08/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The aim of the study was to compare the magnetic resonance imaging (MRI) findings of intracranial haemorrhage (ICH) in the middle- and late trimesters and to explore the relationship between the MRI features of foetal ICH and postnatal outcomes. METHODS This was a retrospective study which recruited foetal ICH diagnosed by MRI in one tertiary centre from 2015 to 2019. The prenatal and postnatal medical records were reviewed. RESULTS Of 39 ICH cases, 82.1% (32) had germinal matrix intraventricular haemorrhage (GM-IVH), and 18.9% (7) were diagnosed with non-GM-IVH. The cerebellum, corpus callosum and subdural space were affected in 5, 1 and 1 non-GM-IVH cases, respectively. MRI confirmed possible ICH on sonogram in 10 cases (35.7%) and the remaining 19 added ICH diagnoses that were not obtained on initial ultrasound imaging. Pregnancy outcome data were available in 82.1% of (32) cases, of which 21 were terminated pregnancies, 1 was foetal demise and 10 were delivered. One neonate died after birth and one infant suffered from hearing loss. The remaining eight patients had favourable outcome. CONCLUSION In our study, evaluation of the relationship between MRI findings and outcomes remains challenging, depending on the timing of examination and the hematoma itself. MRI was an adjunct to US in diagnosing ICH in utero which helps to assess postnatal development.
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15
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Yetisir F, Abaci Turk E, Guerin B, Gagoski BA, Grant PE, Adalsteinsson E, Wald LL. Safety and imaging performance of two-channel RF shimming for fetal MRI at 3T. Magn Reson Med 2021; 86:2810-2821. [PMID: 34240759 DOI: 10.1002/mrm.28895] [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: 04/23/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 11/07/2022]
Abstract
PURPOSE This study investigates whether two-channel radiofrequency (RF) shimming can improve imaging without increasing specific absorption rate (SAR) for fetal MRI at 3T. METHODS Transmit field ( B 1 + ) average and variation in the fetus was simulated in seven numerical pregnant body models. Safety was quantified by maternal and fetal peak local SAR and fetal average SAR. The shim parameter space was divided into improved B 1 + (magnitude and homogeneity) and improved SAR regions, and an overlap where RF shimming improved both classes of metrics compared with birdcage mode was assessed. Additionally, the effect of fetal position, tissue detail, and dielectric properties on transmit field and SAR was studied. RESULTS A region of subject-specific RF shim parameter space improving both B 1 + and SAR metrics was found for five of the seven models. Optimizing only B 1 + metrics improved B 1 + efficiency across models by 15% on average and 28% for the best-case model. B 1 + variation improved by 26% on average and 49% for the best case. However, for these shim settings, fetal SAR increased by up to 106%. The overlap region, where both B 1 + and SAR metrics improve, showed an average B 1 + efficiency improvement of 6% on average across models and 19% for the best-case model. B 1 + variation improved by 13% on average and 40% for the best case. RFS could also decrease maternal/fetal SAR by up to 49%/58%. CONCLUSION RF shimming can improve imaging compared with birdcage mode without increasing fetal and maternal SAR when a patient-specific SAR model is incorporated into the shimming procedure.
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Affiliation(s)
- Filiz Yetisir
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Esra Abaci Turk
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Bastien Guerin
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Borjan A Gagoski
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - P Ellen Grant
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Elfar Adalsteinsson
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, USA
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Lawrence L Wald
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, USA
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16
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Davidson JR, Uus A, Matthew J, Egloff AM, Deprez M, Yardley I, De Coppi P, David A, Carmichael J, Rutherford MA. Fetal body MRI and its application to fetal and neonatal treatment: an illustrative review. THE LANCET. CHILD & ADOLESCENT HEALTH 2021; 5:447-458. [PMID: 33721554 PMCID: PMC7614154 DOI: 10.1016/s2352-4642(20)30313-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/28/2020] [Accepted: 09/08/2020] [Indexed: 12/14/2022]
Abstract
This Review depicts the evolving role of MRI in the diagnosis and prognostication of anomalies of the fetal body, here including head and neck, thorax, abdomen and spine. A review of the current literature on the latest developments in antenatal imaging for diagnosis and prognostication of congenital anomalies is coupled with illustrative cases in true radiological planes with viewable three-dimensional video models that show the potential of post-acquisition reconstruction protocols. We discuss the benefits and limitations of fetal MRI, from anomaly detection, to classification and prognostication, and defines the role of imaging in the decision to proceed to fetal intervention, across the breadth of included conditions. We also consider the current capabilities of ultrasound and explore how MRI and ultrasound can complement each other in the future of fetal imaging.
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Affiliation(s)
- Joseph R Davidson
- Prenatal Cell and Gene Therapy, Elizabeth Garrett Anderson Institute of Women's Health, University College London, London, UK; UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
| | - Alena Uus
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Jacqueline Matthew
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Alexia M Egloff
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Maria Deprez
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Iain Yardley
- Paediatric Surgery, Evelina London Children's Hospital, London, UK
| | - Paolo De Coppi
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children, London, UK; Katholieke Universiteit Leuven, Leuven, Belgium
| | - Anna David
- Prenatal Cell and Gene Therapy, Elizabeth Garrett Anderson Institute of Women's Health, University College London, London, UK; Fetal Medicine Unit, University College London, London, UK
| | - Jim Carmichael
- Paediatric Radiology, Evelina London Children's Hospital, London, UK
| | - Mary A Rutherford
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
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17
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Mormina E, Granata F, Vinci SL, Coglitore A, Caragliano AA, Agostino T, Longo M, Visalli C. Imaging and clinical features of neurocutaneous melanosis in the pediatric population. Curr Med Imaging 2021; 17:1391-1402. [PMID: 34047260 DOI: 10.2174/1573405617666210527091109] [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: 10/12/2020] [Revised: 01/16/2021] [Accepted: 02/12/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Neurocutaneous melanosis (NCM) is a rare nonfamilial phakomatosis characterized by the presence of congenital melanocytic nevi and abnormal melanocytes infiltration of the leptomeninges. OBJECTIVE & METHODS This paper shows the importance of early diagnosis and the most important imaging features of the disease on CT and MR scans. PubMed database was searched from January 1972 to September 2020. Papers including imaging findings of NCM, clinical, follow-up, and treatment features were collected, selecting only 89 studies. DISCUSSION NCM is a term used for the first time by van Bogaert in 1948. It refers to a condition caused by an error during morphogenesis and migration leading to leptomeningeal melanocytic accumulation. Although histological findings are the gold standard for diagnosis confirmation, neuroimaging and clinical features strongly support the suspect of NCM. Localization and extension of the lesions are predictive of neurological manifestations related to increased intracranial pressure, mass lesions, or spinal cord compression. CT demonstrates sites of increased density in the anterior temporal lobe - mainly the amygdala - thalami, cerebellum, and frontal lobes base. However, MRI is the best imaging method to diagnose central nervous system lesions, often appearing as T1-short signal areas of the cerebral parenchyma, indicative of central nervous system melanosis. MRI can also reveal associated intracranial and intraspinal abnormalities. CONCLUSION Early imaging, when available, is helpful if NCM suspect is raised and may be of guidance in comparing later studies. NCM requires a multidisciplinary approach since it is a multisystem disease with a genetic component.
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Affiliation(s)
- Enricomaria Mormina
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Italy
| | - Francesca Granata
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Italy
| | - Sergio Lucio Vinci
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Italy
| | - Alessandra Coglitore
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Italy
| | - Antonio Armando Caragliano
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Italy
| | - Tessitore Agostino
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Italy
| | - Marcello Longo
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Italy
| | - Carmela Visalli
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Italy
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18
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Singh G, Kaur H, Sharma A, Singh J, Alajangi HK, Kumar S, Singla N, Kaur IP, Barnwal RP. Carbon Based Nanodots in Early Diagnosis of Cancer. Front Chem 2021; 9:669169. [PMID: 34109155 PMCID: PMC8181141 DOI: 10.3389/fchem.2021.669169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/10/2021] [Indexed: 12/20/2022] Open
Abstract
Detection of cancer at an early stage is one of the principal factors associated with successful treatment outcome. However, current diagnostic methods are not capable of making sensitive and robust cancer diagnosis. Nanotechnology based products exhibit unique physical, optical and electrical properties that can be useful in diagnosis. These nanotech-enabled diagnostic representatives have proved to be generally more capable and consistent; as they selectively accumulated in the tumor site due to their miniscule size. This article rotates around the conventional imaging techniques, the use of carbon based nanodots viz Carbon Quantum Dots (CQDs), Graphene Quantum Dots (GQDs), Nanodiamonds, Fullerene, and Carbon Nanotubes that have been synthesized in recent years, along with the discovery of a wide range of biomarkers to identify cancer at early stage. Early detection of cancer using nanoconstructs is anticipated to be a distinct reality in the coming years.
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Affiliation(s)
- Gurpal Singh
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
| | - Harinder Kaur
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
| | - Akanksha Sharma
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
- Department of Biophysics, Panjab University, Chandigarh, India
| | - Joga Singh
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
| | | | - Santosh Kumar
- Department of Biotechnology, Panjab University, Chandigarh, India
| | - Neha Singla
- Department of Biophysics, Panjab University, Chandigarh, India
| | - Indu Pal Kaur
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
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19
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Moura LM, Ferreira VLDR, Loureiro RM, de Paiva JPQ, Rosa-Ribeiro R, Amaro E, Soares MBP, Machado BS. The Neurobiology of Zika Virus: New Models, New Challenges. Front Neurosci 2021; 15:654078. [PMID: 33897363 PMCID: PMC8059436 DOI: 10.3389/fnins.2021.654078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/08/2021] [Indexed: 12/21/2022] Open
Abstract
The Zika virus (ZIKV) attracted attention due to one striking characteristic: the ability to cross the placental barrier and infect the fetus, possibly causing severe neurodevelopmental disruptions included in the Congenital Zika Syndrome (CZS). Few years after the epidemic, the CZS incidence has begun to decline. However, how ZIKV causes a diversity of outcomes is far from being understood. This is probably driven by a chain of complex events that relies on the interaction between ZIKV and environmental and physiological variables. In this review, we address open questions that might lead to an ill-defined diagnosis of CZS. This inaccuracy underestimates a large spectrum of apparent normocephalic cases that remain underdiagnosed, comprising several subtle brain abnormalities frequently masked by a normal head circumference. Therefore, new models using neuroimaging and artificial intelligence are needed to improve our understanding of the neurobiology of ZIKV and its true impact in neurodevelopment.
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Affiliation(s)
| | | | | | | | | | - Edson Amaro
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Milena Botelho Pereira Soares
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (IGM-FIOCRUZ), Bahia, Brazil.,University Center SENAI CIMATEC, SENAI Institute of Innovation (ISI) in Advanced Health Systems (CIMATEC ISI SAS), National Service of Industrial Learning - SENAI, Bahia, Brazil
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20
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Frisova V, Cojocaru L, Turan S. A new two-dimensional sonographic approach to the assessment of the fetal hard and soft palates. JOURNAL OF CLINICAL ULTRASOUND : JCU 2021; 49:8-11. [PMID: 32989822 DOI: 10.1002/jcu.22928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/15/2020] [Accepted: 09/07/2020] [Indexed: 06/11/2023]
Abstract
Facial clefts are among the most common congenital defects. Ultrasound (US) imaging of secondary fetal palate, especially the detection of isolated defects, remains challenging. Currently described two-dimensional (2D) and three-dimensional methods are technically demanding and impractical for application during routine fetal anatomy evaluation. As an adjunct method, magnetic resonance imaging can provide additional information but has its limitations. We present a novel 2D US approach using axial and sagittal planes to evaluate the fetal palate and demonstrate the main differences between an intact palate, isolated cleft palate, and a cleft lip with cleft palate.
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Affiliation(s)
- Veronika Frisova
- Profema-Fetal Medicine Centre, Prague, Czech Republic
- Department of Obstetrics and Gynaecology, Faculty Hospital, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Liviu Cojocaru
- Department of Obstetrics, Gynaecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Shifa Turan
- Department of Obstetrics, Gynaecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
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21
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Barrera CA, Victoria T, Escobar FA, Krishnamurthy G, Smith CL, Moldenhauer JS, Biko DM. Imaging of fetal lymphangiectasias: prenatal and postnatal imaging findings. Pediatr Radiol 2020; 50:1872-1880. [PMID: 33252755 DOI: 10.1007/s00247-020-04673-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/25/2020] [Accepted: 03/31/2020] [Indexed: 12/22/2022]
Abstract
Lymphangiectasias are lymphatic malformations characterized by the abnormal dilation and morphology of the lymphatic channels. The classification and treatment of these disorders can be challenging given the limited amount of literature available in children. Various imaging modalities are used to confirm suspected diagnosis, plan the most appropriate treatment, and estimate a prognosis. Prenatal evaluation is performed using both prenatal US imaging and fetal MRI. These modalities are paramount for appropriate parental counseling and planning of perinatal care. During the neonatal period, chest US imaging is a useful modality to evaluate pulmonary lymphangiectasia because other modalities such as conventional radiography and CT display nonspecific findings. Finally, the recent breakthroughs in lymphatic imaging with MRI have allowed us to better classify lymphatic disorders. Dynamic contrast-enhanced lymphangiography, conventional lymphangiography and percutaneous lymphatic procedures offer static and dynamic evaluation of the central conducting lymphatics in children, with excellent spatial resolution and the possibility to provide treatment. The purpose of this review is to discuss the normal and abnormal development of the fetal lymphatic system and how to best depict it by imaging during the prenatal and postnatal life.
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Affiliation(s)
- Christian A Barrera
- Department of Radiology, Children's Hospital of Philadelphia,, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.
| | - Teresa Victoria
- Department of Radiology, Children's Hospital of Philadelphia,, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Fernando A Escobar
- Department of Radiology, Section of Interventional Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ganesh Krishnamurthy
- Department of Radiology, Section of Interventional Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Christopher L Smith
- Division of Cardiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Julie S Moldenhauer
- Center for Fetal Diagnosis and Treatment,, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Surgery, Perelman School of Medicine,, University of Pennsylvania, Philadelphia, PA, USA
| | - David M Biko
- Department of Radiology, Children's Hospital of Philadelphia,, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
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Jiao J, Namburete AIL, Papageorghiou AT, Noble JA. Self-Supervised Ultrasound to MRI Fetal Brain Image Synthesis. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:4413-4424. [PMID: 32833630 DOI: 10.1109/tmi.2020.3018560] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Fetal brain magnetic resonance imaging (MRI) offers exquisite images of the developing brain but is not suitable for second-trimester anomaly screening, for which ultrasound (US) is employed. Although expert sonographers are adept at reading US images, MR images which closely resemble anatomical images are much easier for non-experts to interpret. Thus in this article we propose to generate MR-like images directly from clinical US images. In medical image analysis such a capability is potentially useful as well, for instance for automatic US-MRI registration and fusion. The proposed model is end-to-end trainable and self-supervised without any external annotations. Specifically, based on an assumption that the US and MRI data share a similar anatomical latent space, we first utilise a network to extract the shared latent features, which are then used for MRI synthesis. Since paired data is unavailable for our study (and rare in practice), pixel-level constraints are infeasible to apply. We instead propose to enforce the distributions to be statistically indistinguishable, by adversarial learning in both the image domain and feature space. To regularise the anatomical structures between US and MRI during synthesis, we further propose an adversarial structural constraint. A new cross-modal attention technique is proposed to utilise non-local spatial information, by encouraging multi-modal knowledge fusion and propagation. We extend the approach to consider the case where 3D auxiliary information (e.g., 3D neighbours and a 3D location index) from volumetric data is also available, and show that this improves image synthesis. The proposed approach is evaluated quantitatively and qualitatively with comparison to real fetal MR images and other approaches to synthesis, demonstrating its feasibility of synthesising realistic MR images.
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23
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Zhang Q, Bao ZK, Deng MX, Xu Q, Ding DD, Pan MM, Xi X, Wang FF, Zou Y, Qu F. Fetal growth, fetal development, and placental features in women with polycystic ovary syndrome: analysis based on fetal and placental magnetic resonance imaging. J Zhejiang Univ Sci B 2020; 21:977-989. [PMID: 33843163 PMCID: PMC7759450 DOI: 10.1631/jzus.b2000350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 09/09/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS), a common endocrine-metabolic dysfunction in reproductive-aged women, may be involved in compromised pregnancy and offspring outcomes. This study aimed to investigate whether maternal PCOS affects fetal growth, fetal development, and placental features. METHODS This retrospective case-control study included 60 pregnant women with PCOS (PCOS group) and 120 healthy pregnant women without PCOS (control group). Fetal magnetic resonance imaging (MRI) was performed followed by an ultrasound examination and indications for imaging, including known or suspected fetal pathology, history of fetal abnormality in previous pregnancy or in a family member, and concern for placenta accreta. Fetal MRI images were analyzed for head circumference (HC), abdomen circumference (AC), lung-to-liver signal intensity ratio (LLSIR, a prenatal marker of fetal lung maturity), lengths of liver and kidney diameters in fetuses, and placental relative signal intensity on T2-weighted single-shot fast spin echo (SSFSE) imaging (rSISSFSE), and placental relative apparent diffusion coefficient value (rADC). Data on height and weight of offspring were collected through telephone follow-up. RESULTS Compared to the control group, the PCOS group showed the following characteristics: (1) smaller biparietal diameter and femur length in fetuses (P=0.026 and P=0.005, respectively), (2) smaller HC in fetuses (evident after 32 weeks; P=0.044), (3) lower LLSIR and smaller dorsoventral length of liver in fetuses (evident before 32 weeks; P=0.005 and P=0.019, respectively), and (4) smaller placental thickness (evident before 32 weeks; P=0.017). No significant differences in placental rSISSFSE or rADC were observed between the groups (all P>0.05). No significant differences in height and weight of offspring during childhood existed between the groups (all P>0.05). CONCLUSIONS There exist alterations of fetal growth, fetal development, and placental features from women with PCOS.
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Affiliation(s)
- Qing Zhang
- School of Obstetrics and Gynecology, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Zhong-kun Bao
- Department of Radiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Mei-xiang Deng
- Department of Radiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Qiong Xu
- Department of Radiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Dan-dan Ding
- Department of Radiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Man-man Pan
- School of Obstetrics and Gynecology, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Xi Xi
- School of Obstetrics and Gynecology, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Fang-fang Wang
- Department of Chinese Integrative Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Yu Zou
- Department of Radiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Fan Qu
- Department of Chinese Integrative Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
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24
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Douglas Wilson R, Van Mieghem T, Langlois S, Church P. Guideline No. 410: Prevention, Screening, Diagnosis, and Pregnancy Management for Fetal Neural Tube Defects. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 43:124-139.e8. [PMID: 33212246 DOI: 10.1016/j.jogc.2020.11.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This revised guideline is intended to provide an update on the genetic aspects, prevention, screening, diagnosis, and management of fetal neural tube defects. TARGET POPULATION Women who are pregnant or may become pregnant. Neural tube defect screening should be offered to all pregnant women. OPTIONS For prevention: a folate-rich diet, and folic acid and vitamin B12 supplementation, with dosage depending on risk level. For screening: second-trimester anatomical sonography; first-trimester sonographic screening; maternal serum alpha fetoprotein; prenatal magnetic resonance imaging. For genetic testing: diagnostic amniocentesis with chromosomal microarray and amniotic fluid alpha fetoprotein and acetylcholinesterase; fetal exome sequencing. For pregnancy management: prenatal surgical repair; postnatal surgical repair; pregnancy termination with autopsy. For subsequent pregnancies: prevention and screening options and counselling. OUTCOMES The research on and implementation of fetal surgery for prenatally diagnosed myelomeningocele has added a significant treatment option to the previous options (postnatal repair or pregnancy termination), but this new option carries an increased risk of maternal morbidity. Significant improvements in health and quality of life, both for the mother and the infant, have been shown to result from the prevention, screening, diagnosis, and treatment of fetal neural tube defects. BENEFITS, HARMS, AND COSTS The benefits for patient autonomy and decision-making are provided in the guideline. Harms include an unexpected fetal diagnosis and the subsequent management decisions. Harm can also result if the patient declines routine sonographic scans or if counselling and access to care for neural tube defects are delayed. Cost analysis (personal, family, health care) is not within the scope of this clinical practice guideline. EVIDENCE A directed and focused literature review was conducted using the search terms spina bifida, neural tube defect, myelomeningocele, prenatal diagnosis, fetal surgery, neural tube defect prevention, neural tube defect screening, neural tube defect diagnosis, and neural tube defect management in order to update and revise this guideline. A peer review process was used for content validation and clarity, with appropriate ethical considerations. VALIDATION METHODS The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations). INTENDED AUDIENCE Maternity care professionals who provide any part of pre-conception, antenatal, delivery, and neonatal care. This guideline is also appropriate for patient education. RECOMMENDATIONS (GRADE RATINGS IN PARENTHESES).
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25
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Douglas Wilson R, Van Mieghem T, Langlois S, Church P. Directive clinique n o 410 : Anomalies du tube neural : Prévention, dépistage, diagnostic et prise en charge de la grossesse. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 43:140-157.e8. [PMID: 33212245 DOI: 10.1016/j.jogc.2020.11.002] [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: 01/13/2023]
Abstract
OBJECTIF La présente directive clinique révisée vise à fournir une mise à jour sur les aspects génétiques, la prévention, le dépistage, le diagnostic et la prise en charge des anomalies du tube neural. POPULATION CIBLE Les femmes enceintes ou qui pourraient le devenir. Il convient d'offrir le dépistage des anomalies du tube neural à toutes les femmes enceintes. OPTIONS Pour la prévention : un régime alimentaire riche en acide folique et des suppléments d'acide folique et de vitamine B12 selon une posologie d'après le niveau de risque. Pour le dépistage : l'échographie obstétricale du deuxième trimestre, le dépistage échographique du premier trimestre, le dosage de l'alphafœtoprotéine sérique maternelle et l'imagerie par résonance magnétique prénatale. Pour les tests génétiques : l'amniocentèse diagnostique avec analyse chromosomique sur micropuce et le dosage de l'alphafœtoprotéine et de l'acétylcholinestérase dans le liquide amniotique et le séquençage de l'exome fœtal. Pour la prise en charge de la grossesse : la réparation chirurgicale prénatale, la réparation chirurgicale postnatale et l'interruption de grossesse avec autopsie. Pour les grossesses subséquentes : les options de prévention et de dépistage et les conseils. RéSULTATS: La recherche et la mise en œuvre du traitement chirurgical fœtal en cas de diagnostic prénatal de myéloméningocèle ont ajouté une option thérapeutique fœtale importante aux options précédentes (réparation postnatale ou interruption de grossesse), mais cette nouvelle option comporte un risque accru de morbidité maternelle. La prévention, le dépistage, le diagnostic et le traitement des anomalies du tube neural se révèlent entraîner des améliorations importantes à la mère et au nourrisson en matière de santé et de qualité de vie. BéNéFICES, RISQUES ET COûTS: Le type et l'ampleur des bénéfices, risques et coûts attendus pour les patientes grâce à la mise en œuvre de la présente directive clinique par un établissement de soins de santé intègrent un canal maternel préconception et prénatal adéquat comprenant l'accès des patientes aux soins, les conseils, les analyses et examens, l'imagerie, le diagnostic et l'interprétation. Les bénéfices relatifs à l'autonomie de la patiente et au processus décisionnel sont énoncés dans la présente directive clinique. Les risques comprennent un diagnostic fœtal inattendu et les décisions de prise en charge subséquentes. Le fait que la patiente refuse les échographies habituelles et le retard du conseil ou d'accès aux soins en cas d'anomalie du tube neural comportent également des risques. L'analyse des coûts (personnels, familiaux, santé publique) ne fait pas partie de la portée de la présente directive clinique. DONNéES PROBANTES: Afin de mettre à jour et réviser la présente directive, une revue de la littérature ciblée et dirigée a été effectuée à l'aide des termes de recherche suivants : spina bifida, neural tube defect, myelomeningocele, prenatal diagnosis, fetal surgery, neural tube defect prevention, neural tube defect screening, neural tube defect diagnosis et neural tube defect management. Un processus d'examen par les pairs a été utilisé pour la validation et la clarté du contenu, avec des considérations appropriées d'ordre éthique. MéTHODES DE VALIDATION: Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant l'approche d'évaluation, de développement et d'évaluation (GRADE). Consulter l'annexe A en ligne (le tableau A1 pour les définitions et le tableau A2 pour les interprétations des recommandations fortes et faibles). PROFESSIONNELS CONCERNéS: Professionnels des soins de maternité qui offrent des soins préconception, prénataux, obstétricaux ou néonataux. La présente directive clinique convient également aux fins d'éducation des patientes. RECOMMANDATIONS (CLASSEMENT GRADE ENTRE PARENTHèSES).
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26
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Malinger G, Birnbam R, Haratz KK. Dedicated neurosonography for recognition of pathology associated with mild-to-moderate ventriculomegaly. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 56:319-323. [PMID: 32870586 DOI: 10.1002/uog.22155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Affiliation(s)
- G Malinger
- Fetal Neurology Clinic, Division of Ultrasound in Obstetrics and Gynecology, Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Birnbam
- Fetal Neurology Clinic, Division of Ultrasound in Obstetrics and Gynecology, Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - K K Haratz
- Fetal Neurology Clinic, Division of Ultrasound in Obstetrics and Gynecology, Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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27
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Chalouhi GE, Millischer AÉ, Mahallati H, Siauve N, Melbourne A, Grevent D, Vinit N, Heidet L, Aigrain Y, Ville Y, Blanc T, Salomon LJ. The use of fetal MRI for renal and urogenital tract anomalies. Prenat Diagn 2019; 40:100-109. [PMID: 31736096 DOI: 10.1002/pd.5610] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 12/20/2022]
Abstract
Fetal anomalies are detected in approximately 2% of all fetuses and, among these, genitourinary tract abnormalities account for 30% to 50% of all structural anomalies present at birth. Although ultrasound remains the first line diagnostic modality, fetal MRI provides important additional structural and functional information, especially with the development of faster sequences and the use of functional sequences. The added value of MRI-based imaging is three-fold: (a) improvement of diagnostic accuracy by adequate morphological examination, (b) detection of additional anomalies, and (c) in addition, MRI has the potential to provide information regarding renal function. In this review, we describe the role of fetal MRI in the anatomical evaluation of renal and urogenital tract anomalies, and we also touch upon the contribution of functional MRI to the diagnostic workup of these conditions.
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Affiliation(s)
- Gihad E Chalouhi
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Division of Fetal Medicine, Department of Obstetrics and Gynecology, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon.,Université de Paris, Paris, France
| | - Anne-Élodie Millischer
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France
| | - Houman Mahallati
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Department of Radiology, University of Calgary, Calgary, Canada
| | - Nathalie Siauve
- Imagerie Médicale, Hôpital Louis Mourier APHP, Colombes, France
| | - Andrew Melbourne
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - David Grevent
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France
| | - Nicolas Vinit
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Department of Pediatric Surgery and Urology, Paris, France
| | - Laurence Heidet
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Paris, France.,Pediatric Nephrology Department, Hôpital Universitaire Necker-Enfants Malades, Sorbonne Paris Cité University, Paris, France
| | - Yves Aigrain
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Department of Pediatric Surgery and Urology, Paris, France
| | - Yves Ville
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France
| | - Thomas Blanc
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Department of Pediatric Surgery and Urology, Paris, France.,INSERM U1151-CNRS UMR 8253, Université de Paris, Institut Necker-Enfants Malades, Paris, France.,Université de Paris, Paris, France
| | - Laurent J Salomon
- Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes and Fetus & LUMIERE team, Paris, France.,Université de Paris, Paris, France
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28
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Zemet R, Amdur-Zilberfarb I, Shapira M, Ziv-Baran T, Hoffmann C, Kassif E, Katorza E. Prenatal diagnosis of congenital head, face, and neck malformations-Is complementary fetal MRI of value? Prenat Diagn 2019; 40:142-150. [PMID: 31664716 DOI: 10.1002/pd.5593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/30/2019] [Accepted: 10/11/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the role of fetal magnetic resonance imaging (MRI) as a complement to ultrasound (US) in the prenatal diagnosis of craniofacial anomalies. METHODS A historical cohort study including all pregnant women who were referred for fetal MRI because of antenatal diagnosis of craniofacial anomalies on screening US. Prenatal diagnostic US, MRI, and postnatal diagnosis were compared for consistencies and discrepancies. RESULTS Forty-five pregnant women with 73 suspected fetal craniofacial anomalies diagnosed by US underwent MRI. In 40 out of 73 anomalies (54.8%), US and MRI findings were in complete agreement with postnatal diagnoses. MRI correctly ruled out the diagnosis of 24 anomalies suspected on US and diagnosed four additional pathologies that were not demonstrated by US. Out of the 85 anomalies (suspected by imaging or confirmed postnatally), confident diagnosis could be made by MRI in 68 anomalies (80%), not diagnosed in 10 (11.8%), and over-diagnosed in seven (8.2%). By US, confident diagnosis could be made in 44 anomalies (51.8%), not diagnosed in 11 (12.9%), and over-diagnosed in 30 (35.3%). CONCLUSION MRI is valuable in the antenatal evaluation of fetal craniofacial anomalies and may be useful as an adjunct to US in the prenatal work-up of craniofacial anomalies.
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Affiliation(s)
- Roni Zemet
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Moran Shapira
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tomer Ziv-Baran
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Chen Hoffmann
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Diagnostic Radiology, Sheba Medical Center, Ramat Gan, Israel
| | - Eran Kassif
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eldad Katorza
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Millischer AE, Brasseur-Daudruy M, Mahallati H, Salomon LJ. The use of image fusion in prenatal medicine. Prenat Diagn 2019; 40:18-27. [PMID: 31508835 DOI: 10.1002/pd.5558] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/21/2019] [Accepted: 07/28/2019] [Indexed: 12/27/2022]
Abstract
Fusion imaging (FI), the simultaneous display of the same anatomical region using two imaging modalities, has been used in other areas of medicine for both diagnosis and guiding interventions. Examples include positron emission tomography-computed tomography (PET-CT) imaging in oncology and ultrasound-magnetic resonance imaging (US-MRI) fusion in biopsies of the prostate gland. The underlying principle is to take advantage of the complementary information in each modality to improve accuracy, be it diagnostic accuracy or targeting accuracy in biopsies. For example, PET-CT overlays the metabolic activity of lesions on the superb spatial and anatomical detail of CT. While the historical mainstay of fetal imaging has been ultrasound, advances in ultrafast MR imaging together with advances in fetal MRI over the past two decades, have resulted in the opportunity to explore fusion imaging in fetal medicine. We present an overview of the principles of US-MRI fusion imaging in prenatal medicine, report our local experience, and review the literature in this emerging area. We share our perspective on how FI can improve diagnostic confidence, be used as an educational tool, and potentially enhance guidance in certain fetal procedures.
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Affiliation(s)
- Anne-Elodie Millischer
- Hôpital Necker-Enfants Malades, AP-HP, Université Paris Descartes and Fetus and LUMIERE team, Imagine Institute, Paris, France
| | | | - Houman Mahallati
- Hôpital Necker-Enfants Malades, AP-HP, Université Paris Descartes and Fetus and LUMIERE team, Imagine Institute, Paris, France
| | - Laurent J Salomon
- Hôpital Necker-Enfants Malades, AP-HP, Université Paris Descartes and Fetus and LUMIERE team, Imagine Institute, Paris, France
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Shulman M, Cho E, Aasi B, Cheng J, Nithiyanantham S, Waddell N, Sussman D. Quantitative analysis of fetal magnetic resonance phantoms and recommendations for an anthropomorphic motion phantom. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2019; 33:257-272. [PMID: 31487004 DOI: 10.1007/s10334-019-00775-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/08/2019] [Accepted: 08/27/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To provide a review and quantitative analysis of the available fetal MR imaging phantoms. MATERIALS AND METHODS A literature search was conducted across Pubmed, Google Scholar, and Ryerson University Library databases to identify fetal MR imaging phantoms. Phantoms were graded on a semi-quantitative scale in regards to four evaluation categories: (1) anatomical accuracy in size and shape, (2) dielectric conductivity similar to the simulated tissue, (3) relaxation times similar to simulated tissue, and (4) physiological motion similar to fetal gross body, cardiovascular, and breathing motion. This was followed by statistical analysis to identify significant findings. RESULTS Seventeen fetal phantoms were identified and had an average overall percentage accuracy of 26%, with anatomical accuracy being satisfied the most (56%) and physiological motion the least (7%). Phantoms constructed using 3D printing were significantly more accurate than conventionally constructed phantoms. DISCUSSION Currently available fetal phantoms lack accuracy and motion simulation. 3D printing may lead to higher accuracy compared with traditional manufacturing. Future research needs to focus on properly simulating both fetal anatomy and physiological motion to produce a phantom that is appropriate for fetal MRI sequence development and optimization.
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Affiliation(s)
- Michael Shulman
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada
| | - Eunyoung Cho
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada
| | - Bipin Aasi
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada
| | - Jin Cheng
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada
| | - Saiee Nithiyanantham
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada
| | - Nicole Waddell
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada
| | - Dafna Sussman
- Department of Electrical, Computer, and Biomedical Engineering, Ryerson University, Toronto, ON, M5B 2K3, Canada. .,Institute for Biomedical Engineering, Science and Technology (iBEST), Ryerson University and St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada. .,The Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada. .,Department of Biomedical Physics, Ryerson University, Toronto, ON, M5B 2K3, Canada.
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31
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Roy CW, Marini D, Lloyd DFA, Mawad W, Yoo SJ, Schrauben EM, Jaeggi E, Seed M, Macgowan CK. Preliminary Experience Using Motion Compensated CINE Magnetic Resonance Imaging to Visualise Fetal Congenital Heart Disease. Circ Cardiovasc Imaging 2019; 11:e007745. [PMID: 30558501 DOI: 10.1161/circimaging.118.007745] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Recent advances in cardiovascular magnetic resonance (CMR) imaging have facilitated CINE imaging of the fetal heart. In this work, a preliminary investigation of the utility of multislice CINE CMR for assessing fetal congenital heart disease is performed and compared with echocardiography. METHODS AND RESULTS Multislice CINE CMR and echocardiography images were acquired in 25 pregnant women wherein the fetus had a suspected congenital heart defect based on routine obstetric ultrasound. Pathognomonic images were identified for each subject for qualitative comparison of CMR and echocardiography. Quantitative comparison of CMR and echocardiography was then performed by 2 reviewers using a binary scoring of 9 fetal cardiac anatomic features (identifiable/not-identifiable). Pathognomonic images demonstrated the ability of CMR to visualize a variety of congenital heart defects. Overall CMR was able to identify the majority of the 9 assessed fetal cardiac anatomic features (reviewer 1, 7.1±2.1; reviewer 2, 6.7±2.3). Although both reviewers identified more anatomic features with echocardiography (reviewer 1, 7.8±2.3; reviewer 2, 7.5±2.4; P=0.01), combining information from both modalities enabled identification of additional anatomic features across subjects (reviewer 1, 8.4±1.3; reviewer 2, 8.4±1.2). The primary limiting factor for CMR was inadequate coverage of the fetal cardiac anatomy or noncontiguous slices because of gross fetal movement. CONCLUSIONS CINE CMR enables visualization of fetal congenital heart disease. This work demonstrates the potential of CMR for diagnosing congenital heart disease in utero in conjunction with echocardiography during late gestation.
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Affiliation(s)
- Christopher W Roy
- Department of Medical Biophysics, University of Toronto, Canada (C.W.R., C.K.M.).,Division of Translational Medicine (C.W.R., E.M.S., E.J., C.K.M)
| | - Davide Marini
- Division of Pediatric Cardiology, The Hospital for Sick Children, Toronto, Canada (D.M., W.M., S.-J.Y., E.J., M.S.)
| | - David F A Lloyd
- Division of Imaging Sciences and Biomedical Engineering, King's College London, United Kingdom (D.F.A.L.).,Departments of Paediatric and Fetal Cardiology, Evelina Children's Hospital, London, United Kingdom (D.F.A.L.)
| | - Wadi Mawad
- Division of Pediatric Cardiology, The Hospital for Sick Children, Toronto, Canada (D.M., W.M., S.-J.Y., E.J., M.S.)
| | - Shi-Joon Yoo
- Departments of Pediatrics and Diagnostic Imaging, University of Toronto, Canada (S.-J.Y., E.J., M.S.).,Division of Pediatric Cardiology, The Hospital for Sick Children, Toronto, Canada (D.M., W.M., S.-J.Y., E.J., M.S.)
| | - Eric M Schrauben
- Division of Translational Medicine (C.W.R., E.M.S., E.J., C.K.M)
| | - Edgar Jaeggi
- Departments of Pediatrics and Diagnostic Imaging, University of Toronto, Canada (S.-J.Y., E.J., M.S.).,Division of Translational Medicine (C.W.R., E.M.S., E.J., C.K.M).,Division of Pediatric Cardiology, The Hospital for Sick Children, Toronto, Canada (D.M., W.M., S.-J.Y., E.J., M.S.)
| | - Mike Seed
- Departments of Pediatrics and Diagnostic Imaging, University of Toronto, Canada (S.-J.Y., E.J., M.S.).,Division of Pediatric Cardiology, The Hospital for Sick Children, Toronto, Canada (D.M., W.M., S.-J.Y., E.J., M.S.)
| | - Christopher K Macgowan
- Department of Medical Biophysics, University of Toronto, Canada (C.W.R., C.K.M.).,Division of Translational Medicine (C.W.R., E.M.S., E.J., C.K.M)
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Aydın E, Tanacan A, Büyükeren M, Uçkan H, Yurdakök M, Beksaç MS. Congenital central nervous system anomalies: Ten-year single center experience on a challenging issue in perinatal medicine. J Turk Ger Gynecol Assoc 2019; 20:170-177. [PMID: 30115609 PMCID: PMC6751837 DOI: 10.4274/jtgga.galenos.2018.2018.0079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 08/02/2018] [Indexed: 02/06/2023] Open
Abstract
Objective Our goal was to highlight the prenatal diagnosis and management of central nervous system (CNS) anomalies through sharing our clinic’s experience. Material and Methods We evaluated prenatal findings and postnatal outcomes of neonates who had a CNS anomaly diagnosis in our clinic over a ten-year period. A total of 183 cases with various CNS anomalies were included in the study. Birth or termination preferences of mothers were recorded in all cases, and postnatal diagnosis concordance and prognosis after surgical procedures were evaluated in mothers who chose to continue the pregnancy. Results The mean maternal age was 28.2±5.5 years, mean gravida was 2.2±1.3, and the mean gestational age at diagnosis was 30.5±5.5 weeks. Seventy-five out of 183 (41%) patients chose to terminate their pregnancy. Twenty babies (26.6%) in the termination of pregnancy group had additional anomalies. One hundred eight patients gave birth at our institution. The mean birth weight was 3060±647.5 g, the mean gestational week at delivery was 37.9±1.7 weeks, and mean APGAR score (5th minute) was 8.8±2.3. Four neonates died on the postpartum first day. The postnatal diagnosis of 60 of the 108 (55.5%) patients who gave birth was concordant with the prenatal diagnosis, and 32 of the 108 (29.6%) babies underwent surgical interventions. Conclusion CNS anomalies have a broad spectrum and variable prognoses. This study highlights the limitations of prenatal diagnoses, and the need for parents to have this information in order to determine the course of their pregnancy and prepare themselves for the postnatal challenging treatment/rehabilitation process.
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Affiliation(s)
- Emine Aydın
- Clinic of Obstetrics and Gynecology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Melek Büyükeren
- Department of Child Health and Diseases, Neonatology Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hasan Uçkan
- Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Murat Yurdakök
- Department of Child Health and Diseases, Neonatology Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Sinan Beksaç
- Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Style CC, Mehollin-Ray AR, Verla MA, Lau PE, Cruz SM, Espinoza J, Lee TC, Fernandes CJ, Keswani SG, Olutoye OO. Timing of Prenatal Magnetic Resonance Imaging in the Assessment of Congenital Diaphragmatic Hernia. Fetal Diagn Ther 2019; 47:205-213. [PMID: 31416065 DOI: 10.1159/000501556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/18/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Fetal magnetic resonance imaging (MRI) has been used to stratify severity of congenital diaphragmatic hernia (CDH) after ultrasound diagnosis. The purpose of this study was to determine if timing of MRI influenced prediction of severity of outcome in CDH. METHODS A single institution retrospective review of all CDH referred to our institution from February 2004 to May 2017 was performed. Patients were included if they underwent at least 2 fetal MRIs prior to delivery. Prenatal MRI indices including observed-to-expected total fetal lung volume (o/e TFLV) were evaluated. Indices were categorized by trimester, either 2nd (20-27 weeks gestation) or 3rd trimester (>28 weeks gestation) and further analyzed for outcome predictability. Primary outcomes were survival, extracorporeal membrane oxygenation (ECMO), and pulmonary hypertension (PAH). Student t test and logistic and linear regression were used for data analyses. RESULTS Of 256 fetuses evaluated for CDH, 197 were further characterized by MRI with 57 having both an MRI in the 2nd and 3rd trimesters. There was an average of 9.95 weeks (±4.3) between the 1st and 2nd MRI. Second trimester o/e TFLV was the only independent predictor of survival by logistic regression (OR 0.890, p < 0.01). Third trimester MRI derived lung volumes were associated with, and independent predictors of, severity of PAH and need for ECMO. Interval TFLV growth was a strong predictor of PAH postnatally (OR 0.361, p < 0.01). Overall cohort survival was 79%. CONCLUSION Accuracy of MRI lung volumes to predict outcomes is dependent on the -gestational age at the time of exam. While MRI lung volumes at either the 2nd or 3rd trimester are predictive of morbidity, 2nd trimester lung volumes strongly correlated with mortality.
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Affiliation(s)
- Candace C Style
- Texas Children's Fetal Center and The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Amy R Mehollin-Ray
- Texas Children's Fetal Center, Department of Radiology, Baylor College of Medicine, Houston, Texas, USA
| | - Mariatu A Verla
- Texas Children's Fetal Center and The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Patricio E Lau
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Stephanie M Cruz
- Texas Children's Fetal Center and The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Jimmy Espinoza
- Texas Children's Fetal Center, Department of Maternal Fetal Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Timothy C Lee
- Texas Children's Fetal Center and The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Caraciolo J Fernandes
- Texas Children's Fetal Center, Department of Pediatrics, Newborn Section, Baylor College of Medicine, Houston, Texas, USA
| | - Sundeep G Keswani
- Texas Children's Fetal Center and The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Oluyinka O Olutoye
- Texas Children's Fetal Center and The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA,
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Park J, Kim J, Chang Y, Youn SW, Lee HJ, Kang EJ, Lee KN, Suchánek V, Hyun S, Lee J. Analysis of the time-velocity curve in phase-contrast magnetic resonance imaging: a phantom study. Comput Assist Surg (Abingdon) 2019; 24:3-12. [PMID: 31385716 DOI: 10.1080/24699322.2019.1649066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The aim of this study was to analyze the characteristics of time-velocity curve acquired by phase-contrast magnetic resonance imaging (PC-MRI) using an in-vitro flow model as a reference for hemodynamic studies. The time- velocity curves of the PC-MRI were compared with Doppler ultrasonography (US) and also compared with those obtained in the electromagnetic flowmeter. The correlation between techniques was analyzed using an electromagnetic flowmeter as a reference standard; the maximum, minimum, and average velocities, full-width at half-maximum (FWHM), and ascending gradient (AG) were measured from time-velocity curves. The correlations between an electromagnetic flowmeter and the respective measurement technique for the PC-MRI and Doppler US were found to be high (mean R2 > 0.9, p < 0.05). These results indicate that these measurement techniques are useful for measuring blood flow information and reflect actual flow. The PC-MRI was the best fit for the minimum velocity and FWHM, and the maximum velocity and AG were the best fit for Doppler US. The PC-MRI showed lower maximum velocity value and higher minimum velocity value than Doppler US. Therefore, PC-MRI demonstrates more obtuse time-velocity curve than Doppler US. In addition, the time- velocity curve of PC-MRI could be calibrated by introducing formulae that can convert each measurement value to a reference standard value within a 10% error. The PC-MRI can be used to estimate the Doppler US using this formula.
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Affiliation(s)
- Jieun Park
- Department of Biomedical Engineering, Kyungpook National University , Daegu , Republic of Korea
| | - Junghun Kim
- Department of Biomedical Engineering, Kyungpook National University , Daegu , Republic of Korea
| | - Yongmin Chang
- Department of Radiology, Kyungpook National University & Hospital , Daegu , Republic of Korea
| | - Sung Won Youn
- Department of Radiology, Catholic University of Daegu Medical Center , Daegu , Republic of Korea
| | - Hui Joong Lee
- Department of Radiology, Kyungpook National University & Hospital , Daegu , Republic of Korea
| | - Eun-Ju Kang
- Department of Radiology, Dong-A University College of Medicine , Busan , Republic of Korea
| | - Ki-Nam Lee
- Department of Radiology, Dong-A University College of Medicine , Busan , Republic of Korea
| | - Vojtěch Suchánek
- Department of Radiology, Kyungpook National University & Hospital , Daegu , Republic of Korea
| | - Sinjae Hyun
- Department of Biomedical Engineering, Mercer University , Macon , GA , USA
| | - Jongmin Lee
- Department of Radiology, Kyungpook National University & Hospital , Daegu , Republic of Korea
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Gimenez A, Kopkin R, Chang DK, Belfort M, Reece EM. Advances in Fetal Surgery: Current and Future Relevance in Plastic Surgery. Semin Plast Surg 2019; 33:204-212. [PMID: 31384237 DOI: 10.1055/s-0039-1693431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Scarless healing has long been the holy grail for plastic surgery. While historically fetal surgery has tempted plastic surgeons with the allure of scarless correction of congenital abnormalities, the risks far outweighed the benefits and these interventions never materialized. Current advances in fetal surgery with minimally invasive fetoscopic surgery have made these early fetal interventions safer, leading to expanding applications. While the plastic surgeon's role is limited as of yet, this article provides a review of the history of fetal surgery and the advances that may become relevant to the future plastic surgeon.
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Affiliation(s)
- Alejandro Gimenez
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Rachel Kopkin
- School of Medicine, Health Sciences Center, Louisiana State University, New Orleans, Louisiana.,Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
| | - Daniel K Chang
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Michael Belfort
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
| | - Edward M Reece
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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Tian M, Xiao L, Jian N, Wei X, Liu S, Zhao H, Li G, Zhang S, Liang W, Lin N, Lin X. Accurate diagnosis of fetal cleft lip/palate by typical signs of magnetic resonance imaging. Prenat Diagn 2019; 39:883-889. [PMID: 31169321 DOI: 10.1002/pd.5499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/13/2019] [Accepted: 05/26/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aims to evaluate the accuracy of magnetic resonance imaging (MRI) in diagnosing orofacial clefts and proposes specific signs for determining the type of cleft. METHODS Pregnant women in whom fetal facial malformations are suspected by ultrasonography (US) underwent 1.5 T MRI. The accuracy of the prenatal US and MRI diagnosis was compared with the postnatal findings. RESULTS A total of 71 fetuses were included in the final analysis, which comprised of 35 cases of isolated cleft lip, six cases of cleft lip and alveolus, 21 cases of cleft lip and palate, four cases of isolated cleft palate, and five normal fetuses. MRI was more sensitive than US (MRI 100%, US 77.5%; Fisher's exact test: MRI vs US P=0.000). The accuracy of MRI for all types was 100%. Specific signs (Inverted T, L/anti-L, U, and "Notch" signs) were proposed, indicating the normal hard, unilateral cleft, bilateral cleft, and cleft soft palates, respectively, which can facilitate the identification of different types of cleft palates. CONCLUSION MRI can accurately diagnose the type of cleft based on typical signs, which can serve as a definite diagnostic modality and an effective supplement of US.
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Affiliation(s)
- Mimi Tian
- School of Medicine, Shandong University, Jinan, China
| | - Lianxiang Xiao
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Nan Jian
- School of Medicine, Shandong University, Jinan, China.,CT Department, Heze Municipal Hospital, Heze, China
| | - Xinhong Wei
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Shuwei Liu
- Shandong Provincial Key Laboratory of Mental Disorders, Research Center for Sectional and Imaging Anatomy, Shandong University School of Medicine, Jinan, China
| | - Hui Zhao
- Department of Imaging, Shandong Provincial Western Hospital, Jinan, China
| | - Guan Li
- College of Radiology, Taishan Medical University, Tai'an, China
| | - Shuai Zhang
- School of Medicine, Shandong University, Jinan, China
| | - Wenjia Liang
- Shandong Provincial Key Laboratory of Mental Disorders, Research Center for Sectional and Imaging Anatomy, Shandong University School of Medicine, Jinan, China
| | - Nan Lin
- School of Medicine, Shandong University, Jinan, China
| | - Xiangtao Lin
- School of Medicine, Shandong University, Jinan, China.,Department of Radiology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, China
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Tavares de Sousa M, Hecher K, Yamamura J, Kording F, Ruprecht C, Fehrs K, Behzadi C, Adam G, Schoennagel BP. Dynamic fetal cardiac magnetic resonance imaging in four-chamber view using Doppler ultrasound gating in normal fetal heart and in congenital heart disease: comparison with fetal echocardiography. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 53:669-675. [PMID: 30381848 DOI: 10.1002/uog.20167] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/20/2018] [Accepted: 09/20/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To investigate the diagnostic performance of dynamic fetal cardiac magnetic resonance imaging (MRI), using a MR-compatible Doppler ultrasound (DUS) device for fetal cardiac gating, in differentiating fetuses with congenital heart disease from those with a normal heart, and to compare the technique with fetal echocardiography. METHODS This was a prospective study of eight fetuses with a normal heart and four with congenital heart disease (CHD), at a median of 34 (range, 28-36) weeks' gestation. Dynamic fetal cardiac MRI was performed using a DUS device for direct cardiac gating. The four-chamber view was evaluated according to qualitative findings. Measurements of the length of the left and right ventricles, diameter of the tricuspid and mitral valves, myocardial wall thickness, transverse cardiac diameter and left ventricular planimetry were performed. Fetal echocardiography and postnatal diagnoses were considered the reference standards. RESULTS Direct cardiac gating allowed continuous triggering of the fetal heart, showing high temporal and spatial resolution. Both fetal cardiac MRI and echocardiography in the four-chamber view detected pathological findings in three of the 12 fetuses. Qualitative evaluation revealed overall consistency between echocardiography and MRI. On both echocardiography and MRI, quantitative measurements revealed significant differences between fetuses with a normal heart and those with CHD with respect to the length of the right (P < 0.01 for both) and left (P < 0.01 for both) ventricles and transverse cardiac diameter (P < 0.05 and P < 0.01, respectively). Tricuspid valve diameter on cardiac MRI was found to be significantly different in healthy fetuses from in those with CHD (P < 0.05). CONCLUSIONS For the first time, this study has shown that dynamic fetal cardiac MRI in the four-chamber view, using external cardiac gating, allows evaluation of cardiac anatomy and diagnosis of congenital heart disease in agreement with fetal echocardiography. Dynamic fetal cardiac MRI may be useful as a second-line investigation if conditions for fetal echocardiography are unfavorable. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M Tavares de Sousa
- University Medical Center Hamburg-Eppendorf, Department of Obstetrics and Fetal Medicine, Hamburg, Germany
| | - K Hecher
- University Medical Center Hamburg-Eppendorf, Department of Obstetrics and Fetal Medicine, Hamburg, Germany
| | - J Yamamura
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - F Kording
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - C Ruprecht
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - K Fehrs
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - C Behzadi
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - G Adam
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - B P Schoennagel
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
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Fazecas TM, Araujo Júnior E, Werner H, Daltro P, Peixoto AB, Lima GM, Barbosa AD. Applicability of Magnetic Resonance Imaging in the Assessment of Fetal Urinary Tract Malformations. Can Assoc Radiol J 2019; 70:83-95. [PMID: 30691568 DOI: 10.1016/j.carj.2018.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 07/09/2018] [Accepted: 10/20/2018] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To assess the applicability of magnetic resonance imaging (MRI) to complement ultrasound in the diagnosis of fetal urinary tract anomalies. METHODS This was a retrospective cohort study that included 41 women between 19 weeks and 37 weeks and 6 days of gestation carrying fetuses with malformations of the urinary tract which were initially diagnosed by ultrasound and then referred for MRI. In all cases, the diagnosis was confirmed after birth either through imaging or autopsy. A surface coil was positioned over the abdomen and T2-weighted sequences were obtained in the axial, coronal, and sagittal planes; T1 in at least one plane; and three-dimensional (3-D) TRUFI in fetuses with dilatation of the urinary tract. RESULTS Mean gestational age at the time of MRI examination was 28.21 weeks. The rapid T2 sequences allowed all the anomalies of the fetal urinary tract to be assessed, whereas 3-D TRUFI sequencing proved very useful in evaluating anomalies involving dilatation of the urinary tract. The signs of pulmonary hypoplasia characterized by hypointense signal in the T2-weighted sequences were identified in 13 of the 41 fetuses. CONCLUSION MRI confirmed and added information to the ultrasound regarding fetal urinary tract anomalies, as well as information related to the other associated malformations, their progress in the prenatal period, and possible postnatal prognosis.
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Affiliation(s)
- Tatiana Mendonça Fazecas
- Department of Maternal and Child, Fluminense Federal University (UFF), Niteroi, Rio de Janeiro, Brazil; Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI), Rio de Janeiro, Brazil
| | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil.
| | - Heron Werner
- Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI), Rio de Janeiro, Brazil
| | - Pedro Daltro
- Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI), Rio de Janeiro, Brazil
| | - Alberto Borges Peixoto
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Glaucia Macedo Lima
- Department of Maternal and Child, Fluminense Federal University (UFF), Niteroi, Rio de Janeiro, Brazil
| | - Adauto Dutra Barbosa
- Department of Maternal and Child, Fluminense Federal University (UFF), Niteroi, Rio de Janeiro, Brazil
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Grill FD, Behr AV, Rau A, Ritschl LM, Roth M, Bauer FX, Wolff KD, Esser T, Loeffelbein DJ. Prenatal intrauterine maxillary development - An evaluation with three-dimensional ultrasound. J Craniomaxillofac Surg 2019; 47:1077-1082. [PMID: 30885526 DOI: 10.1016/j.jcms.2019.01.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 01/23/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this prospective study was to investigate normal fetal maxillary development with volume ultrasound during the prenatal phase, for a better estimation of maxillary growth processes. METHODS Some 210 3D volumes were obtained in two measurement series from 38 healthy women (gestational age: 19+2 to 31+4 weeks) using a GE Voluson™ E10 ultrasound system. Maxillary length and width were determined in the axial and sagittal planes. Clearly defined, reproducible landmarks were used for measurements. The results were correlated with gestational age and compared with previously reported studies. RESULTS Total maxillary length ranged from 10.30 to 24.75 mm, total maxillary width from 13.65 to 37.30 mm in an observation period during the second trimester, with high reproducibility for all landmarks. All evaluation results showed steep growth with exponential character. Length growth was determined to be more dominant than width growth. Intra-rater correlation was evaluated to be almost perfect (ICC (3) > 0.8). CONCLUSION This study presents measurements of physiological fetal maxillary development. The defined landmarks proved to be representative for further investigations. This study serves as a baseline for a better understanding of fetal maxillary growth processes, and may be useful for standardising detection of malformations or intrauterine growth restrictions.
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Affiliation(s)
- Florian D Grill
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany
| | - Alexandra V Behr
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany.
| | - Andrea Rau
- Department of Oral and Maxillofacial Surgery, Friedrich Alexander Universität Erlangen-Nürnberg, Germany
| | - Lucas M Ritschl
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany
| | - Maximilian Roth
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany
| | - Franz X Bauer
- Institute of Medical and Polymer Engineering, Technische Universität München, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany
| | | | - Denys J Loeffelbein
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany; Helios Klinik München West, Germany
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Biko DM, Johnstone JA, Dori Y, Victoria T, Oliver ER, Itkin M. Recognition of Neonatal Lymphatic Flow Disorder: Fetal MR Findings and Postnatal MR Lymphangiogram Correlation. Acad Radiol 2018; 25:1446-1450. [PMID: 29580790 DOI: 10.1016/j.acra.2018.02.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 02/13/2018] [Accepted: 02/18/2018] [Indexed: 11/18/2022]
Abstract
RATIONALE AND OBJECTIVES This study aimed to describe prenatal and postnatal imaging features and outcomes of neonates with neonatal lymphatic disorders (NLDs). MATERIALS AND METHODS An institutional review board-approved search of the radiology database for patients with NLD identified five patients. Inclusion criteria include prenatal imaging (fetal magnetic resonance [MR] imaging and ultrasound) and postnatal three-dimensional T2 Sampling Perfection with Application optimized Contrasts using different flip angle Evolution (SPACE) and dynamic contrast-enhanced MR lymphangiography within 6 months of life. Chart review was undertaken to evaluate morbidity and mortality. RESULTS Prenatal finding of "nutmeg lung" or fetal pulmonary lymphatic disorder was identified in all five patients on fetal MR imaging, and in four of five patients on fetal ultrasound. Postnatal dynamic contrast-enhanced MR lymphangiography demonstrated abnormal lymphatic flow to the lungs in four of five patients, but absent in the single patient with coexisting hypoplastic left heart syndrome (HLHS). Dermal backflow was seen in one patient, also the only patient with prenatal body wall edema. Three patients with lymphatic flow to the lungs only were classified as neonatal chylothorax. The patient with dermal backflow and perfusion to the lungs was diagnosed with central lymphatic flow disorder (CLFD). The HLHS patient with normal lymphatic perfusion maintained the HLHS diagnosis. Of the five patients, the patient with CLFD and the one with HLHS expired because of respiratory distress. CONCLUSIONS NLDs can be recognized on prenatal and postnatal imaging and may be primary, as in neonatal chylothorax or CLFD, or secondary. In this small series, "nutmeg lung" was present in all patients. Prenatal imaging demonstrates that body wall edema may correlate with postnatal dermal backflow, which, in our small cohort, carried a poor prognosis.
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Affiliation(s)
- David M Biko
- Department of Radiology, Children's Hospital of Philadelphia, 34th and Civic Center Blvd, Philadelphia, PA 190104.
| | | | - Yoav Dori
- Division of Cardiology, Children's Hospital of Philadelphia
| | - Teresa Victoria
- Department of Radiology, Children's Hospital of Philadelphia, 34th and Civic Center Blvd, Philadelphia, PA 190104
| | - Edward R Oliver
- Department of Radiology, Children's Hospital of Philadelphia, 34th and Civic Center Blvd, Philadelphia, PA 190104
| | - Maxim Itkin
- Department of Radiology, Hospital of the University of Pennsylvania, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
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Gunderman PFR, Shea LAG, Gray BW, Brown BP. Fetal MRI in management of complicated meconium ileus: Prenatal and surgical imaging. Prenat Diagn 2018; 38:685-691. [PMID: 29877592 DOI: 10.1002/pd.5296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 05/08/2018] [Accepted: 05/28/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To review fetal MRI cases surgically proven to have meconium ileus (MI) and obstruction, describe the common fetal MRI findings that distinguish cases of complicated MI, and to compare these findings with surgical images and perinatal outcomes. METHOD We performed a retrospective review of all fetal MRI examinations and the corresponding medical record from our tertiary care children's hospital over an 18-month period. Postnatal management and outcomes were reviewed for these patients, and those patients with surgical or postmortem diagnosis of complicated MI were included in the study. RESULTS Our analysis revealed 7 cases. In this cohort, 3 imaging features of the fetal bowel were repeatedly seen: gradient appearance of intraluminal bowel contents, abnormally localized meconium signal, and collapsed appearance of the colon on MRI. Surgical diagnoses confirmed MI. All live-born infants underwent surgical repair. CONCLUSION Fetal MRI should be included in the diagnostic algorithm of any pregnancy where fetal bowel obstruction is suspected to better risk stratify patients.
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Affiliation(s)
| | - Lindsey A G Shea
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brian W Gray
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brandon P Brown
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
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Holmes LB, Nasri H, Westgate MN, Toufaily MH, Lin AE. The Active Malformations Surveillance Program, Boston in 1972-2012: Methodology and demographic characteristics. Birth Defects Res 2018; 110:148-156. [DOI: 10.1002/bdr2.1156] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/03/2017] [Accepted: 10/12/2017] [Indexed: 01/03/2023]
Affiliation(s)
- Lewis B. Holmes
- Active Malformations Surveillance Program, Department of Pediatric Newborn Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
- Medical Genetics Unit; MassGeneral Hospital for Children, Harvard Medical School; Boston Massachusetts
| | - Hanah Nasri
- Active Malformations Surveillance Program, Department of Pediatric Newborn Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
- Medical Genetics Unit; MassGeneral Hospital for Children, Harvard Medical School; Boston Massachusetts
| | - Marie-Noel Westgate
- Active Malformations Surveillance Program, Department of Pediatric Newborn Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
- Medical Genetics Unit; MassGeneral Hospital for Children, Harvard Medical School; Boston Massachusetts
| | - M. Hassan Toufaily
- Active Malformations Surveillance Program, Department of Pediatric Newborn Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
- Medical Genetics Unit; MassGeneral Hospital for Children, Harvard Medical School; Boston Massachusetts
| | - Angela E. Lin
- Active Malformations Surveillance Program, Department of Pediatric Newborn Medicine; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
- Medical Genetics Unit; MassGeneral Hospital for Children, Harvard Medical School; Boston Massachusetts
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Xia W, Kasprian G, Hu D, Xiao P, Yang W, Chen X. Different information by MRI compare to ultrasound in fetal intracranial space occupying lesions. Childs Nerv Syst 2017; 33:2129-2136. [PMID: 28695339 DOI: 10.1007/s00381-017-3505-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/26/2017] [Indexed: 12/18/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the value of prenatal magnetic resonance imaging (MRI) in characterizing fetal intracranial space occupying lesions in comparison to prenatal ultrasound. METHODS This retrospective study included 50 fetuses (mean age 26 years, mean gestational weeks 31 + 1 GW) with intracranial space occupying lesions, suspected by prenatal screening ultrasound. T2-weighted, T1-weighted, SSFP, and diffusion-weighted sequences of the fetal brain were obtained on a 1.5 T unit. Pathology (n = 5), postmortem MRI (n = 3), or postnatal US (n = 42) was available as standard of reference. RESULTS The fetal MRI provided correct diagnosis in 49 cases (98%), while 35 (70%) by ultrasound, and MRI failed in 1 case (2%), while ultrasound failed in 15 cases (30%). Fetal MR and ultrasound were concordant in 35 of 50 cases (70%), completely discordant in 4 (8%), and partially discordant in 11 (22%) cases. CONCLUSIONS MRI could provide detailed information about the minor lesions, such as focal hemorrhage and periventricular nodules. Meanwhile, it could provide whole view of the lesion in order to delineate the surrounding anatomical structure. But there are still some limitations of its soft-tissue resolution in a case with teratoma; more effort is needed to improve the sequences.
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Affiliation(s)
- Wei Xia
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China. .,Department of Radiology, Hubei Maternal and Children's Hospital, Wuluolu 745, Hongshan District, Wuhan, 430070, China.
| | - Gregor Kasprian
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, A-1090, Vienna, Austria
| | - Daoyu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Peng Xiao
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Wenzhong Yang
- Department of Radiology, Hubei Maternal and Children's Hospital, Wuluolu 745, Hongshan District, Wuhan, 430070, China
| | - Xinlin Chen
- Department of Ultrasound, Hubei Maternal and Children's Hospital, Wuhan, 430070, China
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Millischer AE, Grevent D, Rousseau V, O'Gorman N, Sonigo P, Bessieres B, Ville Y, Boddaert N, Salomon LJ. Fetal MRI compared with ultrasound for the diagnosis of obstructive genital malformations. Prenat Diagn 2017; 37:1138-1145. [PMID: 28921932 DOI: 10.1002/pd.5155] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/02/2017] [Accepted: 09/06/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To compare the accuracy of magnetic resonance imaging (MRI) and ultrasound (US) to diagnose and characterize congenital obstructive genital abnormalities. METHOD Retrospective cohort of 20 fetuses who underwent a fetal MRI following a US diagnosis of obstructive urogenital malformation. We compared MRI and US findings and their correlation with the definitive diagnosis. RESULT The correct diagnosis was obtained in 6/20 (30%) cases and 19/20 cases (95%) with US and MRI, respectively. MRI revealed additional information to US in 15/20 cases (75%) and modified the prenatal management in 14 fetuses (70%). The identification rates of the most important anatomical landmarks for the diagnosis, using US and MRI, were compared. Bladder: US 17/20 (85%) vs MRI 20/20 (100%) P = 0.23; vagina: US 6/19 (31.5%) vs MRI 19/19 (100%) P < 10-4 ; uterus: US 11/19 (57.8%) vs MRI 19/19 (100%) P = 0.003, kidneys: US: 40/40 (100%) MRI: 40/40 (100%) P = 1, ureters: US 14/40 (35%) vs MRI 30/40 (75%) P=0.001, rectum: US 6/20 (30%) MRI 20/20 (100%) P < 10-4 , and sacrum: US 20/20 (100%) vs MRI 17/20 (85%) P = 0.23. CONCLUSION In fetuses with obstructive urogenital malformations, MRI facilitates assessment of major pelvic organs and provides significant information that may alter the prenatal management.
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Cao Y, Wei Y, Yu Y, Wang Z. Safety and efficacy of a novel three-dimensional magnetic resonance imaging model for uterine incision in placenta previa. Int J Gynaecol Obstet 2017; 139:336-341. [PMID: 28842976 DOI: 10.1002/ijgo.12311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 06/27/2017] [Accepted: 08/24/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Yanwen Cao
- Department of Obstetrics and Gynecology; Nanfang Hospital; Southern Medical University; Guangzhou China
- Department of Obstetrics and Gynecology; First People's Hospital of Chenzhou; Chenzhou China
| | - Yanxing Wei
- Department of Obstetrics and Gynecology; Nanfang Hospital; Southern Medical University; Guangzhou China
| | - Yanhong Yu
- Department of Obstetrics and Gynecology; Nanfang Hospital; Southern Medical University; Guangzhou China
| | - Zhijian Wang
- Department of Obstetrics and Gynecology; Nanfang Hospital; Southern Medical University; Guangzhou China
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Brennan S, Watson D, Rudd D, Schneider M, Kandasamy Y. Evaluation of fetal kidney growth using ultrasound: A systematic review. Eur J Radiol 2017; 96:55-64. [PMID: 29103476 DOI: 10.1016/j.ejrad.2017.09.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/06/2017] [Accepted: 09/22/2017] [Indexed: 01/24/2023]
Abstract
PURPOSE To determine the role of ultrasound imaging in evaluating fetal kidney growth. METHODS MEDLINE, CINAHL and EMBASE databases were electronically searched for studies between 1996 and January 2017 and limited to English language. Studies were included if they reported on an ultrasound technique to assess fetal kidney growth and they were not a case report or case series. There was independent selection of studies by two reviewers in consensus with one other reviewer. Data were extracted by one reviewer in consensus with two other reviewers. RESULTS A total of 1785 articles were identified. The full text of 39 of these were assessed for eligibility for inclusion. Twenty-eight studies were then included in the review. Standard two dimensional (2D) fetal renal measurements are easy to perform, however, this review identified that most studies had some methodological limitations. The disadvantage with 2D and three dimensional (3D) fetal renal volumes are that they include the entire kidney and good reproducibility of 3D volumes has not yet been demonstrated. Currently there is limited research on fetal kidney growth in the setting of abnormal fetal growth. Research focussing directly on fetal kidney parenchyma and blood flow is scarce. CONCLUSIONS Some nomograms of 2D and 3D fetal kidney size and volume have been developed. Kidney length is the most popular single fetal kidney measurement; however, it does not seem to be a good indicator of growth. In IUGR fetuses, kidney length remained similar to appropriately grown fetuses whereas AP and TS dimensions were significantly decreased. New ultrasound techniques focusing on the parenchyma of the kidney and perfusion to the kidney should be explored as they may provide more meaningful information on kidney development in the fetus and future kidney function.
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Affiliation(s)
- Sonja Brennan
- Ultrasound Department, The Townsville Hospital, IMB 47 P.O. Box 670, Douglas, Townsville, Queensland, 4810, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, 1 James Cook Drive, Townsville, Queensland 4811, Australia.
| | - David Watson
- Department of Obstetrics and Gynaecology, The Townsville Hospital, IMB 85 P.O. Box 670, Townsville, Queensland 4810, Australia
| | - Donna Rudd
- College of Public Health, Medical and Veterinary Sciences, James Cook University, 1 James Cook Drive, Townsville, Queensland 4811, Australia
| | - Michal Schneider
- Department of Medical Imaging and Radiation Sciences, School of Primary And Allied Health Care, 10 Chancellors Way, Monash University, Clayton, Victoria 3800, Australia
| | - Yogavijayan Kandasamy
- College of Public Health, Medical and Veterinary Sciences, James Cook University, 1 James Cook Drive, Townsville, Queensland 4811, Australia; Department of Neonatology, The Townsville Hospital, IMB 51 P.O. Box 670, Townsville, Queensland 4810, Australia; Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, The University of Newcastle,University Drive, Callaghan, NSW 2308, Australia
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Abstract
This study aimed to evaluate the diagnostic accuracy of fetal magnetic resonance imaging (MRI) for persistent left superior vena cava (LSVC). Prenatal echocardiography (echo) and/or ultrasound (US) and MRI data for 49 fetuses with persistent LSVC, confirmed via postnatal diagnoses between January 2010 and October 2015, were retrospectively reviewed. All prenatal MRI was performed at 1.5 T. Imaging sequences included steady-state free-precession (SSFP), single-shot turbo spin echo (SSTSE), and other sequences. All 49 cases of fetal persistent LSVC were correctly diagnosed via MRI, but only 34 cases (69.4%) were correctly diagnosed via an initial US and/or echo before MRI. Of the 15 cases that were not correctly diagnosed via US and/or echo, 8 had congenital heart diseases (CHDs) and 7 were without CHDs; however, they were associated with extracardiac abnormalities or maternal obesity. Thirty-five cases were associated with other cardiovascular abnormalities; 8, with extracardiac abnormalities; and 6, with no associated condition. In 44 (89.8%) cases, the innominate veins were absent; the remaining cases had innominate veins. In 14.3% of patients (7 cases), the persistent LSVC drained directly into the atrium. Fetal MRI can detect persistent LSVC and play an adjunctive role along with US in the evaluation of persistent LSVC.
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Luo M, Hu C, Zhuang Y, Chen W, Liu F, Xin SX. Numerical assessment of the reduction of specific absorption rate by adding high dielectric materials for fetus MRI at 3 T. ACTA ACUST UNITED AC 2017; 61:455-61. [PMID: 26985683 DOI: 10.1515/bmt-2015-0171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 02/17/2016] [Indexed: 12/16/2022]
Abstract
The specific absorption rate (SAR) is an important issue to be considered in fetus MRI at 3 T due to the high radiofrequency energy deposited inside the body of pregnant woman. The high dielectric material (HDM) has shown its potential for enhancing B1 field and reducing SAR in MRI. The aim of this study is to assess the feasibility of SAR reduction by adding an HDM to the fetus MRI. The feasibility of SAR reduction is numerically assessed in this study, using a birdcage coil in transmission loaded with an electromagnetic pregnant woman model in the SEMCAD-EM solver. The HDMs with different geometric arrangements and dielectric constants are manually optimized. The B1+ ${B_1}^ + $ homogeneity is also considered while calculating the optimized fetus 10 g local SAR among different strategies in the application of HDM. The optimum maximum fetus 10 g local SAR was obtained as 2.25 W/kg, by using two conformal pads placed left and right with the dielectric constant to be 400, reduced by 24.75% compared to that without the HDM. It indicated that the SAR can be significantly reduced with strategic placement of the HDM and the use of HDM may provide a simple, effective and low-cost method for reducing the SAR for the fetus MRI at 3 T.
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Gentillon H, Stefańczyk L, Strzelecki M, Respondek-Liberska M. Texture analysis of the developing human brain using customization of a knowledge-based system. F1000Res 2017. [DOI: 10.12688/f1000research.10401.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Pattern recognition software originally designed for geospatial and other technical applications could be trained by physicians and used as texture-analysis tools for evidence-based practice, in order to improve diagnostic imaging examination during pregnancy.Methods: Various machine-learning techniques and customized datasets were assessed for training of an integrable knowledge-based system (KBS), to determine a hypothetical methodology for texture classification of closely-related anatomical structures in fetal brain magnetic resonance (MR) images. Samples were manually categorized according to the magnetic field of the MRI scanner (i.e. 1.5-tesla (1.5T), 3-tesla (3T)), rotational planes (i.e. coronal, sagittal and axial), and signal weighting (i.e. spin-lattice, spin-spin, relaxation, proton density). In the machine-learning sessions, the operator manually selected relevant regions of interest (ROI) in 1.5/3T MR images. Semi-automatic procedures in MaZda/B11 were performed to determine optimal parameter sets for ROI classification. Four classes were defined: ventricles, thalamus, grey matter, and white matter. Various textures analysis methods were tested. The KBS performed automatic data pre-processing and semi-automatic classification of ROIs.Results: After testing 3456 ROIs, statistical binary classification revealed that combination of reduction techniques with linear discriminant algorithms (LDA) or nonlinear discriminant algorithms (NDA) yielded the best scoring in terms of sensitivity (both 100%, 95% CI: 99.79-100), specificity (both 100%, 95% CI: 99.79-100) and Fisher coefficient (≈E+4, ≈E+5, respectively). Conclusions: LDA and NDA in MaZda can be useful data mining tools for screening a population of interest subjected to a clinical test.
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Wilson RD. Anomalies fœtales affectant le tube neural : Dépistage / diagnostic prénatal et prise en charge de la grossesse. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2017; 38:S496-S511. [PMID: 28063560 DOI: 10.1016/j.jogc.2016.09.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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