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Kitano R, Madan N, Mikami T, Madankumar R, Skotko BG, Santoro S, Ralston SJ, Bianchi DW, Tarui T. Biometric magnetic resonance imaging analysis of fetal brain development in Down syndrome. Prenat Diagn 2023; 43:1450-1458. [PMID: 37698481 DOI: 10.1002/pd.6436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 08/06/2023] [Accepted: 08/27/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVES To assess brain development in living fetuses with Down syndrome (DS) by biometric measurements on fetal brain magnetic resonance images (MRI). METHODS We scanned 10 MRIs of fetuses with confirmed trisomy 21 at birth and 12 control fetal MRIs without any detected anomalies. Fetal brain MRIs were analyzed using 14 fetal brain and skull biometric parameters. We compared measures between DS and controls in both raw MRIs and motion-corrected and anterior-posterior commissure-aligned images. RESULTS In the reconstructed images, the measured values of the height of the cerebellar vermis (HV) and anteroposterior diameter of the cerebellar vermis (APDV) were significantly smaller, and the anteroposterior diameter of the fourth ventricle (APDF) was significantly larger in fetuses with DS than controls. In the raw MRIs, the measured values of the right lateral ventricle were significantly larger in fetuses with DS than in controls. Logistic regression analyses revealed that a new parameter, the cerebellar-to-fourth-ventricle ratio (i.e., (APDV * Height of the vermis)/APDF), was significantly smaller in fetuses with DS than controls and was the most predictive to distinguish between fetuses with DS and controls. CONCLUSIONS The study revealed that fetuses with DS have smaller cerebellums and larger fourth ventricles compared to the controls.
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Affiliation(s)
- Rie Kitano
- Obstetrics and Gynecology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Neel Madan
- Radiology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Takahisa Mikami
- Department of Neurology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Rajeevi Madankumar
- Obstetrics and Gynecology, Long Island Jewish Medical Center, New Hyde Park, New York, USA
| | - Brian G Skotko
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Stephanie Santoro
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Steven J Ralston
- Obstetrics and Gynecology, The University of Maryland, Baltimore, Maryland, USA
| | - Diana W Bianchi
- Section on Prenatal Genomics and Fetal Therapy, Center for Precision Health Research, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Tomo Tarui
- Mother Infant Research Institute, Tufts Medical Center, Boston, Massachusetts, USA
- Pediatric Neurology, Hasbro Children's Hospital, Providence, Rhode Island, USA
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2
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Nguyen T, Heide S, Guilbaud L, Valence S, Perre SV, Blondiaux E, Keren B, Quenum-Miraillet G, Jouannic JM, Mandelbrot L, Picone O, Guet A, Tsatsaris V, Milh M, Girard N, Vincent M, Nizon M, Poirsier C, Vivanti A, Benachi A, Portes VD, Guibaud L, Patat O, Spentchian M, Frugère L, Héron D, Garel C. Abnormalities of the corpus callosum. Can prenatal imaging predict the genetic status? Correlations between imaging phenotype and genotype. Prenat Diagn 2023; 43:746-755. [PMID: 37173814 DOI: 10.1002/pd.6382] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Recent studies have evaluated prenatal exome sequencing (pES) for abnormalities of the corpus callosum (CC). The objective of this study was to compare imaging phenotype and genotype findings. METHOD This multicenter retrospective study included fetuses with abnormalities of the CC between 2018 and 2020 by ultrasound and/or MRI and for which pES was performed. Abnormalities of the CC were classified as complete (cACC) or partial (pACC) agenesis of the CC, short CC (sCC), callosal dysgenesis (CD), interhemispheric cyst (IHC), or pericallosal lipoma (PL), isolated or not. Only pathogenic (class 5) or likely pathogenic (class 4) (P/LP) variants were considered. RESULTS 113 fetuses were included. pES identified P/LP variants for 3/29 isolated cACC, 3/19 isolated pACC, 0/10 isolated sCC, 5/10 isolated CD, 5/13 non-isolated cACC, 3/6 non-isolated pACC, 8/11 non-isolated CD and 0/12 isolated IHC and PL. Associated cerebellar abnormalities were significantly associated with P/LP variants (OR = 7.312, p = 0.027). No correlation was found between phenotype and genotype, except for fetuses with a tubulinopathy and an MTOR pathogenic variant. CONCLUSIONS P/LP variants were more frequent in CD and in non-isolated abnormalities of the CC. No such variants were detected for fetuses with isolated sCC, IHC and PL.
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Affiliation(s)
- Toan Nguyen
- Service de radiologie pédiatrique, Hôpital Armand-Trousseau, Médecine Sorbonne Université, APHP, DMU DIAMENT, GRC Images, Paris, France
| | - Solveig Heide
- Service de génétique médicale, Hôpital Pitié-Salpêtrière, Paris, France
| | - Lucie Guilbaud
- Service de médecine fœtale, Hôpital Armand-Trousseau, Sorbonne Université, APHP, DMU ORIGYNE, Paris, France
| | | | - Saskia Vande Perre
- Service de radiologie pédiatrique, Hôpital Armand-Trousseau, Médecine Sorbonne Université, APHP, DMU DIAMENT, GRC Images, Paris, France
| | - Eléonore Blondiaux
- Service de radiologie pédiatrique, Hôpital Armand-Trousseau, Médecine Sorbonne Université, APHP, DMU DIAMENT, GRC Images, Paris, France
| | - Boris Keren
- Service de génétique médicale, Hôpital Pitié-Salpêtrière, Paris, France
| | | | - Jean-Marie Jouannic
- Service de médecine fœtale, Hôpital Armand-Trousseau, Sorbonne Université, APHP, DMU ORIGYNE, Paris, France
| | - Laurent Mandelbrot
- Service de gynécologie obstétrique, Hôpital Louis-Mourier, Colombes, France
| | - Olivier Picone
- Service de gynécologie obstétrique, Hôpital Louis-Mourier, Colombes, France
| | - Agnès Guet
- Service de neuropédiatrie, Hôpital Louis-Mourier, Colombes, France
| | - Vassilis Tsatsaris
- Service de gynécologie obstétrique, Hôpital Cochin-Port Royal, Paris, France
| | - Mathieu Milh
- Service de neuropédiatrie, CHU de Marseille, AP-HM, Marseille, France
| | - Nadine Girard
- Service de neuroradiologie, CHU de Marseille, AP-HM, Marseille, France
| | | | | | | | - Alexandre Vivanti
- Service de gynécologie obstétrique, CHU Antoine Béclère, Clamart, France
| | - Alexandra Benachi
- Service de gynécologie obstétrique, CHU Antoine Béclère, Clamart, France
| | | | - Laurent Guibaud
- Service d'imagerie pédiatrique et fœtale, Hôpital Femme Mère Enfant, Lyon, France
| | - Olivier Patat
- Service de génétique médicale, Hôpital Purpan, Toulouse, France
| | | | - Lisa Frugère
- Service de génétique médicale, Hôpital Pitié-Salpêtrière, Paris, France
| | - Delphine Héron
- Service de génétique médicale, Hôpital Pitié-Salpêtrière, Paris, France
| | - Catherine Garel
- Service de radiologie pédiatrique, Hôpital Armand-Trousseau, Médecine Sorbonne Université, APHP, DMU DIAMENT, GRC Images, Paris, France
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Fried S, Gafner M, Jeddah D, Gosher N, Hoffman D, Ber R, Mayer A, Katorza E. Correlation between 2D and 3D Fetal Brain MRI Biometry and Neurodevelopmental Outcomes in Fetuses with Suspected Microcephaly and Macrocephaly. AJNR Am J Neuroradiol 2021; 42:1878-1883. [PMID: 34385141 DOI: 10.3174/ajnr.a7225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 05/03/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Definitions of fetal microcephaly and macrocephaly are debatable. A better understanding of their long-term prognoses would help guide parental education and counseling. This study aimed to explore the correlation between 2D and 3D fetal brain MR imaging biometry results and the long-term neurodevelopmental outcomes. MATERIALS AND METHODS This analysis is a historical cohort study. Fetal brain biometry was measured on 2D and 3D MR imaging using a volumetric MR imaging semiautomated algorithm. We measured and assessed the following brain structures: the supratentorial brain volume and cerebellar volume and cerebellar volume/supratentorial brain volume ratio, in addition to commonly used 2D brain MR imaging biometric variables, including occipitofrontal diameter, biparietal diameter, and transcerebellar diameter. Microcephaly was defined as ≤ 3rd percentile; and macrocephaly, as ≥ 97th percentile, corresponding to -2 SDs and +2 SDs. The neurodevelopmental outcome of this study cohort was evaluated using the Vineland-II Adaptive Behavior Scales, and the measurements were correlated to the Vineland standard scores. RESULTS A total of 70 fetuses were included. No significant correlation was observed between the Vineland scores and either the supratentorial brain volume, cerebellar volume, or supratentorial brain volume/cerebellar volume ratio in 3D or 2D MR imaging measurements, after correction for multiple comparisons. No differences were found among fetuses with macrocephaly, normocephaly, or microcephaly regarding the median Vineland standard scores. CONCLUSIONS Provided there is normal brain structure on MR imaging, the developmental milestone achievements in early years are unrelated to 2D and 3D fetal brain MR imaging biometry, in the range of measurements depicted in this study.
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Affiliation(s)
- S Fried
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
- Department of Obstetrics and Gynecology (S.F., E.K.), Sheba Medical Center, Tel-Hashomer, Israel
| | - M Gafner
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
- Department of Pediatrics B (M.G.), Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - D Jeddah
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
| | - N Gosher
- Hadassah Medical School (N.G.), The Hebrew University of Jerusalem, Jerusalem, Israel
| | - D Hoffman
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
| | - R Ber
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
| | - A Mayer
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
- Department of Diagnostic Radiology (A.M.), Sheba Medical Center, Tel-Hashomer, Israel
| | - E Katorza
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
- Department of Obstetrics and Gynecology (S.F., E.K.), Sheba Medical Center, Tel-Hashomer, Israel
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Khawam M, de Dumast P, Deman P, Kebiri H, Yu T, Tourbier S, Lajous H, Hagmann P, Maeder P, Thiran JP, Meuli R, Dunet V, Bach Cuadra M, Koob M. Fetal Brain Biometric Measurements on 3D Super-Resolution Reconstructed T2-Weighted MRI: An Intra- and Inter-observer Agreement Study. Front Pediatr 2021; 9:639746. [PMID: 34447726 PMCID: PMC8383736 DOI: 10.3389/fped.2021.639746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 06/07/2021] [Indexed: 11/27/2022] Open
Abstract
We present the comparison of two-dimensional (2D) fetal brain biometry on magnetic resonance (MR) images using orthogonal 2D T2-weighted sequences (T2WSs) vs. one 3D super-resolution (SR) reconstructed volume and evaluation of the level of confidence and concordance between an experienced pediatric radiologist (obs1) and a junior radiologist (obs2). Twenty-five normal fetal brain MRI scans (18-34 weeks of gestation) including orthogonal 3-mm-thick T2WSs were analyzed retrospectively. One 3D SR volume was reconstructed per subject based on multiple series of T2WSs. The two observers performed 11 2D biometric measurements (specifying their level of confidence) on T2WS and SR volumes. Measurements were compared using the paired Wilcoxon rank sum test between observers for each dataset (T2WS and SR) and between T2WS and SR for each observer. Bland-Altman plots were used to assess the agreement between each pair of measurements. Measurements were made with low confidence in three subjects by obs1 and in 11 subjects by obs2 (mostly concerning the length of the corpus callosum on T2WS). Inter-rater intra-dataset comparisons showed no significant difference (p > 0.05), except for brain axial biparietal diameter (BIP) on T2WS and for brain and skull coronal BIP and coronal transverse cerebellar diameter (DTC) on SR. None of them remained significant after correction for multiple comparisons. Inter-dataset intra-rater comparisons showed statistical differences in brain axial and coronal BIP for both observers, skull coronal BIP for obs1, and axial and coronal DTC for obs2. After correction for multiple comparisons, only axial brain BIP remained significantly different, but differences were small (2.95 ± 1.73 mm). SR allows similar fetal brain biometry as compared to using the conventional T2WS while improving the level of confidence in the measurements and using a single reconstructed volume.
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Affiliation(s)
- Marie Khawam
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Priscille de Dumast
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.,CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Pierre Deman
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.,CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Hamza Kebiri
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.,CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Thomas Yu
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland.,Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Sébastien Tourbier
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Hélène Lajous
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.,CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Patric Hagmann
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Philippe Maeder
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Jean-Philippe Thiran
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.,CIBM Center for Biomedical Imaging, Lausanne, Switzerland.,Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Reto Meuli
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Vincent Dunet
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Meritxell Bach Cuadra
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.,CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Mériam Koob
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
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Gafner M, Yagel I, Fried S, Ezra O, Bar-Yosef O, Katorza E. Fetal brain biometry in isolated mega cisterna magna: MRI and US study. J Matern Fetal Neonatal Med 2020; 35:4199-4207. [PMID: 33207970 DOI: 10.1080/14767058.2020.1849094] [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: 10/22/2022]
Abstract
OBJECTIVE To characterize the biometric parameters in ultrasound and brain MRI of fetuses with isolated mega cisterna magna (MCM). METHODS Cross-sectional historical cohort study conducted at a single tertiary medical center between 2011 and 2018. All fetuses underwent US and brain MRI scans. Matching analysis was performed according to gender and gestational age. RESULTS The study included a total of 103 fetuses; 44 fetuses with isolated MCM in the study group, and a control group of 59 fetuses with normal CNS. The study group had larger biparietal diameter (BPD) (86 vs. 79.8 mm, p = .001) and head circumference (HC) (318 vs. 292 mm, p < .001) on ultrasound. On MRI, study group had larger occipitofrontal diameter (OFD) (99 vs. 92 mm, p < .001) and BPD (77 vs. 72 mm, p < .001). Male fetuses' prevalence was higher in the study group (77.3% vs. 47.5%). After matching 20 fetuses from each group, the study group had larger HC (310.1 versus 300.7 mm, p = .029) and OFD (113.4 versus 108.3 mm, p = .009) on ultrasound, and larger OFD (97.4 versus 94.6, p = .013) on brain MRI. CONCLUSIONS Isolated MCM may be related to other large fetal CNS biometric measurements in both ultrasound and MRI and might be influenced by fetal gender.
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Affiliation(s)
- Michal Gafner
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Itai Yagel
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel
| | - Shalev Fried
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Osnat Ezra
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel
| | - Omer Bar-Yosef
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pediatric Neurology Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Eldad Katorza
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel
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