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Tarui T, Gimovsky AC, Madan N. Fetal neuroimaging applications for diagnosis and counseling of brain anomalies: Current practice and future diagnostic strategies. Semin Fetal Neonatal Med 2024; 29:101525. [PMID: 38632010 PMCID: PMC11156536 DOI: 10.1016/j.siny.2024.101525] [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] [Indexed: 04/19/2024]
Abstract
Advances in fetal brain neuroimaging, especially fetal neurosonography and brain magnetic resonance imaging (MRI), allow safe and accurate anatomical assessments of fetal brain structures that serve as a foundation for prenatal diagnosis and counseling regarding fetal brain anomalies. Fetal neurosonography strategically assesses fetal brain anomalies suspected by screening ultrasound. Fetal brain MRI has unique technological features that overcome the anatomical limits of smaller fetal brain size and the unpredictable variable of intrauterine motion artifact. Recent studies of fetal brain MRI provide evidence of improved diagnostic and prognostic accuracy, beginning with prenatal diagnosis. Despite technological advances over the last several decades, the combined use of different qualitative structural biomarkers has limitations in providing an accurate prognosis. Quantitative analyses of fetal brain MRIs offer measurable imaging biomarkers that will more accurately associate with clinical outcomes. First-trimester ultrasound opens new opportunities for risk assessment and fetal brain anomaly diagnosis at the earliest time in pregnancy. This review includes a case vignette to illustrate how fetal brain MRI results interpreted by the fetal neurologist can improve diagnostic perspectives. The strength and limitations of conventional ultrasound and fetal brain MRI will be compared with recent research advances in quantitative methods to better correlate fetal neuroimaging biomarkers of neuropathology to predict functional childhood deficits. Discussion of these fetal sonogram and brain MRI advances will highlight the need for further interdisciplinary collaboration using complementary skills to continue improving clinical decision-making following precision medicine principles.
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Affiliation(s)
- Tomo Tarui
- Pediatric Neurology, Pediatrics, Hasbro Children's Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Alexis C Gimovsky
- Maternal Fetal Medicine, Obstetrics and Gynecology, Women & Infants Hospital of Rhode Island, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Neel Madan
- Neuroradiology, Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Correa S, Nichols ES, Mueller ME, de Vrijer B, Eagleson R, McKenzie CA, de Ribaupierre S, Duerden EG. Default mode network functional connectivity strength in utero and the association with fetal subcortical development. Cereb Cortex 2023; 33:9144-9153. [PMID: 37259175 PMCID: PMC10350815 DOI: 10.1093/cercor/bhad190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023] Open
Abstract
The default mode network is essential for higher-order cognitive processes and is composed of an extensive network of functional and structural connections. Early in fetal life, the default mode network shows strong connectivity with other functional networks; however, the association with structural development is not well understood. In this study, resting-state functional magnetic resonance imaging and anatomical images were acquired in 30 pregnant women with singleton pregnancies. Participants completed 1 or 2 MR imaging sessions, on average 3 weeks apart (43 data sets), between 28- and 39-weeks postconceptional ages. Subcortical volumes were automatically segmented. Activation time courses from resting-state functional magnetic resonance imaging were extracted from the default mode network, medial temporal lobe network, and thalamocortical network. Generalized estimating equations were used to examine the association between functional connectivity strength between default mode network-medial temporal lobe, default mode network-thalamocortical network, and subcortical volumes, respectively. Increased functional connectivity strength in the default mode network-medial temporal lobe network was associated with smaller right hippocampal, left thalamic, and right caudate nucleus volumes, but larger volumes of the left caudate. Increased functional connectivity strength in the default mode network-thalamocortical network was associated with smaller left thalamic volumes. The strong associations seen among the default mode network functional connectivity networks and regionally specific subcortical volume development indicate the emergence of short-range connectivity in the third trimester.
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Affiliation(s)
- Susana Correa
- Neuroscience Program, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 3K7, Canada
- Western Institute for Neuroscience, Western University, London, ON N6A 3K7, Canada
| | - Emily S Nichols
- Western Institute for Neuroscience, Western University, London, ON N6A 3K7, Canada
- Applied Psychology, Faculty of Education, Western University, London, ON N6A 3K7, Canada
| | - Megan E Mueller
- Applied Psychology, Faculty of Education, Western University, London, ON N6A 3K7, Canada
| | - Barbra de Vrijer
- Obstetrics & Gynaecology, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 3K7, Canada
| | - Roy Eagleson
- Western Institute for Neuroscience, Western University, London, ON N6A 3K7, Canada
- Biomedical Engineering, Western University, London, ON N6A 3K7, Canada
- Electrical and Computer Engineering, Western University, London, ON N6A 3K7, Canada
| | - Charles A McKenzie
- Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 3K7, Canada
| | - Sandrine de Ribaupierre
- Western Institute for Neuroscience, Western University, London, ON N6A 3K7, Canada
- Biomedical Engineering, Western University, London, ON N6A 3K7, Canada
- Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 3K7, Canada
- Clinical Neurological Sciences, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 3K7, Canada
- Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 3K7, Canada
| | - Emma G Duerden
- Western Institute for Neuroscience, Western University, London, ON N6A 3K7, Canada
- Applied Psychology, Faculty of Education, Western University, London, ON N6A 3K7, Canada
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Tarui T, Madan N, Graham G, Kitano R, Akiyama S, Takeoka E, Reid S, Yun HJ, Craig A, Samura O, Grant E, Im K. Comprehensive quantitative analyses of fetal magnetic resonance imaging in isolated cerebral ventriculomegaly. Neuroimage Clin 2023; 37:103357. [PMID: 36878148 PMCID: PMC9999203 DOI: 10.1016/j.nicl.2023.103357] [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: 09/26/2022] [Revised: 02/08/2023] [Accepted: 02/20/2023] [Indexed: 03/06/2023]
Abstract
Isolated cerebral ventriculomegaly (IVM) is the most common prenatally diagnosed brain anomaly occurs in 0.2-1 % of pregnancies. However, knowledge of fetal brain development in IVM is limited. There is no prenatal predictor for IVM to estimate individual risk of neurodevelopmental disability occurs in 10 % of children. To characterize brain development in fetuses with IVM and delineate their individual neuroanatomical variances, we performed comprehensive post-acquisition quantitative analysis of fetal magnetic resonance imaging (MRI). In volumetric analysis, brain MRI of fetuses with IVM (n = 20, 27.0 ± 4.6 weeks of gestation, mean ± SD) had revealed significantly increased volume in the whole brain, cortical plate, subcortical parenchyma, and cerebrum compared to the typically developing fetuses (controls, n = 28, 26.3 ± 5.0). In the cerebral sulcal developmental pattern analysis, fetuses with IVM had altered sulcal positional (both hemispheres) development and combined features of sulcal positional, depth, basin area, in both hemispheres compared to the controls. When comparing distribution of similarity index of individual fetuses, IVM group had shifted toward to lower values compared to the control. About 30 % of fetuses with IVM had no overlap with the distribution of control fetuses. This proof-of-concept study shows that quantitative analysis of fetal MRI can detect emerging subtle neuroanatomical abnormalities in fetuses with IVM and their individual variations.
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Affiliation(s)
- Tomo Tarui
- Mother Infant Research Institute, Tufts Medical Center, Boston, USA; Pediatric Neurology, Hasbro Children's Hospital, Providence, USA.
| | - Neel Madan
- Radiology, Tufts Medical Center, Boston, USA
| | - George Graham
- Obstetrics and Gynecology, South Shore Hospital, South Weymouth, USA
| | - Rie Kitano
- Mother Infant Research Institute, Tufts Medical Center, Boston, USA
| | - Shizuko Akiyama
- Mother Infant Research Institute, Tufts Medical Center, Boston, USA
| | - Emiko Takeoka
- Mother Infant Research Institute, Tufts Medical Center, Boston, USA
| | - Sophie Reid
- Mother Infant Research Institute, Tufts Medical Center, Boston, USA
| | - Hyuk Jin Yun
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, USA
| | - Alexa Craig
- Pediatric Neurology, Maine Medical Center, Portland, USA
| | - Osamu Samura
- Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo, Japan
| | - Ellen Grant
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, USA
| | - Kiho Im
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, USA.
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Tsurugizawa T, Kumamoto T, Yoshioka Y. Utilization of potato starch suspension for MR-microimaging in ex vivo mouse embryos. iScience 2022; 25:105694. [PMID: 36567713 PMCID: PMC9768372 DOI: 10.1016/j.isci.2022.105694] [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: 05/25/2022] [Revised: 07/31/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022] Open
Abstract
Magnetic resonance (MR) microimaging of the mouse embryo is a promising tool to noninvasively investigate the microstructure of the brain of a developing mouse. The proton-free fluid is used for the liquid surrounding the specimen in MR microimaging, but the potential issue of image quality remains due to the air bubbles on the specimen and the retained water proton in the curvature of the embryo. Furthermore, the specimen may move during the scanning, resulting in motion artifact. Here, we developed the new concept of the ex vivo microimaging protocol with the robust method using the potato starch-containing biological polymers. Potato starch suspension with PBS significantly reduced T1 and T2 signal intensity of the suspension and strongly suppressed the motion of the embryo. Furthermore, potato starch-PBS suspension is stable for long-time scanning at room temperature. These results indicate the utility of potato starch suspension for MR microimaging in mouse embryos.
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Affiliation(s)
- Tomokazu Tsurugizawa
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Higashi, Tsukuba 305-8568, Japan,Faculty of Engineering, Information and Systems, University of Tsukuba, Tsukuba 305-8573, Japan,Jikei University School of Medicine, 3-25-8 Nishishinbashi, Tokyo 105-8461, Japan,Graduate School of Frontier Biosciences, Osaka University, Suita 565-0871, Japan,Center for Information and Neural Networks (CiNet), Osaka University and National Institute of Information and Communications Technology (NICT), Suita 565-0871, Japan,Corresponding author
| | - Takuma Kumamoto
- Developmental Neuroscience Project, Department of Brain & Neurosciences, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
| | - Yoshichika Yoshioka
- Graduate School of Frontier Biosciences, Osaka University, Suita 565-0871, Japan,Center for Information and Neural Networks (CiNet), Osaka University and National Institute of Information and Communications Technology (NICT), Suita 565-0871, Japan,Corresponding author
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Peretz R, Halevy T, Gafner M, Fried S, Revesz Y, Mayer A, Katorza E. Volumetric Brain MRI Study in Fetuses with Intrauterine Growth Restriction Using a Semiautomated Method. AJNR Am J Neuroradiol 2022; 43:1674-1679. [PMID: 36202548 PMCID: PMC9731260 DOI: 10.3174/ajnr.a7665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/31/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE According to the medical literature, it is known that intrauterine growth restriction is associated with abnormal fetal brain findings. The aim of this study was to assess the volume of fetal brain structures in fetuses with intrauterine growth restriction compared with the control group and to examine the effect of intrauterine growth restriction on birth weight in relation to the effect on the volumes of these structures. MATERIALS AND METHODS This historical cohort study included 26 fetuses diagnosed with intrauterine growth restriction due to placental insufficiency. The control group included 66 fetuses with MR imaging scans demonstrating normal brain structures. The volumes of the supratentorial brain, left and right hemispheres, and the cerebellum were measured using a semiautomatic method. In addition, the cerebellum and supratentorial brain ratio was calculated. The measurements of each brain structure were then converted to percentiles according to growth curves. RESULTS The absolute volumes and percentiles of all brain structures examined were smaller in the intrauterine growth restriction group. All examined brain structures showed results that were statistically significant (P < .015). There was no statistically significant difference in the cerebellum/supratentorial brain ratio (P > .39). The difference in brain volume percentiles was statistically smaller than the difference in birth weight and birth weight percentiles (Dolberg growth curves) between the groups. CONCLUSIONS Intrauterine growth restriction affects the volume of brain structures, as measured by quantitative MR imaging. Compared with healthy controls, the effect on birth weight was more prominent than the effect on brain structures, possibly due to the "brain-preserving" capability.
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Affiliation(s)
- R Peretz
- From the Sackler School of Medicine (R.P., M.G., S.F., Y.R., A.M., E.K.), Tel Aviv University, Tel Aviv, Israel
| | - T Halevy
- Sheba Medical Center (T.H., Y.R.), Tel-Hashomer, Israel
| | - M Gafner
- From the Sackler School of Medicine (R.P., M.G., S.F., Y.R., 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
| | - S Fried
- From the Sackler School of Medicine (R.P., M.G., S.F., Y.R., A.M., E.K.), Tel Aviv University, Tel Aviv, Israel
| | - Y Revesz
- From the Sackler School of Medicine (R.P., M.G., S.F., Y.R., A.M., E.K.), Tel Aviv University, Tel Aviv, Israel
- Sheba Medical Center (T.H., Y.R.), Tel-Hashomer, Israel
| | - A Mayer
- From the Sackler School of Medicine (R.P., M.G., S.F., Y.R., 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 (R.P., M.G., S.F., Y.R., A.M., E.K.), Tel Aviv University, Tel Aviv, Israel
- Department of Obstetrics and Gynecology (E.K.), Gertner Institute for Epidemiology
- Health Policy Research (E.K.)
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Ren JY, Zhu M, Wang G, Gui Y, Jiang F, Dong SZ. Quantification of Intracranial Structures Volume in Fetuses Using 3-D Volumetric MRI: Normal Values at 19 to 37 Weeks' Gestation. Front Neurosci 2022; 16:886083. [PMID: 35645723 PMCID: PMC9133784 DOI: 10.3389/fnins.2022.886083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe purpose of this study is to establish a reference of intracranial structure volumes in normal fetuses ranging from 19 to 37 weeks' gestation (mean 27 weeks).Materials and MethodsA retrospective analysis of 188 MRI examinations (1.5 T) of fetuses with a normal brain appearance (19–37 gestational weeks) from January 2018 to December 2021 was included in this study. Three dimensional (3-D) volumetric parameters from slice-to-volume reconstructed (SVR) images, such as total brain volume (TBV), cortical gray matter volume (GMV), subcortical brain tissue volume (SBV), intracranial cavity volume (ICV), lateral ventricles volume (VV), cerebellum volume (CBV), brainstem volume (BM), and extra-cerebrospinal fluid volume (e-CSFV), were quantified by manual segmentation from two experts. The mean, SD, minimum, maximum, median, and 25th and 75th quartiles for intracranial structures volume were calculated per gestational week. A linear regression analysis was used to determine the gestational weekly age-related change adjusted for sex. A t-test was used to compare the mean TBV and ICV values to previously reported values at each gestational week. The formulas to calculate intracranial structures volume derived from our data were created using a regression model. In addition, we compared the predicted mean TBV values derived by our formula with the expected mean TBV predicted by the previously reported Jarvis' formula at each time point. For intracranial volumes, the intraclass correlation coefficient (ICC) was calculated to convey association within and between observers.ResultsThe intracranial volume data are shown in graphs and tabular summaries. The male fetuses had significantly larger VV compared with female fetuses (p = 0.01). Measured mean ICV values at 19 weeks are significantly different from those published in the literature (p < 0.05). Means were compared with the expected TBV generated by the previously reported formula, showing statistically differences at 22, 26, 29, and 30 weeks' gestational age (GA) (all p < 0.05). A comparison between our data-derived formula and the previously reported formula for TBV showed very similar values at every GA. The predicted TBV means derived from the previously reported formula were all within the 95% confidence interval (CI) of the predicted means of this study. Intra- and inter-observer agreement was high, with an intraclass correlation coefficient larger than 0.98.ConclusionWe have shown that the intracranial structural volume of the fetal brain can be reliably quantified using 3-D volumetric MRI with a high degree of reproducibility and reinforces the existing data with more robust data in the earlier second and third stages of pregnancy.
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Affiliation(s)
- Jing-Ya Ren
- Department of Radiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ming Zhu
- Department of Radiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Guanghai Wang
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, School of Medicine, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Yiding Gui
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, School of Medicine, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Fan Jiang
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, School of Medicine, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Su-Zhen Dong
- Department of Radiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Su-Zhen Dong
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Early magnetic resonance imaging biomarkers of schizophrenia spectrum disorders: Toward a fetal imaging perspective. Dev Psychopathol 2021; 33:899-913. [PMID: 32489161 DOI: 10.1017/s0954579420000218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
There is mounting evidence to implicate the intrauterine environment as the initial pathogenic stage for neuropsychiatric disease. Recent developments in magnetic resonance imaging technology are making a multimodal analysis of the fetal central nervous system a reality, allowing analysis of structural and functional parameters. Exposures to a range of pertinent risk factors whether preconception or in utero can now be indexed using imaging techniques within the fetus' physiological environment. This approach may determine the first "hit" required for diseases that do not become clinically manifest until adulthood, and which only have subtle clinical markers during childhood and adolescence. A robust characterization of a "multi-hit" hypothesis may necessitate a longitudinal birth cohort; within this investigative paradigm, the full range of genetic and environmental risk factors can be assessed for their impact on the early developing brain. This will lay the foundation for the identification of novel biomarkers and the ability to devise methods for early risk stratification and disease prevention. However, these early markers must be followed over time: first, to account for neural plasticity, and second, to assess the effects of postnatal exposures that continue to drive the individual toward disease. We explore these issues using the schizophrenia spectrum disorders as an illustrative paradigm. However, given the potential richness of fetal magnetic resonance imaging, and the likely overlap of biomarkers, these concepts may extend to a range of neuropsychiatric conditions.
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Mckinnon K, Kendall GS, Tann CJ, Dyet L, Sokolska M, Baruteau KP, Marlow N, Robertson NJ, Peebles D, Srinivasan L. Biometric assessments of the posterior fossa by fetal MRI: A systematic review. Prenat Diagn 2020; 41:258-270. [PMID: 33251640 DOI: 10.1002/pd.5874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/07/2020] [Accepted: 11/19/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Posterior fossa abnormalities (PFAs) are commonly identified within routine screening and are a frequent indication for fetal magnetic resonance imaging (MRI). Although biometric measurements of the posterior fossa (PF) are established on fetal ultrasound and MRI, qualitative visual assessments are predominantly used to differentiate PFAs. OBJECTIVES This systematic review aimed to assess 2-dimensional (2D) biometric measurements currently in use for assessing the PF on fetal MRI to delineate different PFAs. METHODS The protocol was registered (PROSPERO ID CRD42019142162). Eligible studies included T2-weighted MRI PF measurements in fetuses with and without PFAs, including measurements of the PF, or other brain areas relevant to PFAs. RESULTS 59 studies were included - 6859 fetuses had 62 2D PF and related measurements. These included linear, area and angular measurements, representing measures of PF size, cerebellum/vermis, brainstem, and supratentorial measurements. 11 measurements were used in 10 or more studies and at least 1200 fetuses. These dimensions were used to characterise normal for gestational age, diagnose a range of pathologies, and predict outcome. CONCLUSION A selection of validated 2D biometric measurements of the PF on fetal MRI may be useful for identification of PFA in different clinical settings. Consistent use of these measures, both clinically and for research, is recommended.
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Affiliation(s)
- Katie Mckinnon
- Neonatal Department, University College London Hospitals NHS Foundation Trust, London, UK.,Institute for Women's Health, University College London, London, UK
| | - Giles S Kendall
- Neonatal Department, University College London Hospitals NHS Foundation Trust, London, UK.,Institute for Women's Health, University College London, London, UK
| | - Cally J Tann
- Neonatal Department, University College London Hospitals NHS Foundation Trust, London, UK.,MARCH Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Leigh Dyet
- Neonatal Department, University College London Hospitals NHS Foundation Trust, London, UK.,Institute for Women's Health, University College London, London, UK
| | - Magdalena Sokolska
- Institute for Women's Health, University College London, London, UK.,Medical Physics Department, University College London Hospitals NHS Foundation Trust, London, UK
| | - Kelly Pegoretti Baruteau
- Institute for Women's Health, University College London, London, UK.,Radiology Department, University College London Hospitals NHS Foundation Trust, London, UK
| | - Neil Marlow
- Neonatal Department, University College London Hospitals NHS Foundation Trust, London, UK.,Institute for Women's Health, University College London, London, UK
| | - Nicola J Robertson
- Neonatal Department, University College London Hospitals NHS Foundation Trust, London, UK.,Institute for Women's Health, University College London, London, UK
| | - Donald Peebles
- Institute for Women's Health, University College London, London, UK.,Obstetric Department, University College London Hospitals NHS Foundation Trust, London, UK
| | - Latha Srinivasan
- Neonatal Department, University College London Hospitals NHS Foundation Trust, London, UK.,Institute for Women's Health, University College London, London, UK
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Gafner M, Fried S, Gosher N, Jeddah D, Sade EK, Barzilay E, Mayer A, Katorza E. Fetal Brain Biometry: Is there an Agreement among Ultrasound, MRI and the Measurements at Birth? Eur J Radiol 2020; 133:109369. [PMID: 33126174 DOI: 10.1016/j.ejrad.2020.109369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 01/02/2023]
Abstract
PURPOSE Measurement of the fetal brain can be achieved by different modalities, we aimed to assess the agreement between these methods and the head circumference at birth. METHODS A retrospective study conducted between 2011-2018 at a tertiary referral medical center. Sonographic head circumference (HC), 2D MRI bi-parietal diameter (BPD) and occipito-frontal diameter (OFD), 3D MRI supra-tentorial volume (STV), and head circumference (HC) at birth were measured and converted into centiles according to gestational age. Spearman's rank correlation coefficient was used to assess the correlation between the modalities. RESULTS A total of 88 fetuses were included. Mean gestational age at the time of fetal US and brain MRI acquisition were 34.4 ± 2.8 and 34.6 ± 2.6 weeks, respectively. A correlation was found between prenatal sonographic HC and the 3D MRI STV centiles (Rs = 0.859, p < 0.001), the BPD in 2D MRI (Rs = 0.813, p < 0.001), and the OFD in 2D MRI (Rs = 0.840, p < 0.001). Sonographic HC, OFD on 2D MRI, and STV on 3D MRI were all found to be correlated with the HC at birth (Rs = 0.865, p < 0.001; Rs 0.816, p < 0.001; Rs = 0.825, p < 0.001, respectively). CONCLUSIONS There is a statistically significant agreement among the different prenatal clinically used modalities for measuring fetal brain and the head circumference at birth, however, this correlation is not perfect. Further study is needed to investigate the long-term prognosis of these fetuses.
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Affiliation(s)
- Michal Gafner
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Shalev Fried
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Noa Gosher
- Hadassah Medical School, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Danielle Jeddah
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eliel Kedar Sade
- Department of Obstetrics and Gynecology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
| | - Eran Barzilay
- Department of Obstetrics and Gynecology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
| | - Arnaldo Mayer
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Diagnostic Radiology, Sheba Medical Center, Ramat-Gan, Israel
| | - Eldad Katorza
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Diagnostic Radiology, Sheba Medical Center, Ramat-Gan, Israel; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel
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10
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Ventricular and total brain volumes in infants with congenital heart disease: a longitudinal study. J Perinatol 2020; 40:1383-1388. [PMID: 32546829 PMCID: PMC8186433 DOI: 10.1038/s41372-020-0711-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 04/16/2020] [Accepted: 06/02/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Quantitative MRI techniques help recognize delayed brain development in fetuses with congenital heart disease (CHD). Ventriculomegaly became an early marker of brain dysmaturity. OBJECTIVE Evaluate longitudinally the cerebral ventricular and total brain volumes (TBV) in infants with CHD compared to normal neonates: testing the fetal brain dysmaturity and following its progression post operatively. STUDY DESIGN Fetal and post-operative MRIs were obtained on fetuses/neonates with CHD requiring invasive intervention within the first month after birth. Volumetric measurement was done with ITK-SNAP and analyzed post-hoc. RESULTS Ten cases were evaluated with a significant decrease in ventricular volumes from the fetal to the post-operative neonatal timepoint (p = 0.0297). Infants with HLHS had a significant increase postoperatively in their TBV (p = 0.0396). CONCLUSIONS TBV increased post operatively inversely mirrored by the decrement of the ventricular volumes. This could be explained by the establishment an increase of brain blood flow after surgery.
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Thomason ME. Development of Brain Networks In Utero: Relevance for Common Neural Disorders. Biol Psychiatry 2020; 88:40-50. [PMID: 32305217 PMCID: PMC7808399 DOI: 10.1016/j.biopsych.2020.02.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/05/2020] [Accepted: 02/05/2020] [Indexed: 01/27/2023]
Abstract
Magnetic resonance imaging, histological, and gene analysis approaches in living and nonliving human fetuses and in prematurely born neonates have provided insight into the staged processes of prenatal brain development. Increased understanding of micro- and macroscale brain network development before birth has spurred interest in understanding the relevance of prenatal brain development to common neurological diseases. Questions abound as to the sensitivity of the intrauterine brain to environmental programming, to windows of plasticity, and to the prenatal origin of disorders of childhood that involve disruptions in large-scale network connectivity. Much of the available literature on human prenatal neural development comes from cross-sectional or case studies that are not able to resolve the longitudinal consequences of individual variation in brain development before birth. This review will 1) detail specific methodologies for studying the human prenatal brain, 2) summarize large-scale human prenatal neural network development, integrating findings from across a variety of experimental approaches, 3) explore the plasticity of the early developing brain as well as potential sex differences in prenatal susceptibility, and 4) evaluate opportunities to link specific prenatal brain developmental processes to the forms of aberrant neural connectivity that underlie common neurological disorders of childhood.
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Affiliation(s)
- Moriah E Thomason
- Department of Child and Adolescent Psychiatry, Department of Population Health, and Neuroscience Institute, New York University Langone Health, New York, New York.
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12
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Zhao SX, Ma HL, Lv FR, Zhang ZW, Chen B, Xiao YH. Lateral ventricular volume and calcarine sulcus depth: a fetal MRI analysis of mild ventriculomegaly: A STROBE compliant article. Medicine (Baltimore) 2020; 99:e20679. [PMID: 32569198 PMCID: PMC7310869 DOI: 10.1097/md.0000000000020679] [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] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to quantify changes in the lateral ventricular volume, the depth of the calcarine sulcus (CS), and apparent diffusion coefficient (ADC) values of occipital lobe in fetuses with isolated mild ventriculomegaly (IMVM) using MRI.Seventy-one fetuses with IMVM at 25 to 38 weeks gestational age (GA) and 58 fetuses with normal lateral ventricles at 25 to 38 weeks GA were enrolled. Volumes of the lateral ventricles were measured by 3D magnetic resonance hydrography. Depths of the CS and ADC values were also evaluated. All differences were tested by t test. Bivariate correlations were performed using Pearson method.Fetuses with IMVM had significantly larger lateral ventricular volumes and smaller CS depths than controls (volumes: 9.37 ± 2.20 mL vs 5.04 ± 1.33 mL, respectively, P < .001; depths: 8.27 ± 2.55 mm vs 10.30 ± 3.14 mm, respectively, P < .001). In IMVM cases, the CS depths were smaller on the side with the larger ventricle (8.10 ± 2.54 mm vs 9.59 ± 2.81 mm, P < .001). No differences were observed in occipital lobe ADC values between the2 groups (IMVM = 1.80 ± 0.24 μm/ms; controls = 1.78 ± 0.28 μm/ms, P > .05).Fetuses with IMVM had larger lateral ventricular volumes, shallower CS depths, but normal occipital lobe ADC values.
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Affiliation(s)
| | | | | | | | - Bo Chen
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University
| | - Yun-hua Xiao
- Department of Radiology, The People 's Hospital of Chongqing Yubei District, Yubei District, Chongqing, China
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Fujita S, Hagiwara A, Hori M, Warntjes M, Kamagata K, Fukunaga I, Andica C, Maekawa T, Irie R, Takemura MY, Kumamaru KK, Wada A, Suzuki M, Ozaki Y, Abe O, Aoki S. Three-dimensional high-resolution simultaneous quantitative mapping of the whole brain with 3D-QALAS: An accuracy and repeatability study. Magn Reson Imaging 2019; 63:235-243. [DOI: 10.1016/j.mri.2019.08.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 08/19/2019] [Accepted: 08/19/2019] [Indexed: 11/24/2022]
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Grinberg A, Katorza E, Hoffman D, Ber R, Mayer A, Lipitz S. Volumetric MRI Study of the Brain in Fetuses with Intrauterine Cytomegalovirus Infection and Its Correlation to Neurodevelopmental Outcome. AJNR Am J Neuroradiol 2019; 40:353-358. [PMID: 30760462 DOI: 10.3174/ajnr.a5948] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/01/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In recent years, effort has been made to study 3D biometry as a method for fetal brain assessment. In this study, we aimed to compare brain volumes of fetuses with cytomegalovirus infection and noninfected controls. Also, we wanted to assess whether there is a correlation to their neurodevelopmental outcome as observed after several years. MATERIALS AND METHODS A retrospective cohort study examined MR imaging brain scans of 42 fetuses (at 30-34 weeks' gestational age) that were diagnosed with intrauterine cytomegalovirus infection. Volumetric measurements of 6 structures were assessed using a semiautomated designated program and were compared with a control group of 50 fetuses. Data collected included prenatal history and MR imaging and sonographic and neurodevelopmental follow-up. RESULTS We found that all brain volumes measured were smaller in the cytomegalovirus-infected group and that there was a correlation between smaller cerebellar volume and lower Vineland II Adaptive Behavior Scales questionnaire scores, especially in the fields of daily living and communication skills. CONCLUSIONS In this study, we found that brain volumes are affected by intrauterine cytomegalovirus infection and that it has a developmental prognostic meaning. Such information, which should be supported by further research, may help clinicians further analyze imaging data to treat and make a better assessment of these fetuses.
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Affiliation(s)
- A Grinberg
- From the Antenatal Diagnostic Unit (A.G., E.K., D.H., R.B., S.L.), Department of Obstetrics and Gynecology
- Sackler School of Medicine (A.G., E.K., D.H., R.B., A.M., S.L.), Tel Aviv University, Tel Aviv, Israel
| | - E Katorza
- From the Antenatal Diagnostic Unit (A.G., E.K., D.H., R.B., S.L.), Department of Obstetrics and Gynecology
- Sackler School of Medicine (A.G., E.K., D.H., R.B., A.M., S.L.), Tel Aviv University, Tel Aviv, Israel
| | - D Hoffman
- From the Antenatal Diagnostic Unit (A.G., E.K., D.H., R.B., S.L.), Department of Obstetrics and Gynecology
- Sackler School of Medicine (A.G., E.K., D.H., R.B., A.M., S.L.), Tel Aviv University, Tel Aviv, Israel
| | - R Ber
- From the Antenatal Diagnostic Unit (A.G., E.K., D.H., R.B., S.L.), Department of Obstetrics and Gynecology
- Sackler School of Medicine (A.G., E.K., D.H., R.B., A.M., S.L.), Tel Aviv University, Tel Aviv, Israel
| | - A Mayer
- Department of Diagnostic Radiology (A.M.), Chaim Sheba Medical Center, Tel-Hashomer, Israel
- Sackler School of Medicine (A.G., E.K., D.H., R.B., A.M., S.L.), Tel Aviv University, Tel Aviv, Israel
| | - S Lipitz
- From the Antenatal Diagnostic Unit (A.G., E.K., D.H., R.B., S.L.), Department of Obstetrics and Gynecology
- Sackler School of Medicine (A.G., E.K., D.H., R.B., A.M., S.L.), Tel Aviv University, Tel Aviv, Israel
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15
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Özbek A, Göçmen Mas N, Turan S, Ay B, Serim Demirgören B, Nilüfer Yonguç G, Karabekir S, İpek Polat A, Semra Hız A, Gencer Kıdak Ö. Cerebellar volume in early-onset schizophrenia and its association with severity of symptoms. J Int Med Res 2018; 47:411-419. [PMID: 30304968 PMCID: PMC6384474 DOI: 10.1177/0300060518803028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives This study aimed to investigate whether early-onset schizophrenia (EOS) cases differ from controls regarding volumes of the total cerebellum and the right and left cerebellar hemispheres, and volumetric asymmetry. Correlations of cerebellar volumes and asymmetry indices with severity of symptoms and general functioning in cases of EOS were also assessed. Methods Adolescents with EOS (n = 23) were compared with controls (n = 23). Sociodemographic and clinical data, and magnetic resonance imaging scans that were acquired for routine clinical purposes were collected retrospectively. Cerebellar volumes were evaluated using the stereological method. Asymmetry indices were subsequently calculated. Scores of the Positive and Negative Syndrome Scale and the Children’s Global Assessment Scale were used to assess the severity of symptoms and general functionality. Results There were no significant differences in any of the cerebellar volumes and asymmetry indices between the two groups. Neither cerebellar volumes nor asymmetry indices were correlated with the severity of symptoms and general functionality in EOS. Conclusions Our findings suggest that the early-onset form of schizophrenia does not show apparent volumetric changes of the cerebellum. Additionally, the neural circuits involved in formation of symptomatology may not reflect any correlation with cerebellar volumes at mid-adolescence.
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Affiliation(s)
- Aylin Özbek
- 1 Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Nüket Göçmen Mas
- 2 Department of Anatomy, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Serkan Turan
- 1 Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Bari Ay
- 1 Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Burcu Serim Demirgören
- 1 Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | | | - Selim Karabekir
- 3 Department of Neurosurgery, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ayşe İpek Polat
- 4 Department of Child Neurology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ayşe Semra Hız
- 4 Department of Child Neurology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Özlem Gencer Kıdak
- 1 Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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16
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Andescavage NN, du Plessis A, McCarter R, Serag A, Evangelou I, Vezina G, Robertson R, Limperopoulos C. Complex Trajectories of Brain Development in the Healthy Human Fetus. Cereb Cortex 2018; 27:5274-5283. [PMID: 27799276 DOI: 10.1093/cercor/bhw306] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 09/10/2016] [Indexed: 11/13/2022] Open
Abstract
This study characterizes global and hemispheric brain growth in healthy human fetuses during the second half of pregnancy using three-dimensional MRI techniques. We studied 166 healthy fetuses that underwent MRI between 18 and 39 completed weeks gestation. We created three-dimensional high-resolution reconstructions of the brain and calculated volumes for left and right cortical gray matter (CGM), fetal white matter (FWM), deep subcortical structures (DSS), and the cerebellum. We calculated the rate of growth for each tissue class according to gestational age and described patterns of hemispheric growth. Each brain region demonstrated major increases in volume during the second half of gestation, the most pronounced being the cerebellum (34-fold), followed by FWM (22-fold), CGM (21-fold), and DSS (10-fold). The left cerebellar hemisphere, CGM, and DSS had larger volumes early in gestation, but these equalized by term. It has been increasingly recognized that brain asymmetry evolves throughout the human life span. Advanced quantitative MRI provides noninvasive measurements of early structural asymmetry between the left and right fetal brain that may inform functional and behavioral laterality differences seen in children and young adulthood.
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Affiliation(s)
- Nickie N Andescavage
- Division of Neonatology, Children's National Health System, Washington, DC 20010, USA.,Department of Pediatrics, George Washington University School of Medicine, Washington, DC 20052, USA
| | - Adre du Plessis
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC 20052, USA.,Division of Fetal and Translational Medicine, Children's National Health System, Washington, DC 20010, USA
| | - Robert McCarter
- Division of Biostatistics and Informatics, Children's National Health System, Washington, DC 20010, USA
| | - Ahmed Serag
- Division of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC 20010, USA
| | - Iordanis Evangelou
- Division of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC 20010, USA
| | - Gilbert Vezina
- Division of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC 20010, USA.,Department of Radiology, George Washington University School of Medicine, Washington, DC 20052, USA
| | - Richard Robertson
- Department of Radiology, Children's Hospital Boston, Boston, MA 02115, USA.,Department of Radiology, Harvard Medical School, Cambridge, MA 02115, USA
| | - Catherine Limperopoulos
- Division of Fetal and Translational Medicine, Children's National Health System, Washington, DC 20010, USA.,Division of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC 20010, USA.,Department of Radiology, George Washington University School of Medicine, Washington, DC 20052, USA
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17
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Conte G, Milani S, Palumbo G, Talenti G, Boito S, Rustico M, Triulzi F, Righini A, Izzo G, Doneda C, Zolin A, Parazzini C. Prenatal Brain MR Imaging: Reference Linear Biometric Centiles between 20 and 24 Gestational Weeks. AJNR Am J Neuroradiol 2018. [PMID: 29519792 DOI: 10.3174/ajnr.a5574] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND PURPOSE Evaluation of biometry is a fundamental step in prenatal brain MR imaging. While different studies have reported reference centiles for MR imaging biometric data of fetuses in the late second and third trimesters of gestation, no one has reported them in fetuses in the early second trimester. We report centiles of normal MR imaging linear biometric data of a large cohort of fetal brains within 24 weeks of gestation. MATERIALS AND METHODS From the data bases of 2 referral centers of fetal medicine, accounting for 3850 examinations, we retrospectively collected 169 prenatal brain MR imaging examinations of singleton pregnancies, between 20 and 24 weeks of gestational age, with normal brain anatomy at MR imaging and normal postnatal neurologic development. To trace the reference centiles, we used the CG-LMS method. RESULTS Reference biometric centiles for the developing structures of the cerebrum, cerebellum, brain stem, and theca were obtained. The overall interassessor agreement was adequate for all measurements. CONCLUSIONS Reference biometric centiles of the brain structures in fetuses between 20 and 24 weeks of gestational age may be a reliable tool in assessing fetal brain development.
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Affiliation(s)
- G Conte
- From the Neuroradiology Unit (G.C.,G.P., F.T.)
| | - S Milani
- Department of Clinical Sciences and Community Health (S.M., A.Z.), Laboratory of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro,"
| | - G Palumbo
- From the Neuroradiology Unit (G.C.,G.P., F.T.)
| | - G Talenti
- Neuroradiology Unit (G.T.), Padua University Hospital, Padua, Italy
| | - S Boito
- Division of Prenatal Diagnosis (S.B.), Istituto Di Ricovero e Cura a Carattere Scientifico Fondazione Ca' Granda Ospedale Policlinico, Milan, Italy
| | - M Rustico
- Fetal Therapy Unit "Umberto Nicolini" (M.R.), Department of Woman Mother and Neonate
| | - F Triulzi
- From the Neuroradiology Unit (G.C.,G.P., F.T.)
- Department of Pathophysiology and Transplantation (F.T.), Università degli Studi di Milano, Milan, Italy
| | - A Righini
- Department of Paediatric Radiology and Neuroradiology (A.R., G.I., C.D., C.P.), Ospedale dei Bambini "V. Buzzi," Milan, Italy
| | - G Izzo
- Department of Paediatric Radiology and Neuroradiology (A.R., G.I., C.D., C.P.), Ospedale dei Bambini "V. Buzzi," Milan, Italy
| | - C Doneda
- Department of Paediatric Radiology and Neuroradiology (A.R., G.I., C.D., C.P.), Ospedale dei Bambini "V. Buzzi," Milan, Italy
| | - A Zolin
- Department of Clinical Sciences and Community Health (S.M., A.Z.), Laboratory of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro,"
| | - C Parazzini
- Department of Paediatric Radiology and Neuroradiology (A.R., G.I., C.D., C.P.), Ospedale dei Bambini "V. Buzzi," Milan, Italy
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18
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Zhao SX, Xiao YH, Lv FR, Zhang ZW, Sheng B, Ma HL. Lateral ventricular volume measurement by 3D MR hydrography in fetal ventriculomegaly and normal lateral ventricles. J Magn Reson Imaging 2017; 48:266-273. [PMID: 29251798 DOI: 10.1002/jmri.25927] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/30/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND In fetuses with prenatal ventriculomegaly (VM), ventricular volume on MRI has been shown to correlate with poor postnatal outcomes and in utero death. 3D magnetic resonance hydrography (MRH) has been widely used for MR cholangiopancreatography. PURPOSE To investigate the reliability of 3D MRH for lateral ventricular volume measurement in fetuses with VM and normal lateral ventricles, using manual multisection planimetry (MSP) as a reference standard. STUDY TYPE Prospective study. POPULATION Thirty-five fetuses with VM at 24-37 gestational weeks (GA) and 35 fetuses with normal lateral ventricles at 24-38 GA. FIELD STRENGTH/SEQUENCE 1.5T MRI with 3D MRH and T2 -weighted single-shot fast-spin echo sequence. ASSESSMENT Left, right, and total lateral ventricle volumes in fetuses were acquired from 3D MRH and manual MSP. All image analysis was performed by a radiologist twice and another radiologist once, blindly. STATISTICAL TESTS Analysis of linear regression analysis, Pearson's correlation coefficient, Bland-Altman plots, intraclass correlation coefficient (ICC), and independent samples t-test were used for statistical analyses. RESULTS There were highly significant relationships between all 3D MRH and manual MSP measurements of lateral ventricular volumes (rVM = 0.92-0.98; rN = 0.95-0.98; all P < 0.0001; VM: VM group, N: normal group), although left, right, and total lateral ventricular volumes measured by 3D MRH tended to be slightly larger than MSP (biasVM 0.1 ± 0.95, 0.26 ± 0.63, and 0.3 ± 0.68 mL, respectively; biasN 0.1 ± 0.95, 0.26 ± 0.63, and 0.3 ± 0.68 mL, respectively). Interrater agreement and intrarater repeatability were also excellent for 3D MRH (ICCVM = 0.994-0.99, ICCN = 0.989-0.992; ICCVM = 0.975-0.987, ICCN = 0.958-0.971, respectively). 3D MRH showed significantly reduced measurement time (VM: 3.55 ± 0.42 vs. 11.81 ± 0.13 min; N: 3.08 ± 0.39 vs. 12.12 ± 0.11 min; all P < 0.0001). DATA CONCLUSION Lateral ventricular volume measurement by 3D MRH was comparable to manual MSP. LEVEL OF EVIDENCE 1 Technical Efficacy Stage 1 J. Magn. Reson. Imaging 2017.
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Affiliation(s)
- Si-Xiu Zhao
- Department of Radiology, First Affiliated Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong District, Chongqing, China
| | - Yun-Hua Xiao
- Department of Radiology, People's Hospital of Chongqing Yubei District, Yubei District, Chongqing, China
| | - Fu-Rong Lv
- Department of Radiology, First Affiliated Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong District, Chongqing, China
| | - Zhi-Wei Zhang
- Department of Radiology, First Affiliated Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong District, Chongqing, China
| | - Bo Sheng
- Department of Radiology, First Affiliated Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong District, Chongqing, China
| | - Hong-Li Ma
- Department of Radiology, First Affiliated Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong District, Chongqing, China
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Yaniv G, Katorza E, Tsehmaister Abitbol V, Eisenkraft A, Bercovitz R, Bader S, Hoffmann C. Discrepancy in fetal head biometry between ultrasound and MRI in suspected microcephalic fetuses. Acta Radiol 2017; 58:1519-1527. [PMID: 28304179 DOI: 10.1177/0284185117698865] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Microcephaly is one of the most common fetal structural abnormalities, and prenatal microcephaly is considered a group I malformation of cortical development diagnosed according to ultrasound (US) skull measurements. Purpose To evaluate the agreement between fetal head US and magnetic resonance imaging (MRI) biometric measurements of suspected microcephalic fetuses. Material and Methods This institutional review board-approved retrospective study with waived informed consent included 180 pregnant women and was conducted at our medical center from March 2011 to April 2013. Biparietal diameter (BPD) and occipitofrontal diameter (OFD) results of fetal head US normograms were compared to normograms for MRI. We used Pearson and Spearman rho non-parametric correlation coefficients to assess the association between two quantitative variables, paired t-test for paired quantitative variables, and McNemar test for paired qualitative variables. Results The average BPD but not the average OFD percentiles in fetal head US differed significantly from the MRI results ( P < 0.0001). When looking at the accepted microcephaly threshold, both BPD and OFD percentiles differed significantly from MRI ( P < 0.0001 and P < 0.004, respectively). There was no correlation between US-measured skull biometry and MRI-measured brain biometry. Estimated cerebrospinal fluid volumes were significantly lower in the study group compared to 120 fetuses with normal findings in prenatal head US and MRI. Also, we have created a MRI-based normogram of fetal head circumference and gestational age. Conclusion The diagnosis of microcephaly by US alone may be insufficient and ideally should be validated by MRI before a final diagnosis is established.
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Affiliation(s)
- Gal Yaniv
- Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eldad Katorza
- Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Vered Tsehmaister Abitbol
- Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arik Eisenkraft
- The Institute for Research in Military Medicine, The Faculty of Medicine, The Hebrew University of Jerusalem, Israel
- The IDF Medical Corps
- Department of Pediatrics, Safra Children’s Hospital, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronen Bercovitz
- Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Salim Bader
- Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Chen Hoffmann
- Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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20
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Ber R, Hoffman D, Hoffman C, Polat A, Derazne E, Mayer A, Katorza E. Volume of Structures in the Fetal Brain Measured with a New Semiautomated Method. AJNR Am J Neuroradiol 2017; 38:2193-2198. [PMID: 28838909 DOI: 10.3174/ajnr.a5349] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 06/12/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE Measuring the volume of fetal brain structures is challenging due to fetal motion, low resolution, and artifacts caused by maternal tissue. Our aim was to introduce a new, simple, Matlab-based semiautomated method to measure the volume of structures in the fetal brain and present normal volumetric curves of the structures measured. MATERIALS AND METHODS The volume of the supratentorial brain, left and right hemispheres, cerebellum, and left and right eyeballs was measured retrospectively by the new semiautomated method in MR imaging examinations of 94 healthy fetuses. Four volume ratios were calculated. Interobserver agreement was calculated with the intraclass correlation coefficient, and a Bland-Altman plot was drawn for comparison of manual and semiautomated method measurements of the supratentorial brain. RESULTS We present normal volumetric curves and normal percentile values of the structures measured according to gestational age and of the ratios between the cerebellum and the supratentorial brain volume and the total eyeball and the supratentorial brain volume. Interobserver agreement was good or excellent for all structures measured. The Bland-Altman plot between manual and semiautomated measurements showed a maximal relative difference of 7.84%. CONCLUSIONS We present a technologically simple, reproducible method that can be applied prospectively and retrospectively on any MR imaging protocol, and we present normal volumetric curves measured. The method shows results like manual measurements while being less time-consuming and user-dependent. By applying this method on different cranial and extracranial structures, anatomic and pathologic, we believe that fetal volumetry can turn from a research tool into a practical clinical one.
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Affiliation(s)
- R Ber
- From the Departments of Obstetrics and Gynecology (R.B., D.H., A.P., E.K.)
| | - D Hoffman
- From the Departments of Obstetrics and Gynecology (R.B., D.H., A.P., E.K.)
| | - C Hoffman
- Diagnostic Imaging (C.H., A.M.), Chaim Sheba Medical Center, Tel Hashomer, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sackler Faculty of Medicine (C.H., E.D.), Tel-Aviv University, Tel-Aviv, Israel
| | - A Polat
- From the Departments of Obstetrics and Gynecology (R.B., D.H., A.P., E.K.)
| | - E Derazne
- Sackler Faculty of Medicine (C.H., E.D.), Tel-Aviv University, Tel-Aviv, Israel
| | - A Mayer
- Diagnostic Imaging (C.H., A.M.), Chaim Sheba Medical Center, Tel Hashomer, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - E Katorza
- From the Departments of Obstetrics and Gynecology (R.B., D.H., A.P., E.K.)
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21
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Kyriakopoulou V, Vatansever D, Davidson A, Patkee P, Elkommos S, Chew A, Martinez-Biarge M, Hagberg B, Damodaram M, Allsop J, Fox M, Hajnal JV, Rutherford MA. Normative biometry of the fetal brain using magnetic resonance imaging. Brain Struct Funct 2017; 222:2295-2307. [PMID: 27885428 PMCID: PMC5504265 DOI: 10.1007/s00429-016-1342-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 11/15/2016] [Indexed: 12/16/2022]
Abstract
The fetal brain shows accelerated growth in the latter half of gestation, and these changes can be captured by 2D and 3D biometry measurements. The aim of this study was to quantify brain growth in normal fetuses using Magnetic Resonance Imaging (MRI) and to produce reference biometry data and a freely available centile calculator ( https://www.developingbrain.co.uk/fetalcentiles/ ). A total of 127 MRI examinations (1.5 T) of fetuses with a normal brain appearance (21-38 gestational weeks) were included in this study. 2D and 3D biometric parameters were measured from slice-to-volume reconstructed images, including 3D measurements of supratentorial brain tissue, lateral ventricles, cortex, cerebellum and extra-cerebral CSF and 2D measurements of brain biparietal diameter and fronto-occipital length, skull biparietal diameter and occipitofrontal diameter, head circumference, transverse cerebellar diameter, extra-cerebral CSF, ventricular atrial diameter, and vermis height, width, and area. Centiles were constructed for each measurement. All participants were invited for developmental follow-up. All 2D and 3D measurements, except for atrial diameter, showed a significant positive correlation with gestational age. There was a sex effect on left and total lateral ventricular volumes and the degree of ventricular asymmetry. The 5th, 50th, and 95th centiles and a centile calculator were produced. Developmental follow-up was available for 73.1% of cases [mean chronological age 27.4 (±10.2) months]. We present normative reference charts for fetal brain MRI biometry at 21-38 gestational weeks. Developing growth trajectories will aid in the better understanding of normal fetal brain growth and subsequently of deviations from typical development in high-risk pregnancies or following premature delivery.
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Affiliation(s)
- Vanessa Kyriakopoulou
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK.
| | - Deniz Vatansever
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK
| | - Alice Davidson
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK
| | - Prachi Patkee
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK
| | - Samia Elkommos
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK
| | - Andrew Chew
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK
| | - Miriam Martinez-Biarge
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK
| | - Bibbi Hagberg
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Kungsgatan, 12 411 18, Gothenburg, Sweden
| | - Mellisa Damodaram
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK
| | - Joanna Allsop
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK
| | - Matt Fox
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK
| | - Joseph V Hajnal
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK
| | - Mary A Rutherford
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, 1st Floor South Wing, London, SE1 7EH, UK
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22
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Andescavage NN, DuPlessis A, McCarter R, Vezina G, Robertson R, Limperopoulos C. Cerebrospinal Fluid and Parenchymal Brain Development and Growth in the Healthy Fetus. Dev Neurosci 2017; 38:420-429. [PMID: 28315866 DOI: 10.1159/000456711] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 01/17/2017] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE The objective of this study was to apply quantitative magnetic resonance imaging to characterize absolute cerebrospinal fluid (CSF) development, as well as its relative development to fetal brain parenchyma in the healthy human fetus. DESIGN We created three-dimensional high-resolution reconstructions of the developing brain for healthy fetuses between 18 and 40 weeks' gestation, segmented the parenchymal and CSF spaces, and calculated the volumes for the lateral, third, and fourth ventricles; extra-axial CSF space; and the cerebrum, cerebellum, and brainstem. From these data, we constructed normograms of the resulting volumes according to gestational age and described the relative development of CSF to fetal brain parenchyma. RESULTS Each CSF space demonstrated major increases in volumetric growth during the second half of gestation: third ventricle (23-fold), extra-axial CSF (11-fold), fourth ventricle (8-fold), and lateral ventricle (2-fold). Total CSF volume was related to total brain volume (p < 0.01), as was lateral ventricle to cerebral volume (p < 0.01); however, the fourth ventricle was not related to cerebellar or brainstem volume (p = 0.18-0.19). RELEVANCE Abnormalities of the CSF spaces are the most common anomalies of neurologic development detected on fetal screening using neurosonography. Normative values of absolute CSF volume, as well as relative growth in comparison to intracranial parenchyma, provide valuable insight into normal fetal neurodevelopment. These data may provide important biomarkers of early deviations from normal growth, better distinguish between benign variants and early disease, and serve as reference standards for postnatal growth and development in the premature infant.
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23
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Jarvis D, Akram R, Mandefield L, Paddock M, Armitage P, Griffiths PD. Quantification of total fetal brain volume using 3D MR imaging data acquired in utero. Prenat Diagn 2016; 36:1225-1232. [PMID: 27862111 DOI: 10.1002/pd.4961] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 10/28/2016] [Accepted: 11/01/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Interpretation of magnetic resonance (MR) imaging of the fetal brain in utero is primarily undertaken using 2D images to provide anatomical information about structural abnormalities. It is now possible to obtain 3D image acquisitions that allow measurement of fetal brain volumes that are potentially useful clinically. The aim of our current work is to provide reference values of total brain volumes obtained from a cohort of low risk fetuses with no abnormalities on ante-natal ultrasonography and in utero MR imaging. METHOD Images from volume MR acquisitions of 132 fetuses were used to extract brain volumes by manual segmentation. Reproducibility and reliability were assessed by analysis of the results of two subgroups who had repeated measurements made by the primary and a secondary observer. RESULTS Intra-observer and inter-observer agreement was high with no statistically significant differences between and within observers (p = 0.476 and p = 0.427, respectively). The results of the brain volume assessments are presented graphically with mean and 95% prediction limits alongside estimates of normal growth rates. CONCLUSION We have shown that fetal brain volumes can be reliably extracted from in utero MR (iuMR) imaging 3D datasets with a high degree of reproducibility. The resultant data could potentially be used as a reference tool in the clinical setting. © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Deborah Jarvis
- Academic Unit of Radiology, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Rahim Akram
- Academic Unit of Radiology, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Laura Mandefield
- ScHARR Clinical Trials and Research Unit, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Michael Paddock
- Academic Unit of Radiology, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Paul Armitage
- Academic Unit of Radiology, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Paul D Griffiths
- Academic Unit of Radiology, University of Sheffield, Sheffield, South Yorkshire, UK
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Polat A, Barlow S, Ber R, Achiron R, Katorza E. Volumetric MRI study of the intrauterine growth restriction fetal brain. Eur Radiol 2016; 27:2110-2118. [PMID: 27491875 DOI: 10.1007/s00330-016-4502-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/25/2016] [Accepted: 06/30/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Intrauterine growth restriction (IUGR) is a pathologic fetal condition known to affect the fetal brain regionally and associated with future neurodevelopmental abnormalities. This study employed MRI to assess in utero regional brain volume changes in IUGR fetuses compared to controls. METHODS Retrospectively, using MRI images of fetuses at 30-34 weeks gestational age, a total of 8 brain regions-supratentorial brain and cavity, cerebral hemispheres, temporal lobes and cerebellum-were measured for volume in 13 fetuses with IUGR due to placental insufficiency and in 21 controls. Volumes and their ratios were assessed for difference using regression models. Reliability was assessed by intraclass correlation coefficients (ICC) between two observers. RESULTS In both groups, all structures increase in absolute volume during that gestation period, and the rate of cerebellar growth is higher compared to that of supratentorial structures. All structures' absolute volumes were significantly smaller for the IUGR group. Cerebellar to supratentorial ratios were found to be significantly smaller (P < 0.05) for IUGR compared to controls. No other significant ratio differences were found. ICC showed excellent agreement. CONCLUSIONS The cerebellar to supratentorial volume ratio is affected in IUGR fetuses. Additional research is needed to assess this as a radiologic marker in relation to long-term outcome. KEY POINTS • IUGR is a pathologic fetal condition affecting the brain • IUGR is associated with long-term neurodevelopmental abnormalities; fetal characterization is needed • This study aimed to evaluate regional brain volume differences in IUGR • Cerebellar to supratentorial volume ratios were smaller in IUGR fetuses • This finding may play a role in long-term development of IUGR fetuses.
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Affiliation(s)
- A Polat
- Department of Obstetrics and Gynecology, the Chaim Sheba Medical Center, Tel Hashomer, Affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - S Barlow
- Department of Obstetrics and Gynecology, the Chaim Sheba Medical Center, Tel Hashomer, Affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Ber
- Department of Obstetrics and Gynecology, the Chaim Sheba Medical Center, Tel Hashomer, Affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Achiron
- Department of Obstetrics and Gynecology, the Chaim Sheba Medical Center, Tel Hashomer, Affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Katorza
- Department of Obstetrics and Gynecology, the Chaim Sheba Medical Center, Tel Hashomer, Affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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25
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Vasung L, Lepage C, Radoš M, Pletikos M, Goldman JS, Richiardi J, Raguž M, Fischi-Gómez E, Karama S, Huppi PS, Evans AC, Kostovic I. Quantitative and Qualitative Analysis of Transient Fetal Compartments during Prenatal Human Brain Development. Front Neuroanat 2016; 10:11. [PMID: 26941612 PMCID: PMC4764715 DOI: 10.3389/fnana.2016.00011] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 02/01/2016] [Indexed: 02/04/2023] Open
Abstract
The cerebral wall of the human fetal brain is composed of transient cellular compartments, which show characteristic spatiotemporal relationships with intensity of major neurogenic events (cell proliferation, migration, axonal growth, dendritic differentiation, synaptogenesis, cell death, and myelination). The aim of the present study was to obtain new quantitative data describing volume, surface area, and thickness of transient compartments in the human fetal cerebrum. Forty-four postmortem fetal brains aged 13–40 postconceptional weeks (PCW) were included in this study. High-resolution T1 weighted MR images were acquired on 19 fetal brain hemispheres. MR images were processed using in-house software (MNI-ACE toolbox). Delineation of fetal compartments was performed semi-automatically by co-registration of MRI with histological sections of the same brains, or with the age-matched brains from Zagreb Neuroembryological Collection. Growth trajectories of transient fetal compartments were reconstructed. The composition of telencephalic wall was quantitatively assessed. Between 13 and 25 PCW, when the intensity of neuronal proliferation decreases drastically, the relative volume of proliferative (ventricular and subventricular) compartments showed pronounced decline. In contrast, synapse- and extracellular matrix-rich subplate compartment continued to grow during the first two trimesters, occupying up to 45% of telencephalon and reaching its maximum volume and thickness around 30 PCW. This developmental maximum coincides with a period of intensive growth of long cortico-cortical fibers, which enter and wait in subplate before approaching the cortical plate. Although we did not find significant age related changes in mean thickness of the cortical plate, the volume, gyrification index, and surface area of the cortical plate continued to exponentially grow during the last phases of prenatal development. This cortical expansion coincides developmentally with the transformation of embryonic cortical columns, dendritic differentiation, and ingrowth of axons. These results provide a quantitative description of transient human fetal brain compartments observable with MRI. Moreover, they will improve understanding of structural-functional relationships during brain development, will enable correlation between in vitro/in vivo imaging and fine structural histological studies, and will serve as a reference for study of perinatal brain injuries.
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Affiliation(s)
- Lana Vasung
- Department of Developmental Neuroscience, Croatian Institute for Brain Research, School of Medicine, University of ZagrebZagreb, Croatia; Division of Development and Growth, Department of Pediatrics, University of GenevaGeneva, Switzerland
| | - Claude Lepage
- Ludmer Centre for Neuroinformatics, McGill Centre for Integrative Neuroscience, Department of Biomedical Engineering, Montreal Neurological Institute, Montreal, McGill University Montreal, QC, Canada
| | - Milan Radoš
- Department of Developmental Neuroscience, Croatian Institute for Brain Research, School of Medicine, University of Zagreb Zagreb, Croatia
| | - Mihovil Pletikos
- Department of Developmental Neuroscience, Croatian Institute for Brain Research, School of Medicine, University of ZagrebZagreb, Croatia; Department of Neuroscience and Kavli Institute for Neuroscience, Yale School of MedicineNew Haven, CT, USA
| | - Jennifer S Goldman
- Ludmer Centre for Neuroinformatics, McGill Centre for Integrative Neuroscience, Department of Biomedical Engineering, Montreal Neurological Institute, Montreal, McGill University Montreal, QC, Canada
| | - Jonas Richiardi
- Laboratory of Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva Geneva, Switzerland
| | - Marina Raguž
- Department of Developmental Neuroscience, Croatian Institute for Brain Research, School of Medicine, University of Zagreb Zagreb, Croatia
| | - Elda Fischi-Gómez
- Division of Development and Growth, Department of Pediatrics, University of Geneva Geneva, Switzerland
| | - Sherif Karama
- Ludmer Centre for Neuroinformatics, McGill Centre for Integrative Neuroscience, Department of Biomedical Engineering, Montreal Neurological Institute, Montreal, McGill University Montreal, QC, Canada
| | - Petra S Huppi
- Division of Development and Growth, Department of Pediatrics, University of Geneva Geneva, Switzerland
| | - Alan C Evans
- Ludmer Centre for Neuroinformatics, McGill Centre for Integrative Neuroscience, Department of Biomedical Engineering, Montreal Neurological Institute, Montreal, McGill University Montreal, QC, Canada
| | - Ivica Kostovic
- Department of Developmental Neuroscience, Croatian Institute for Brain Research, School of Medicine, University of Zagreb Zagreb, Croatia
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26
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Lockwood Estrin G, Kyriakopoulou V, Makropoulos A, Ball G, Kuhendran L, Chew A, Hagberg B, Martinez-Biarge M, Allsop J, Fox M, Counsell SJ, Rutherford MA. Altered white matter and cortical structure in neonates with antenatally diagnosed isolated ventriculomegaly. NEUROIMAGE-CLINICAL 2016; 11:139-148. [PMID: 26937382 PMCID: PMC4753810 DOI: 10.1016/j.nicl.2016.01.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 01/05/2016] [Accepted: 01/12/2016] [Indexed: 12/31/2022]
Abstract
Ventriculomegaly (VM) is the most common central nervous system abnormality diagnosed antenatally, and is associated with developmental delay in childhood. We tested the hypothesis that antenatally diagnosed isolated VM represents a biological marker for altered white matter (WM) and cortical grey matter (GM) development in neonates. 25 controls and 21 neonates with antenatally diagnosed isolated VM had magnetic resonance imaging at 41.97(± 2.94) and 45.34(± 2.14) weeks respectively. T2-weighted scans were segmented for volumetric analyses of the lateral ventricles, WM and cortical GM. Diffusion tensor imaging (DTI) measures were assessed using voxel-wise methods in WM and cortical GM; comparisons were made between cohorts. Ventricular and cortical GM volumes were increased, and WM relative volume was reduced in the VM group. Regional decreases in fractional anisotropy (FA) and increases in mean diffusivity (MD) were demonstrated in WM of the VM group compared to controls. No differences in cortical DTI metrics were observed. At 2 years, neurodevelopmental delays, especially in language, were observed in 6/12 cases in the VM cohort. WM alterations in isolated VM cases may be consistent with abnormal development of WM tracts involved in language and cognition. Alterations in WM FA and MD may represent neural correlates for later neurodevelopmental deficits. This study compared brain development in neonates with isolated VM to controls. Neonates with isolated VM have enlarged cortical volumes compared to controls. FA was reduced and MD was increased in the WM of the VM cohort. Children with antenatal isolated VM are at increased risk for language delay.
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Affiliation(s)
- G Lockwood Estrin
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom; Robert Steiner Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London W12 0HS, United Kingdom
| | - V Kyriakopoulou
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - A Makropoulos
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - G Ball
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - L Kuhendran
- Robert Steiner Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London W12 0HS, United Kingdom
| | - A Chew
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom; Robert Steiner Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London W12 0HS, United Kingdom
| | - B Hagberg
- Robert Steiner Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London W12 0HS, United Kingdom; Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Kungsgatan 12, 411 18 Gothenburg, Sweden
| | - M Martinez-Biarge
- Robert Steiner Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London W12 0HS, United Kingdom
| | - J Allsop
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - M Fox
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - S J Counsell
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - M A Rutherford
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
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27
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Abstract
Magnetic resonance imaging of the human fetal brain has been a clinical tool for many years and provides valuable additional information to compliment more common ultrasound studies. Advances in both MRI acquisition and post processing over the last 10 years have enabled full 3D imaging and the accurate combination of data acquired in different head positions to create improved geometric integrity, tissue contrast, and resolution. This research is now motivating the development of new quantitative MRI-based techniques for clinical imaging that can more accurately characterize brain development and detect abnormalities. In this article, we will review some of the key areas that are driving changes in our understanding of fetal brain growth using quantitative measures derived from in utero MRI and the possible directions for its increased use in improving the evaluation of pregnancies and the accurate characterization of abnormal brain growth.
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Affiliation(s)
- Colin Studholme
- Biomedical Image Computing Group, Departments of Pediatrics, Bioengineering and Radiology, University of Washington, Seattle, WA.
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28
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Gholipour A, Estroff JA, Barnewolt CE, Robertson RL, Grant PE, Gagoski B, Warfield SK, Afacan O, Connolly SA, Neil JJ, Wolfberg A, Mulkern RV. Fetal MRI: A Technical Update with Educational Aspirations. CONCEPTS IN MAGNETIC RESONANCE. PART A, BRIDGING EDUCATION AND RESEARCH 2014; 43:237-266. [PMID: 26225129 PMCID: PMC4515352 DOI: 10.1002/cmr.a.21321] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Fetal magnetic resonance imaging (MRI) examinations have become well-established procedures at many institutions and can serve as useful adjuncts to ultrasound (US) exams when diagnostic doubts remain after US. Due to fetal motion, however, fetal MRI exams are challenging and require the MR scanner to be used in a somewhat different mode than that employed for more routine clinical studies. Herein we review the techniques most commonly used, and those that are available, for fetal MRI with an emphasis on the physics of the techniques and how to deploy them to improve success rates for fetal MRI exams. By far the most common technique employed is single-shot T2-weighted imaging due to its excellent tissue contrast and relative immunity to fetal motion. Despite the significant challenges involved, however, many of the other techniques commonly employed in conventional neuro- and body MRI such as T1 and T2*-weighted imaging, diffusion and perfusion weighted imaging, as well as spectroscopic methods remain of interest for fetal MR applications. An effort to understand the strengths and limitations of these basic methods within the context of fetal MRI is made in order to optimize their use and facilitate implementation of technical improvements for the further development of fetal MR imaging, both in acquisition and post-processing strategies.
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Affiliation(s)
- Ali Gholipour
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Judith A Estroff
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Carol E Barnewolt
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Richard L Robertson
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - P Ellen Grant
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Borjan Gagoski
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Simon K Warfield
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Onur Afacan
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Susan A Connolly
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jeffrey J Neil
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Adam Wolfberg
- Boston Maternal Fetal Medicine, Boston, Massachusetts, USA
| | - Robert V Mulkern
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
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29
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Jarvis DA, Armitage P, Dean A, Griffiths PD. Surface reconstructions of foetal brain abnormalities using ultrafast steady state 3D acquisitions. Clin Radiol 2014; 69:1084-91. [PMID: 25062925 DOI: 10.1016/j.crad.2014.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 06/10/2014] [Accepted: 06/16/2014] [Indexed: 12/15/2022]
Abstract
MRI of the foetal brain in utero is performed in routine clinical practice using sequences that produce two-dimensional (2D) images. Recent developments in image post-processing have allowed the construction of three-dimensional (3D) volume data sets from 2D images acquired in different anatomical planes, but these have limitations due to the unpredictable nature of foetal movement. These limitations have been overcome by development of several different advanced computer techniques, which require specialist knowledge, software, and processing methods, which are rarely available in routine clinical settings. Our aim was to develop a technique that can be used in routine clinical situations without the need for custom-developed or expensive software by utilizing MRI sequences that can produce a 3D data set in "ultrafast" timescales. The 3D dataset, combined with versatile image post-processing and visualization techniques, has resulted in the production of high-resolution images of foetal brain surfaces in utero. The aim of this paper is to demonstrate our methods and early results by way of a pictorial review illustrating a range of developmental brain disease in utero.
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Affiliation(s)
- D A Jarvis
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK.
| | - P Armitage
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - A Dean
- Histopathology Department, Cambridge University Hospitals NHS Foundation Trust, Box 235, Hills Road, Cambridge CB2 0QQ, UK
| | - P D Griffiths
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
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30
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Multidimensional analysis of fetal posterior fossa in health and disease. THE CEREBELLUM 2014; 12:632-44. [PMID: 23553467 DOI: 10.1007/s12311-013-0470-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Fetal magnetic resonance imaging (MRI) is now routinely used to further investigate cerebellar malformations detected with ultrasound. However, the lack of 2D and 3D biometrics in the current literature hinders the detailed characterisation and classification of cerebellar anomalies. The main objectives of this fetal neuroimaging study were to provide normal posterior fossa growth trajectories during the second and third trimesters of pregnancy via semi-automatic segmentation of reconstructed fetal brain MR images and to assess common cerebellar malformations in comparison with the reference data. Using a 1.5-T MRI scanner, 143 MR images were obtained from 79 normal control and 53 fetuses with posterior fossa abnormalities that were grouped according to the severity of diagnosis on visual MRI inspections. All quantifications were performed on volumetric datasets, and supplemental outcome information was collected from the surviving infants. Normal growth trajectories of total brain, cerebellar, vermis, pons and fourth ventricle volumes showed significant correlations with 2D measurements and increased in second-order polynomial trends across gestation (Pearson r, p < 0.05). Comparison of normal controls to five abnormal cerebellum subgroups depicted significant alterations in volumes that could not be detected exclusively with 2D analysis (MANCOVA, p < 0.05). There were 15 terminations of pregnancy, 8 neonatal deaths, and a spectrum of genetic and neurodevelopmental outcomes in the assessed 24 children with cerebellar abnormalities. The given posterior fossa biometrics enhance the delineation of normal and abnormal cerebellar phenotypes on fetal MRI and confirm the advantages of utilizing advanced neuroimaging tools in clinical fetal research.
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Yang L, Chen L, Qiu X, Zhang Z, Liu S, Wang G, Xiao L, Lin X. Fetal cerebral lobes development between 20 and 28 weeks gestational age: A postmortem MR study. Int J Dev Neurosci 2013; 32:23-7. [PMID: 24060494 DOI: 10.1016/j.ijdevneu.2013.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 09/12/2013] [Accepted: 09/12/2013] [Indexed: 10/26/2022] Open
Affiliation(s)
- Linlin Yang
- Department of RadiologyThe Second Hospital of Shandong UniversityNo. 247 Beiyuan Road250033JinanShandongPR China
| | - Liguang Chen
- Department of MRShandong Medical Imaging Research InstituteNo. 324 Jingwu RoadJinan250021ShandongPR China
| | - Xiuling Qiu
- Department of MRShandong Medical Imaging Research InstituteNo. 324 Jingwu RoadJinan250021ShandongPR China
| | - Zhonghe Zhang
- Shandong Provincial HospitalNo. 324 Jingwu RoadJinan250021ShandongPR China
| | - Shuwei Liu
- Research Center for Sectional and Imaging AnatomyShandong University School of MedicineNo. 44 West Wenhua RoadJinan250012ShandongPR China
| | - Guangbin Wang
- Department of MRShandong Medical Imaging Research InstituteNo. 324 Jingwu RoadJinan250021ShandongPR China
| | - Lianxiang Xiao
- Department of MRShandong Medical Imaging Research InstituteNo. 324 Jingwu RoadJinan250021ShandongPR China
| | - Xiangtao Lin
- Department of MRShandong Medical Imaging Research InstituteNo. 324 Jingwu RoadJinan250021ShandongPR China
- Shandong University School of MedicineNo. 44 West Wenhua RoadJinan250012ShandongPR China
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Abstract
To date, growth of the human fetal cerebellum has been estimated primarily from linear measurements from ultrasound and 2D magnetic resonance imaging (MRI). In this study, we use 3D analytical methods to develop normative growth trajectories for the cerebellum in utero. We measured cerebellar volume, linear dimensions, and local surface curvature from 3D reconstructed MRI of the human fetal brain (N = 46). We found that cerebellar volume increased approximately 7-fold from 20 to 31 gestational weeks. The better fit of the exponential curve (R (2) = 0.96) compared to the linear curve (R (2) = 0.92) indicated acceleration in growth. Within-subject cerebellar and cerebral volumes were highly correlated (R (2) = 0.94), though the cerebellar percentage of total brain volume increased from approximately 2.4% to 3.7% (R (2) = 0.63). Right and left hemispheric volumes did not significantly differ. Transcerebellar diameter, vermal height, and vermal anterior to posterior diameter increased significantly at constant rates. From the local curvature analysis, we found that expansion along the inferior and superior aspects of the hemispheres resulted in decreased convexity, which is likely due to the physical constraints of the dura surrounding the cerebellum and the adjacent brainstem. The paired decrease in convexity along the inferior vermis and increased convexity of the medial hemisphere represents development of the paravermian fissure, which becomes more visible during this period. In this 3D morphometric analysis of the human fetal cerebellum, we have shown that cerebellar growth is accelerating at a greater pace than the cerebrum and described how cerebellar growth impacts the shape of the structure.
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Rajagopalan V, Scott J, Habas PA, Kim K, Rousseau F, Glenn OA, Barkovich AJ, Studholme C. Mapping directionality specific volume changes using tensor based morphometry: an application to the study of gyrogenesis and lateralization of the human fetal brain. Neuroimage 2012; 63:947-58. [PMID: 22503938 PMCID: PMC3732053 DOI: 10.1016/j.neuroimage.2012.03.092] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 03/27/2012] [Accepted: 03/30/2012] [Indexed: 12/29/2022] Open
Abstract
Tensor based morphometry (TBM) is a powerful approach to analyze local structural changes in brain anatomy. However, conventional scalar TBM methods do not completely capture all direction specific volume changes required to model complex changes such as those during brain growth. In this paper, we describe novel TBM descriptors for studying direction-specific changes in a subject population which can be used in conjunction with scalar TBM to analyze local patterns in directionality of volume change during brain development. We also extend the methodology to provide a new approach to mapping directional asymmetry in deformation tensors associated with the emergence of structural asymmetry in the developing brain. We illustrate the use of these methods by studying developmental patterns in the human fetal brain, in vivo. Results show that fetal brain development exhibits a distinct spatial pattern of anisotropic growth. The most significant changes in the directionality of growth occur in the cortical plate at major sulci. Our analysis also detected directional growth asymmetry in the peri-Sylvian region and the medial frontal lobe of the fetal brain.
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Affiliation(s)
- Vidya Rajagopalan
- Biomedical Image Computing Group, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA.
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Scott JA, Habas PA, Rajagopalan V, Kim K, Barkovich AJ, Glenn OA, Studholme C. Volumetric and surface-based 3D MRI analyses of fetal isolated mild ventriculomegaly: brain morphometry in ventriculomegaly. Brain Struct Funct 2012; 218:645-55. [PMID: 22547094 DOI: 10.1007/s00429-012-0418-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Accepted: 04/10/2012] [Indexed: 12/17/2022]
Abstract
Diagnosis of fetal isolated mild ventriculomegaly (IMVM) is the most common brain abnormality on prenatal ultrasound. We have set to identify potential alterations in brain development specific to IMVM in tissue volume and cortical and ventricular local surface curvature derived from in utero magnetic resonance imaging (MRI). Multislice 2D T2-weighted MRI were acquired from 32 fetuses (16 IMVM, 16 controls) between 22 and 25.5 gestational weeks. The images were motion-corrected and reconstructed into 3D volumes for volumetric and curvature analyses. The brain images were automatically segmented into cortical plate, cerebral mantle, deep gray nuclei, and ventricles. Volumes were compared between IMVM and control subjects. Surfaces were extracted from the segmentations for local mean surface curvature measurement on the inner cortical plate and the ventricles. Linear models were estimated for age-related and ventricular volume-associated changes in local curvature in both the inner cortical plate and ventricles. While ventricular volume was enlarged in IMVM, all other tissue volumes were not different from the control group. Ventricles increased in curvature with age along the atrium and anterior body. Increasing ventricular volume was associated with reduced curvature over most of the ventricular surface. The cortical plate changed in curvature with age at multiple sites of primary sulcal formation. Reduced cortical folding was detected near the parieto-occipital sulcus in IMVM subjects. While tissue volume appears to be preserved in brains with IMVM, cortical folding may be affected in regions where ventricles are dilated.
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Affiliation(s)
- Julia A Scott
- Biomedical Image Computing Group, Departments of Pediatrics, Bioengineering, and Radiology, University of Washington, Seattle, WA 98195, USA.
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Kochunov P, Rogers W, Mangin JF, Lancaster J. A library of cortical morphology analysis tools to study development, aging and genetics of cerebral cortex. Neuroinformatics 2012; 10:81-96. [PMID: 21698393 DOI: 10.1007/s12021-011-9127-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sharing of analysis techniques and tools is among the main driving forces of modern neuroscience. We describe a library of tools developed to quantify global and regional differences in cortical anatomy in high resolution structural MR images. This library is distributed as a plug-in application for popular structural analysis software, BrainVisa (BV). It contains tools to measure global and regional gyrification, gray matter thickness and sulcal and gyral white matter spans. We provide a description of each tool and examples for several case studies to demonstrate their use. These examples show how the BV library was used to study cortical folding process during antenatal development and recapitulation of this process during cerebral aging. Further, the BV library was used to perform translation research in humans and non-human primates on the genetics of cerebral gyrification. This library, including source code and self-contained binaries for popular computer platforms, is available from the NIH-Neuroimaging Informatics Tools and Resources Clearinghouse (NITRC) resource ( http://www.nitrc.org/projects/brainvisa_ext ).
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Affiliation(s)
- Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
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Gholipour A, Akhondi-Asl A, Estroff JA, Warfield SK. Multi-atlas multi-shape segmentation of fetal brain MRI for volumetric and morphometric analysis of ventriculomegaly. Neuroimage 2012; 60:1819-31. [PMID: 22500924 PMCID: PMC3329183 DOI: 10.1016/j.neuroimage.2012.01.128] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Revised: 01/05/2012] [Accepted: 01/29/2012] [Indexed: 11/18/2022] Open
Abstract
The recent development of motion robust super-resolution fetal brain MRI holds out the potential for dramatic new advances in volumetric and morphometric analysis. Volumetric analysis based on volumetric and morphometric biomarkers of the developing fetal brain must include segmentation. Automatic segmentation of fetal brain MRI is challenging, however, due to the highly variable size and shape of the developing brain; possible structural abnormalities; and the relatively poor resolution of fetal MRI scans. To overcome these limitations, we present a novel, constrained, multi-atlas, multi-shape automatic segmentation method that specifically addresses the challenge of segmenting multiple structures with similar intensity values in subjects with strong anatomic variability. Accordingly, we have applied this method to shape segmentation of normal, dilated, or fused lateral ventricles for quantitative analysis of ventriculomegaly (VM), which is a pivotal finding in the earliest stages of fetal brain development, and warrants further investigation. Utilizing these innovative techniques, we introduce novel volumetric and morphometric biomarkers of VM comparing these values to those that are generated by standard methods of VM analysis, i.e., by measuring the ventricular atrial diameter (AD) on manually selected sections of 2D ultrasound or 2D MRI. To this end, we studied 25 normal and abnormal fetuses in the gestation age (GA) range of 19 to 39 weeks (mean=28.26, stdev=6.56). This heterogeneous dataset was essentially used to 1) validate our segmentation method for normal and abnormal ventricles; and 2) show that the proposed biomarkers may provide improved detection of VM as compared to the AD measurement.
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Affiliation(s)
- Ali Gholipour
- Computational Radiology Laboratory, Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
| | - Alireza Akhondi-Asl
- Computational Radiology Laboratory, Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
| | - Judy A. Estroff
- Advanced Fetal Care Center, Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
| | - Simon K. Warfield
- Computational Radiology Laboratory, Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
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Clouchoux C, Guizard N, Evans AC, du Plessis AJ, Limperopoulos C. Normative fetal brain growth by quantitative in vivo magnetic resonance imaging. Am J Obstet Gynecol 2012; 206:173.e1-8. [PMID: 22055336 DOI: 10.1016/j.ajog.2011.10.002] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 07/15/2011] [Accepted: 10/03/2011] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of the study was to characterize total and regional volumetric brain growth in healthy fetuses during the second and third trimesters of pregnancy, using an automated method. STUDY DESIGN We developed and validated an automated method to quantify global and regional in vivo brain volumes using fetal magnetic resonance imaging. We then computed the percentage of growth for each brain structure in a cohort of 64 healthy fetuses (25.4-36.6 weeks' gestational age). RESULTS The cerebellum demonstrated the greatest maturation rate, with a 4-fold increase (384%) in volume between 25.4 and 36.6 weeks, and a relative growth rate of 12.87% per week. Both total brain and cerebral volumes increased by 230% and brain stem volume by 134% over the same gestational age period. Conversely, lateral ventricular volume decreased by 4.18% per week. CONCLUSION The availability and ongoing validation of normative fetal brain growth trajectories will provide important tools for early detection of impaired fetal brain growth upon which to manage high-risk pregnancies.
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Affiliation(s)
- Cedric Clouchoux
- Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC 20010, USA
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Clouchoux C, Limperopoulos C. Novel applications of quantitative MRI for the fetal brain. Pediatr Radiol 2012; 42 Suppl 1:S24-32. [PMID: 22395718 DOI: 10.1007/s00247-011-2178-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Accepted: 04/27/2011] [Indexed: 11/30/2022]
Abstract
The advent of ultrafast MRI acquisitions is offering vital insights into the critical maturational events that occur throughout pregnancy. Concurrent with the ongoing enhancement of ultrafast imaging has been the development of innovative image-processing techniques that are enabling us to capture and quantify the exuberant growth, and organizational and remodeling processes that occur during fetal brain development. This paper provides an overview of the role of advanced neuroimaging techniques to study in vivo brain maturation and explores the application of a range of new quantitative imaging biomarkers that can be used clinically to monitor high-risk pregnancies.
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Affiliation(s)
- Cédric Clouchoux
- Division of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC, USA.
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Huisman TA. Fetal Magnetic Resonance Imaging of the Brain: Is Ventriculomegaly the Tip of the Syndromal Iceberg? Semin Ultrasound CT MR 2011; 32:491-509. [DOI: 10.1053/j.sult.2011.08.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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40
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Studholme C. Mapping fetal brain development in utero using magnetic resonance imaging: the Big Bang of brain mapping. Annu Rev Biomed Eng 2011; 13:345-68. [PMID: 21568716 PMCID: PMC3682118 DOI: 10.1146/annurev-bioeng-071910-124654] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The development of tools to construct and investigate probabilistic maps of the adult human brain from magnetic resonance imaging (MRI) has led to advances in both basic neuroscience and clinical diagnosis. These tools are increasingly being applied to brain development in adolescence and childhood, and even to neonatal and premature neonatal imaging. Even earlier in development, parallel advances in clinical fetal MRI have led to its growing use as a tool in challenging medical conditions. This has motivated new engineering developments encompassing optimal fast MRI scans and techniques derived from computer vision, the combination of which allows full 3D imaging of the moving fetal brain in utero without sedation. These promise to provide a new and unprecedented window into early human brain growth. This article reviews the developments that have led us to this point, examines the current state of the art in the fields of fast fetal imaging and motion correction, and describes the tools to analyze dynamically changing fetal brain structure. New methods to deal with developmental tissue segmentation and the construction of spatiotemporal atlases are examined, together with techniques to map fetal brain growth patterns.
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Affiliation(s)
- Colin Studholme
- Biomedical Image Computing Group, Departments of Pediatrics, Bioengineering, and Radiology, University of Washington, Seattle, WA 98195, USA.
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Kong FZ, Huang F, Xu Q, Li ZP, Lin XT, Sun B, Yin Q, Chen CC. Sectional anatomy of the fetal brain in uterus at term on the sagittal plane. Taiwan J Obstet Gynecol 2011; 50:172-8. [PMID: 21791303 DOI: 10.1016/j.tjog.2011.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2010] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To provide sectional anatomic data for the precise localization of developmental malformation of fetal brain in sagittal magnetic resonance imaging (MRI). METHOD After abdominal and pelvic MRI scanning, the gravid specimen was cut into serial sagittal slices in correspondence with MRI in a low temperature laboratory to demonstrate the structures of fetal brain. RESULT (1) Directional determination of the sloping and rotating fetal head. From the serial sagittal sections of pregnant cadaver at term, we concluded that, the longitudinal lying and cephalic presentation fetal had run into maternal pelvis, and rotated and sloped to right. Anteroposterior position and median sagittal plane of the fetal was in correspondence with his mother's. (2) Seven serial sagittal sections of the fetal brain were obtained through lateral surface of the right cerebral hemisphere, lateral sulcus, internal capsule, median sagittal plane, middle cerebellar peduncle, brainstem, and lateral surface of the left cerebral hemisphere. CONCLUSION Through the comparison study between sagittal sections and corresponding MRI of fetal brain at term, we could obtain morphological anatomic structures and MRI of fetal brain, providing morphological demonstration of the intrauterine development of fetal brain and auxiliary diagnosis of ultrasound and MRI in pregnant woman.
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Affiliation(s)
- Fan-Zhen Kong
- Department of Human Anatomy, Binzhou Medical College, Yantai, Shandong, China
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42
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Local tissue growth patterns underlying normal fetal human brain gyrification quantified in utero. J Neurosci 2011; 31:2878-87. [PMID: 21414909 DOI: 10.1523/jneurosci.5458-10.2011] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Existing knowledge of growth patterns in the living fetal human brain is based upon in utero imaging studies by magnetic resonance imaging (MRI) and ultrasound, which describe overall growth and provide mainly qualitative findings. However, formation of the complex folded cortical structure of the adult brain requires, in part, differential rates of regional tissue growth. To better understand these local tissue growth patterns, we applied recent advances in fetal MRI motion correction and computational image analysis techniques to 40 normal fetal human brains covering a period of primary sulcal formation (20-28 gestational weeks). Growth patterns were mapped by quantifying tissue locations that were expanding more or less quickly than the overall cerebral growth rate, which reveal increasing structural complexity. We detected increased local relative growth rates in the formation of the precentral and postcentral gyri, right superior temporal gyrus, and opercula, which differentiated between the constant growth rate in underlying cerebral mantle and the accelerating rate in the cortical plate undergoing folding. Analysis focused on the cortical plate revealed greater volume increases in parietal and occipital regions compared to the frontal lobe. Cortical plate growth patterns constrained to narrower age ranges showed that gyrification, reflected by greater growth rates, was more pronounced after 24 gestational weeks. Local hemispheric volume asymmetry was located in the posterior peri-Sylvian area associated with structural lateralization in the mature brain. These maps of fetal brain growth patterns construct a spatially specific baseline of developmental biomarkers with which to correlate abnormal development in the human.
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43
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Quantitative in vivo MRI measurement of cortical development in the fetus. Brain Struct Funct 2011; 217:127-39. [PMID: 21562906 DOI: 10.1007/s00429-011-0325-x] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 04/28/2011] [Indexed: 01/25/2023]
Abstract
Normal brain development is associated with expansion and folding of the cerebral cortex following a highly orchestrated sequence of gyral-sulcal formation. Although several studies have described the evolution of cerebral cortical development ex vivo or ex utero, to date, very few studies have characterized and quantified the gyrification process for the in vivo fetal brain. Recent advances in fetal magnetic resonance imaging and post-processing computational methods are providing new insights into fetal brain maturation in vivo. In this study, we investigate the in vivo fetal cortical folding pattern in healthy fetuses between 25 and 35 weeks gestational age using 3-D reconstructed fetal cortical surfaces. We describe the in vivo fetal gyrification process using a robust feature extraction algorithm applied directly on the cortical surface, providing an explicit delineation of the sulcal pattern during fetal brain development. We also delineate cortical surface measures, including surface area and gyrification index. Our data support an exuberant third trimester gyrification process and suggest a non-linear evolution of sulcal development. The availability of normative indices of cerebral cortical developing in the living fetus may provide critical insights on the timing and progression of impaired cerebral development in the high-risk fetus.
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Scott JA, Habas PA, Kim K, Rajagopalan V, Hamzelou KS, Corbett-Detig JM, Barkovich AJ, Glenn OA, Studholme C. Growth trajectories of the human fetal brain tissues estimated from 3D reconstructed in utero MRI. Int J Dev Neurosci 2011; 29:529-36. [PMID: 21530634 DOI: 10.1016/j.ijdevneu.2011.04.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 03/16/2011] [Accepted: 04/07/2011] [Indexed: 12/20/2022] Open
Abstract
In the latter half of gestation (20-40 gestational weeks), human brain growth accelerates in conjunction with cortical folding and the deceleration of ventricular zone progenitor cell proliferation. These processes are reflected in changes in the volume of respective fetal tissue zones. Thus far, growth trajectories of the fetal tissue zones have been extracted primarily from 2D measurements on histological sections and magnetic resonance imaging (MRI). In this study, the volumes of major fetal zones-cortical plate (CP), subplate and intermediate zone (SP+IZ), germinal matrix (GMAT), deep gray nuclei (DG), and ventricles (VENT)--are calculated from automatic segmentation of motion-corrected, 3D reconstructed MRI. We analyzed 48 T2-weighted MRI scans from 39 normally developing fetuses in utero between 20.57 and 31.14 gestational weeks (GW). The supratentorial volume (STV) increased linearly at a rate of 15.22% per week. The SP+IZ (14.75% per week) and DG (15.56% per week) volumes increased at similar rates. The CP increased at a greater relative rate (18.00% per week), while the VENT (9.18% per week) changed more slowly. Therefore, CP increased as a fraction of STV and the VENT fraction declined. The total GMAT volume slightly increased then decreased after 25 GW. We did not detect volumetric sexual dimorphisms or total hemispheric volume asymmetries, which may emerge later in gestation. Further application of the automated fetal brain segmentation to later gestational ages will bridge the gap between volumetric studies of premature brain development and normal brain development in utero.
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Affiliation(s)
- Julia A Scott
- Biomedical Image Computing Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
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Haratz KK, Oliveira PS, Rolo LC, Nardozza LMM, Milani HF, Barreto EQ, Araujo Júnior E, Ajzen SA, Moron AF. Fetal cerebral ventricle volumetry: comparison between 3D ultrasound and magnetic resonance imaging in fetuses with ventriculomegaly. J Matern Fetal Neonatal Med 2011; 24:1384-91. [DOI: 10.3109/14767058.2011.556205] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Farkas N, Hoffmann C, Ben-Sira L, Lev D, Schweiger A, Kidron D, Lerman-Sagie T, Malinger G. Does normal fetal brain ultrasound predict normal neurodevelopmental outcome in congenital cytomegalovirus infection? Prenat Diagn 2011; 31:360-6. [PMID: 21413035 DOI: 10.1002/pd.2694] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2009] [Revised: 11/20/2010] [Accepted: 12/06/2010] [Indexed: 11/10/2022]
Abstract
OBJECTIVE We evaluated the neuropsychological outcome of children with proven congenital cytomegalovirus (CMV) infection and normal consecutive fetal neurosonographic examinations. METHODS We retrospectively reviewed laboratory and imaging findings of children with congenital CMV infection. The study group consisted of children with a positive polymerase chain reaction (PCR) in amniotic fluid and virus isolation in urine in the first week of life, and normal fetal ultrasonographic (US) examination findings, including a normal multiplanar neurosonographic evaluation. Patients with abnormal magnetic resonance (MR) findings were not excluded. The study and control groups were evaluated for cognitive, language, and motor development at one follow-up examination conducted at 11-81 months of age. RESULTS Children with congenital CMV infection and normal fetal brain findings in the US examination did not differ from the control group in terms of cognitive, language, motor, emotional-behavioral, and executive functioning. There were no differences between congenitally infected children who had a normal fetal brain MR examination and children whose fetal brain MR examination raised suspicion of a possible brain insult. CONCLUSIONS Normal neurosonographic examinations during pregnancy appear to predict a normal early neuropsychological outcome in fetuses with congenital CMV infection. Outcome did not correlate with suspected abnormal white matter on fetal MR imaging.
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Habas PA, Kim K, Rousseau F, Glenn OA, Barkovich AJ, Studholme C. Atlas-based segmentation of developing tissues in the human brain with quantitative validation in young fetuses. Hum Brain Mapp 2011; 31:1348-58. [PMID: 20108226 DOI: 10.1002/hbm.20935] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Imaging of the human fetus using magnetic resonance (MR) is an essential tool for quantitative studies of normal as well as abnormal brain development in utero. However, because of fundamental differences in tissue types, tissue properties and tissue distribution between the fetal and adult brain, automated tissue segmentation techniques developed for adult brain anatomy are unsuitable for this data. In this paper, we describe methodology for automatic atlas-based segmentation of individual tissue types in motion-corrected 3D volumes reconstructed from clinical MR scans of the fetal brain. To generate anatomically correct automatic segmentations, we create a set of accurate manual delineations and build an in utero 3D statistical atlas of tissue distribution incorporating developing gray and white matter as well as transient tissue types such as the germinal matrix. The probabilistic atlas is associated with an unbiased average shape and intensity template for registration of new subject images to the space of the atlas. Quantitative whole brain 3D validation of tissue labeling performed on a set of 14 fetal MR scans (20.57-22.86 weeks gestational age) demonstrates that this atlas-based EM segmentation approach achieves consistently high DSC performance for the main tissue types in the fetal brain. This work indicates that reliable measures of brain development can be automatically derived from clinical MR imaging and opens up possibility of further 3D volumetric and morphometric studies with multiple fetal subjects.
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Affiliation(s)
- Piotr A Habas
- Biomedical Image Computing Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California 94143, USA.
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Hoffmann C, Grossman R, Bokov I, Lipitz S, Biegon A. Effect of cytomegalovirus infection on temporal lobe development in utero: quantitative MRI studies. Eur Neuropsychopharmacol 2010; 20:848-54. [PMID: 20833515 DOI: 10.1016/j.euroneuro.2010.08.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Revised: 08/17/2010] [Accepted: 08/18/2010] [Indexed: 10/19/2022]
Abstract
Several environmental factors, including viral infections during fetal development, are known to increase the risk of schizophrenia. Cytomegalovirus (CMV) is the main cause of viral congenital infection. Since changes in temporal lobe structures are a consistent finding in imaging studies of adult schizophrenics, we investigated possible derangement in temporal lobe development in CMV infected fetuses. Abdominal MRI (1.5 T) was performed using a single-shot fast spin echo T2-weighted sequence. MRI volumetry was employed to measure brain and temporal lobe size in 27 CMV infected fetuses and 52 gestational age matched controls in utero. The ratio of temporal lobe to whole brain was computed for each fetus and group comparisons were performed using Student's t-test or ANOVA. Temporal lobe volumes, normalized to whole brain and co-varied with gestational age; were significantly smaller in fetuses infected with CMV compared to uninfected fetuses. (Infected group mean ± SEM: 0.086 ± 0.006, controls: 0.113 ± 0.003, p<0.0001). Infection during the 1st and 2nd trimester had a more pronounced effect than infection during the 3rd trimester. Infected fetuses with no MRI findings had significantly lower temporal lobe/whole brain ratios than controls (0.092 ± 0.008, p<0.01, N=11) and the lowest ratios were observed in fetuses with overt findings such as cysts or gray matter heterotopy (0.067 ± 0.015). These results demonstrate the ability of quantitative fetal brain MRI to detect previously unreported, specific deficits in brain development in CMV infected fetuses, which, in conjunction with other genetic and environmental factors, may contribute to the risk of developing schizophrenia later in life.
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Affiliation(s)
- Chen Hoffmann
- Radiology Department, Chaim Sheba Medical Center, Tel Hashomer, Israel
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Gholipour A, Estroff JA, Warfield SK. Robust super-resolution volume reconstruction from slice acquisitions: application to fetal brain MRI. IEEE TRANSACTIONS ON MEDICAL IMAGING 2010; 29:1739-58. [PMID: 20529730 PMCID: PMC3694441 DOI: 10.1109/tmi.2010.2051680] [Citation(s) in RCA: 189] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Fast magnetic resonance imaging slice acquisition techniques such as single shot fast spin echo are routinely used in the presence of uncontrollable motion. These techniques are widely used for fetal magnetic resonance imaging (MRI) and MRI of moving subjects and organs. Although high-quality slices are frequently acquired by these techniques, inter-slice motion leads to severe motion artifacts that are apparent in out-of-plane views. Slice sequential acquisitions do not enable 3-D volume representation. In this study, we have developed a novel technique based on a slice acquisition model, which enables the reconstruction of a volumetric image from multiple-scan slice acquisitions. The super-resolution volume reconstruction is formulated as an inverse problem of finding the underlying structure generating the acquired slices. We have developed a robust M-estimation solution which minimizes a robust error norm function between the model-generated slices and the acquired slices. The accuracy and robustness of this novel technique has been quantitatively assessed through simulations with digital brain phantom images as well as high-resolution newborn images. We also report here successful application of our new technique for the reconstruction of volumetric fetal brain MRI from clinically acquired data.
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Affiliation(s)
- Ali Gholipour
- Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
| | - Judy A. Estroff
- Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
| | - Simon K. Warfield
- Department of Radiology, Children’s Hospital Boston, and Harvard Medical School, Boston, MA, 02115 USA
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Diagnosis and treatment of vein of Galen aneurysmal malformations. Childs Nerv Syst 2010; 26:879-87. [PMID: 20049460 DOI: 10.1007/s00381-009-1063-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2009] [Accepted: 11/19/2009] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Vein of Galen aneurysmal malformations (VGAM) are rare but clinically significant intracranial arteriovenous shunt lesions that most often present in neonates and infants. METHODS Retrospective clinical data were collected for patients evaluated with a diagnosis of VGAM from 1994 to 2007. RESULTS Thirteen patients with VGAM were evaluated from 1994 to 2007. Seven patients presented emergently with medically intractable cardiac failure, and six were treated in the first 2 weeks of life. Five children treated after this period (1.5-31 months of age) manifested enlarging head circumference, abnormal development, or subarachnoid hemorrhage. Eleven patients were managed endovascularly. Four disease or procedure-related complications occurred. Two complications were associated with poor outcome, both of which occurred in patients treated at less than 2 weeks of age. Two other patients experienced transient neurological deficits with no evidence of permanent sequelae. Outcome in the six patients treated emergently in the first 2 weeks of life included two patients who developed normally, one with mild to moderate neurological deficits, one with severe neurological deficits, and two deaths. Outcome in the five older patients (treated between 1.5 and 31 months) was considerably better than in the group treated early and included three with normal outcome and two with mild neurological deficits. CONCLUSIONS Contemporary endovascular techniques remain the preferred treatment for VGAM in all age groups. Early diagnosis and multimodality treatment are essential for the best management and treatment of the complex constellation of clinical problems often arising from this disorder.
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