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Illapani VSP, Edmondson DA, Cecil KM, Altaye M, Kumar M, Harpster K, Parikh NA. Magnetic resonance spectroscopy brain metabolites at term and 3-year neurodevelopmental outcomes in very preterm infants. Pediatr Res 2022; 92:299-306. [PMID: 33654289 PMCID: PMC8410891 DOI: 10.1038/s41390-021-01434-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Noninvasive advanced neuroimaging and neurochemical assessment can identify subtle abnormalities and predict neurodevelopmental impairments. Our objective was to quantify white matter metabolite levels and evaluate their relationship with neurodevelopmental outcomes at age 3 years. METHODS Our study evaluated a longitudinal prospective cohort of very premature infants (<32 weeks gestational age) with single-voxel proton magnetic resonance spectroscopy from the centrum semiovale performed at term-equivalent age and standardized cognitive, verbal, and motor assessments at 3 years corrected age. We separately examined metabolite ratios in the left and right centrum semiovale. We also conducted an exploratory interaction analysis for high/low socioeconomic status (SES) to evaluate the relationship between metabolites and neurodevelopmental outcomes, after adjusting for confounders. RESULTS We found significant relationships between choline/creatine levels in the left and right centrum semiovale and motor development scores. Exploratory interaction analyses revealed that, for infants with low SES, there was a negative association between choline/creatine in the left centrum semiovale and motor assessment scores at age 3 years. CONCLUSIONS Brain metabolites from the centrum semiovale at term-equivalent age were associated with motor outcomes for very preterm infants at 3 years corrected age. This effect may be most pronounced for infants with low SES. IMPACT Motor development at 3 years corrected age for very preterm infants is inversely associated with choline neurochemistry within the centrum semiovale on magnetic resonance spectroscopy at term-equivalent age, especially in infants with low socioeconomic status. No prior studies have studied metabolites in the centrum semiovale to predict neurodevelopmental outcomes at 3 years corrected age based on high/low socioeconomic status. For very preterm infants with lower socioeconomic status, higher choline-to-creatine ratio in central white matter is associated with worse neurodevelopmental outcomes.
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Affiliation(s)
| | - David A. Edmondson
- Imaging Research Center, Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Kim M. Cecil
- Imaging Research Center, Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH;,Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Manoj Kumar
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, INDIA
| | - Karen Harpster
- Division of Occupational Therapy and Physical Therapy, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Nehal A. Parikh
- Division of Neonatology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH,Corresponding author’s contact information: Nehal A. Parikh, DO, MS, Professor of Pediatrics, Cincinnati Children’s Hospital, 3333 Burnet Ave, MLC 7009, Cincinnati, OH 45229, (513) 636-7584 (Business), (513) 803-0969 (Fax),
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Pradhan S, Kapse K, Jacobs M, Niforatos-Andescavage N, Quistorff JL, Lopez C, Bannantine KL, Andersen NR, Vezina G, Limperopoulos C. Non-invasive measurement of biochemical profiles in the healthy fetal brain. Neuroimage 2020; 219:117016. [PMID: 32526384 PMCID: PMC7491254 DOI: 10.1016/j.neuroimage.2020.117016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/26/2020] [Accepted: 06/01/2020] [Indexed: 11/29/2022] Open
Abstract
Proton magnetic resonance spectroscopy (1H-MRS) of the fetal brain can be used to study emerging metabolite profiles in the developing brain. Identifying early deviations in brain metabolic profiles in high-risk fetuses may offer important adjunct clinical information to improve surveillance and management during pregnancy.
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Affiliation(s)
- Subechhya Pradhan
- Center for the Developing Brain, Children's National Hospital, Washington, DC, 20010, USA; Department of Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC, 20010, USA; Department of Radiology, The George Washington University School of Medicine, Washington, DC, 20052, USA; Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, 20052, USA
| | - Kushal Kapse
- Center for the Developing Brain, Children's National Hospital, Washington, DC, 20010, USA
| | - Marni Jacobs
- Department of Biostatistics and Study Methodology, Children's Research Institute, Children's National Hospital, Washington, DC, 20010, USA; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, CA, 92093, USA
| | - Nickie Niforatos-Andescavage
- Center for the Developing Brain, Children's National Hospital, Washington, DC, 20010, USA; Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, 20052, USA; Division of Neonatology, Children's National Hospital, Washington, DC, 20010, USA
| | - Jessica Lynn Quistorff
- Center for the Developing Brain, Children's National Hospital, Washington, DC, 20010, USA
| | - Catherine Lopez
- Center for the Developing Brain, Children's National Hospital, Washington, DC, 20010, USA
| | - Kathryn Lee Bannantine
- Center for the Developing Brain, Children's National Hospital, Washington, DC, 20010, USA
| | | | - Gilbert Vezina
- Department of Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC, 20010, USA
| | - Catherine Limperopoulos
- Center for the Developing Brain, Children's National Hospital, Washington, DC, 20010, USA; Department of Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC, 20010, USA; Department of Radiology, The George Washington University School of Medicine, Washington, DC, 20052, USA; Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, 20052, USA.
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3
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Doğer E, Özdamar Ö, Çakıroğlu Y, Ceylan Y, Çakır Ö, Anık Y, Çalışkan E. The predictive value of lactate peak detected by the magnetic resonance spectroscopy in the brain of growth-restricted fetuses for adverse perinatal outcomes. J Matern Fetal Neonatal Med 2015; 29:3178-82. [PMID: 26553844 DOI: 10.3109/14767058.2015.1118040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To compare perinatal outcomes between patients with and without abnormal Doppler findings and lactate peak in the fetal brain detected by magnetic resonance spectroscopy ((1)HMRS) and to assess the feasibility of fetal brain lactate in the prediction of adverse obstetric outcomes in growth-restricted fetuses. METHODS Pregnancies with FGR fetuses underwent Doppler ultrasonography and 3 Tesla (1)HMRS for the presence of lactate peak prior to the delivery. Patients were assigned into the following groups; normal Doppler, no lactate peak (Group 1), normal Doppler, lactate peak (+) (Group II), abnormal Doppler, no lactate peak (Group III), abnormal Doppler, lactate peak (+) (Group IV). RESULTS Five perinatal deaths, all in Group IV, were encountered (p < 0.001). Perinatal death rate was higher in patients with Doppler flow abnormality ((5/12 (41.7%)) than in patients without Doppler abnormality (0/23) (p < 0.001) and was significantly higher in the presence (5/18 (27.8%)) than in the absence of lactate peak (0/17) (p = 0.019). CONCLUSIONS Fetuses with brain lactate peak detected by (1)HMRS in addition to altered Doppler findings are more likely to develop short-term morbidities and perinatal death. Fetal brain lactate detected by (1)HMRS may represent a clinical marker of altered brain metabolism and further perinatal complications.
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Affiliation(s)
- Emek Doğer
- a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey
| | - Özkan Özdamar
- b Department of Obstetrics and Gynecology , Gölcük Military Hospital , Kocaeli , Turkey , and
| | - Yiğit Çakıroğlu
- a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey
| | - Yasin Ceylan
- a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey
| | - Özgür Çakır
- c Department of Radiology , School of Medicine, Kocaeli University , Kocaeli , Turkey
| | - Yonca Anık
- c Department of Radiology , School of Medicine, Kocaeli University , Kocaeli , Turkey
| | - Eray Çalışkan
- a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey
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4
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Shetty AN, Gabr RE, Rendon DA, Cassady CI, Mehollin-Ray AR, Lee W. Improving spectral quality in fetal brain magnetic resonance spectroscopy using constructive averaging. Prenat Diagn 2015; 35:1294-300. [PMID: 26348874 DOI: 10.1002/pd.4689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/28/2015] [Accepted: 09/03/2015] [Indexed: 11/10/2022]
Abstract
PURPOSE A common source of loss in signal-to-noise ratio (SNR) in fetal brain magnetic resonance spectroscopy (MRS) is from fetal movement and temporal magnetic field drift. We investigated the feasibility of using constructive averaging strategies for improving the spectral quality and recovering the SNR loss from these effects. MATERIALS AND METHODS Eight fetuses, between 20 3/7 and 38 2/7 weeks' gestation, were scanned with MRS at 1.5 T. Single-voxel point-resolved spectroscopy of the fetal brain with TE = 144 ms (in one case additional TE = 288 ms) was performed in a dynamic mode, and individual spectra of 128 acquisitions were saved. With constructive averaging strategy individual acquisitions were corrected for phase variations and frequency drift before averaging. Constructively averaged spectra were compared to those using conventional averaging to evaluate differences in spectral quality and SNR. RESULTS The definition of key metabolite peaks was qualitatively improved using constructive averaging, including the doublet structure of lactate in one case. Constructive averaging was associated with SNR increases, ranging from 11% to 40%, and the SNR further improved in one case when outliers from severe motion were rejected before averaging. CONCLUSION Our results demonstrate the feasibility of using constructive averaging for improving SNR in fetal MRS, which is likely to improve the characterization of fetal brain metabolites.
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Affiliation(s)
- Anil N Shetty
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.,Texas Children's Fetal Center, Houston, TX, USA
| | - Refaat E Gabr
- Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center, Houston, TX, USA
| | - David A Rendon
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - Christopher I Cassady
- Texas Children's Fetal Center, Houston, TX, USA.,Department of Radiology, Baylor College of Medicine, Houston, TX, USA.,Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, USA
| | - Amy R Mehollin-Ray
- Texas Children's Fetal Center, Houston, TX, USA.,Department of Radiology, Baylor College of Medicine, Houston, TX, USA.,Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, USA
| | - Wesley Lee
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.,Texas Children's Fetal Center, Houston, TX, USA
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Biegon A, Hoffmann C. Quantitative magnetic resonance imaging of the fetal brain in utero: Methods and applications. World J Radiol 2014; 6:523-529. [PMID: 25170390 PMCID: PMC4147433 DOI: 10.4329/wjr.v6.i8.523] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 04/24/2014] [Accepted: 06/11/2014] [Indexed: 02/07/2023] Open
Abstract
Application of modern magnetic resonance imaging (MRI) techniques to the live fetus in utero is a relatively recent endeavor. The relative advantages and disadvantages of clinical MRI relative to the widely used and accepted ultrasonographic approach are the subject of a continuing debate; however the focus of this review is on the even younger field of quantitative MRI as applied to non-invasive studies of fetal brain development. The techniques covered under this header include structural MRI when followed by quantitative (e.g., volumetric) analysis, as well as quantitative analyses of diffusion weighted imaging, diffusion tensor imaging, magnetic resonance spectroscopy and functional MRI. The majority of the published work reviewed here reflects information gathered from normal fetuses scanned during the 3rd trimester, with relatively smaller number of studies of pathological samples including common congenital pathologies such as ventriculomegaly and viral infection.
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Abstract
Magnetic resonance imaging (MRI) has been used to image the in utero fetus for the past 3 decades. Although not as commonplace as other patient-oriented MRI, it is a growing field and demonstrating a role in the clinical care of the fetus. Indeed, the body of literature involving fetal MRI exceeds 3000 published articles. Indeed, there is interest in accessing even the healthy fetus with MRI to further understand the development of humans during the fetal stage. On the horizon is fetal imaging using 3.0-T clinical systems. Although a clear path is not necessarily determined, experiments, theoretical calculations, advances in pulse sequence design, new hardware, and experience from imaging at 1.5 T help define the path.
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Affiliation(s)
- Robert C Welsh
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109-5667, USA.
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Cetin I, Barberis B, Brusati V, Brighina E, Mandia L, Arighi A, Radaelli T, Biondetti P, Bresolin N, Pardi G, Rango M. Lactate detection in the brain of growth-restricted fetuses with magnetic resonance spectroscopy. Am J Obstet Gynecol 2011; 205:350.e1-7. [PMID: 21861968 DOI: 10.1016/j.ajog.2011.06.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 04/29/2011] [Accepted: 06/06/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of the study was to determine the feasibility of detecting fetal brain lactate, a marker of fetal metabolic acidemia, using a noninvasive technique, proton magnetic resonance spectroscopy ((1)H MRS), in intrauterine growth-restricted (IUGR) fetuses. STUDY DESIGN In vivo human fetal brain lactate detection was determined by (1)H MRS in 5 fetuses with IUGR. Oxygenation and acid-base balance data were obtained at birth. RESULTS (1)H MRS analysis showed the presence of a lactate peak in the brain of the most severely affected IUGR fetus, with abnormal umbilical artery Doppler and fetal heart rate tracing. This finding was consistent with the low oxygen content and high lactic acid concentration observed in umbilical blood obtained at delivery. CONCLUSION (1)H MRS allows the noninvasive detection of cerebral lactate in IUGR fetuses. Lactate detected by (1)H MRS may represent a possible marker of in utero cerebral injury or underperfusion.
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Affiliation(s)
- Irene Cetin
- Center for Fetal Research Giorgio Pardi, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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8
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Charles-Edwards GD, Jan W, To M, Maxwell D, Keevil SF, Robinson R. Non-invasive detection and quantification of human foetal brain lactate in utero by magnetic resonance spectroscopy. Prenat Diagn 2010; 30:260-6. [PMID: 20120007 DOI: 10.1002/pd.2463] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the feasibility of foetal cerebral lactate detection and quantification by proton magnetic resonance spectroscopy ((1)H-MRS) in pregnancies at increased risk of cerebral hypoxia, using a clinical 1.5 T magnetic resonance imaging (MRI) system. METHOD Localised (1)H-MRS was performed in four patients with pregnancies in their third trimester complicated by intrauterine growth restriction (IUGR). A long echo time (TE) of 288 ms was used to maximise detection and conspicuity of the lactate methyl resonance, together with a short TE MRS acquisition to check for the presence of lipid contamination. Individual peaks in the resulting spectra were measured, corrected for relaxation and referenced to the unsuppressed water signal to provide metabolite concentrations. RESULTS A resonance peak consistent with the presence of lactate was observed in all cases. In one subject, this was confounded by the identification of significant lipid contamination in the short TE MRS acquisition. The range of measured lactate concentrations was 2.0-3.3 mmol/kg and compared well with preterm neonatal MRS studies. CONCLUSION The non-invasive detection and quantification of foetal cerebral lactate by MRS is achievable on a clinical 1.5 T MRI system.
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9
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Proton magnetic resonance spectroscopy in the fetus. Eur J Obstet Gynecol Reprod Biol 2010; 158:3-8. [PMID: 20413207 DOI: 10.1016/j.ejogrb.2010.03.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 12/23/2009] [Accepted: 03/04/2010] [Indexed: 11/22/2022]
Abstract
Magnetic Resonance Imaging (MRI) has become an established technique in fetal medicine, providing complementary information to ultrasound in studies of the brain. MRI can provide detailed structural information irrespective of the position of the fetal head or maternal habitus. Proton Magnetic Resonance Spectroscopy ((1)HMRS) is based on the same physical principles as MRI but data are collected as a spectrum, allowing the biochemical and metabolic status of in vivo tissue to be studied in a non-invasive manner. (1)HMRS has been used to assess metabolic function in the neonatal brain but fetal studies have been limited, primarily due to fetal motion. This review will assess the technique and findings from fetal studies to date.
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10
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Abstract
Fetal MRI is becoming an increasingly powerful imaging tool for studying brain development in vivo. Until recently, the application of advanced magnetic resonance imaging techniques was limited by motion in the nonsedated fetus. Extensive research efforts currently underway are focusing on the development of dedicated magnetic resonance imaging sequences and sophisticated postprocessing techniques that are revolutionizing our ability to study the healthy and compromised fetus. The ongoing refinement of these magnetic resonance imaging techniques will undoubtedly lead to the development of cornerstone biomarkers that will provide healthcare caregivers with vital, and currently lacking, information upon which to counsel parents effectively, and base rational decisions regarding the timing and type of novel medical and surgical interventions currently on the horizon.
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11
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Brighina E, Bresolin N, Pardi G, Rango M. Human fetal brain chemistry as detected by proton magnetic resonance spectroscopy. Pediatr Neurol 2009; 40:327-42. [PMID: 19380068 DOI: 10.1016/j.pediatrneurol.2008.11.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Revised: 11/03/2008] [Accepted: 11/19/2008] [Indexed: 11/25/2022]
Abstract
Magnetic resonance spectroscopy represents an invaluable tool for the in vivo study of brain development at the chemistry level. Whereas magnetic resonance spectroscopy has received wide attention in pediatric and adult settings, only a few studies were performed on the human fetal brain. They revealed changes occurring throughout gestation in the levels of the main metabolites detected by proton magnetic resonance spectroscopy (N-acetylaspartate, choline, myo-inositol, creatine, and glutamate), providing a reference for the normal metabolic brain development. Throughout the third trimester of gestation, N-acetylaspartate gradually increases, whereas choline undergoes a slow reduction during the process of myelination. Less clear are the modifications in creatine, myo-inositol, and glutamate levels. Under conditions of fetal distress, the meaning of lactate detection is unclear, and further studies are needed. Another field for investigation involves the possibility of early detection of glutamate levels in fetuses at risk for hypoxic-ischemic encephalopathy, because the role of glutamate excitotoxicity in this context is well-established. Because metabolic modifications may precede functional or morphologic changes in the central nervous system, magnetic resonance spectroscopy may likely serve as a powerful, noninvasive tool for the early diagnosis and prognosis of different pathologic conditions.
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Affiliation(s)
- Erika Brighina
- Foundation Instituto di Ricerca e Cura a Carattere Scientifico Policlinico, Mangiagalli and Regina Elena, University of Milan, Milan, Italy
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Rutherford M, Jiang S, Allsop J, Perkins L, Srinivasan L, Hayat T, Kumar S, Hajnal J. MR imaging methods for assessing fetal brain development. Dev Neurobiol 2008; 68:700-11. [PMID: 18383541 DOI: 10.1002/dneu.20614] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Fetal magnetic resonance imaging provides an ideal tool for investigating growth and development of the brain in vivo. Current imaging methods have been hampered by fetal motion but recent advances in image acquisition can produce high signal to noise, high resolution 3-dimensional datasets suitable for objective quantification by state of the art post acquisition computer programs. Continuing development of imaging techniques will allow a unique insight into the developing brain, more specifically process of cell migration, axonal pathway formation, and cortical maturation. Accurate quantification of these developmental processes in the normal fetus will allow us to identify subtle deviations from normal during the second and third trimester of pregnancy either in the compromised fetus or in infants born prematurely.
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Affiliation(s)
- Mary Rutherford
- Imaging Sciences Department, MRC Clinical Sciences Centre, Imperial College, London W12 OHS, UK.
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Garel C. Fetal MRI: what is the future? ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2008; 31:123-128. [PMID: 18254129 DOI: 10.1002/uog.5249] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Abstract
Future application of fetal brain monitoring is explored by selecting and analysing articles for information on types of brain damage that can be monitored, where in the brain this can be done, how long after the risk exposure, and with what method of investigation. A limited number of--mainly--case histories reported that early (cell death and oedema) and late (gliosis) effects of brain damage can be demonstrated before birth with multiplanar ultrasound and magnetic resonance imaging, and that hypoxic ischaemic injury or infection can induce local or widespread brain injury, occurring as transient or longer-lasting changes in age-related predilection areas for which normal features are known. The antenatal role of risk factors inducing abnormal brain development can be studied longitudinally with ultrasound and magnetic resonance imaging. A multidisciplinary approach will facilitate the introduction of various techniques with adequate know-how of underlying processes, to evaluate the predictive value on neurological outcome and prevent premature introduction into clinical application.
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Affiliation(s)
- Johanna I P de Vries
- Institute of Fundamental and Clinical Human Movement Sciences, Department of Obstetrics and Gynaecology, VU University Medical Centre, Post Box 7057, 1007 MB Amsterdam, The Netherlands.
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Abstract
Ultrasonography is the primary prenatal screening modality used in the evaluation of the fetus and the maternal pelvis. However, fetal MR imaging plays a complementary role to prenatal ultrasound in the evaluation of the fetus with suspected abnormalities. MR imaging's role includes confirming or excluding possible lesions, defining their full extent, aiding in their characterization, and demonstrating other associated abnormalities. As newer techniques such as diffusion imaging, MR spectroscopy, and functional studies are used more widely, it is hoped that additional information will be made available by this modality to physicians evaluating and taking care of fetuses.
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Affiliation(s)
- Rosalind B Dietrich
- Department of Radiology, University of California, San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103, USA.
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Abstract
MR is now routinely and widely used in fetal neuroimaging and has proven to be valuable in the detection of many cerebral lesions, either genetically determined or acquired in utero. However, its efficiency has certain limits in the detection of diffuse white-matter abnormalities, the evaluation of fibre development and the demonstration of metabolic disorders. Moreover, conventional fetal MR imaging provides only a morphological approach to the fetal brain. New techniques such as diffusion-weighted imaging, diffusion tensor imaging, proton MR spectroscopy and functional MR imaging are developing. The majority of these are not used routinely. The principles, aims, technical problems and possible applications of these techniques for imaging the fetus are discussed.
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Affiliation(s)
- Catherine Garel
- Department of Paediatric Imaging, Hôpital Robert Debré, 48 boulevard Sérurier, 75012 Paris, France.
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17
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Current awareness in prenatal diagnosis. Prenat Diagn 2004; 24:1025-30. [PMID: 15828089 DOI: 10.1002/pd.784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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