1
|
Ren JY, Zhu M, Dong SZ. Sex differences in normal fetal regional brain apparent diffusion coefficient changes assessed by in utero DWI. Front Pediatr 2024; 12:1354475. [PMID: 38567183 PMCID: PMC10985338 DOI: 10.3389/fped.2024.1354475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Objective There are differences in the vulnerability of male and female fetal brains to adverse intrauterine exposure, preterm birth, and associated perinatal brain injury. The main objective of this study was to identify any statistically significant difference in the change of apparent diffusion coefficient (ADC) in the intracranial regions of male and female fetuses in the second and third trimesters. Methods Diffusion-weighted imaging (DWI) was performed in 200 fetuses between 20 and 37 gestational ages (GA) with normal results or suspicious results on sonography followed by structural MRI. Pairwise ADC values of the regions of interest (ROIs) were manually delineated on either side of the cerebral white matter: frontal white matter (FWM), parietal white matter (PWM), occipital white matter (OWM), temporal white matter (TWM), basal ganglia (BG), thalamus (THA), cerebellar hemisphere (CBM), and a single measurement in the pons. The changes in these values were studied over the gestational range, along with potential sex differences and asymmetries of the cerebral hemispheres. Results During the third trimester, ADC values in OWM, TWM, and CBM were significantly higher in male fetuses than those in female fetuses (p < 0.05). After the correction of false-discovery rates (FDR), the difference in CBM was the only statistically significant (p = 0.0032). However, the decreased rate of ADC values in male fetuses in CWM (except for FWM), BG, THA, CBM, and pons was higher than that in female fetuses during the second and third trimesters. Conclusions We have shown some differences in the intracranial regional ADC changes between male and female fetuses using in utero DWI during the second and third trimesters.
Collapse
Affiliation(s)
| | | | - Su-Zhen Dong
- Department of Radiology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
2
|
Kobal L, Surlan Popovic K, Avsenik J, Vipotnik Vesnaver T. ADC values as a biomarker of fetal brain maturation. Radiol Oncol 2023; 57:178-183. [PMID: 37341193 DOI: 10.2478/raon-2023-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/17/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND During the period of fetal development, myelination plays a key role and follows specific time and spatial sequences. The water content in the brain is inversely proportional to myelination - the more myelinated the brain, the lower the water content in it. The diffusion of water molecules can be quantitatively assessed using the apparent diffusion coefficient (ADC). We were interested in whether, by determining the ADC values, we could quantitatively evaluate the development of the fetal brain. PATIENTS AND METHODS The study included 42 fetuses with gestational age 25 to 35 weeks. We manually selected 13 regions on diffusion-weighted images. Statistically significant differences between ADC values were checked using one-way analysis of variance and Tukey's post hoc test. The relationship between the ADC values and the gestational age of the fetuses was then assessed using linear regression. RESULTS The average gestational age of the fetuses was 29.8 ± 2.4 weeks. ADC values in the thalami, pons and cerebellum differed significantly among each other and from the ADC values in other brain regions. In the thalami, pons and cerebellum, linear regression showed a significant decrease in ADC values with increasing gestational age. CONCLUSIONS ADC values change with the increasing gestational age of the fetus and differ among different brain regions. In the pons, cerebellum and thalami, the ADC coefficient could be used as a biomarker of fetal brain maturation since ADC values decrease linearly with increasing gestational age.
Collapse
Affiliation(s)
- Lucija Kobal
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Jernej Avsenik
- Clinical Institute of Radiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Tina Vipotnik Vesnaver
- Clinical Institute of Radiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
3
|
Jia F, Liao Y, Li X, Ye Z, Li P, Zhou X, Li Q, Wang S, Ning G, Qu H. Preliminary Study on Quantitative Assessment of the Fetal Brain Using MOLLI T1 Mapping Sequence. J Magn Reson Imaging 2022; 56:1505-1512. [PMID: 35394092 DOI: 10.1002/jmri.28195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Prenatal quantitative evaluation of myelin is important. However, few techniques are suitable for the quantitative evaluation of fetal myelination. PURPOSE To optimize a modified Look-Locker inversion recovery (MOLLI) T1 mapping sequence for fetal brain development study. STUDY TYPE Prospective observational preliminary cohort study. POPULATION A total of 71 women with normal fetuses divided into mid-pregnancy (gestational age 24-28 weeks, N = 25) and late pregnancy (gestational age > 28 weeks, N = 46) groups. FIELD STRENGTH/SEQUENCE A 3 T/MOLLI sequence. ASSESSMENT T1 values were measured in pedunculus cerebri, basal ganglia, thalamus, posterior limb of the internal capsule, temporal white matter, occipital white matter, frontal white matter, and parietal white matter by two radiologists (11 and 16 years of experience, respectively). STATISTICAL TESTS The Kruskal-Wallis test was used for reginal comparison. For each region of interest (ROI), differences in T1 values between the mid and late pregnancy groups were assessed by the Mann Whitney U test. Pearson correlation coefficients (r) were used to evaluate the correlations between T1 values and gestational age for each ROI. Intraobserver and interobserver agreement was determined by the intraclass correlation coefficient (ICC). A P value <0.05 was considered statistically significant. RESULTS Interobserver and intraobserver agreements of T1 were good for all ROIs (all ICCs > 0.700). There were significant differences in T1 values between lobal white matter and deep regions, respectively. Significant T1 values differences were found between middle and late pregnancy groups in pedunculus cerebri, basal ganglion, thalamus, posterior limb of the internal capsule, temporal, and occipital white matter. The T1 values showed significantly negative correlations with gestational weeks in pedunculus cerebri (r = -0.80), basal ganglion (r = -0.60), thalamus (r = -0.68), and posterior limb of the internal capsule (r = -0.77). DATA CONCLUSION The T1 values of fetal brain may be assessed using the MOLLI sequence and may reflect the myelination. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
Collapse
Affiliation(s)
- Fenglin Jia
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yi Liao
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Xuesheng Li
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Zhijun Ye
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Pei Li
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Xiaoyue Zhou
- MR Collaborations, Siemens Healthineers, Shanghai, People's Republic of China
| | - Qing Li
- MR Collaborations, Siemens Healthineers, Shanghai, People's Republic of China
| | - Shaoyu Wang
- MR Scientific Marketing, Siemens Healthineers, Shanghai, People's Republic of China
| | - Gang Ning
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Haibo Qu
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| |
Collapse
|
4
|
Antonelli A, Capuani S, Ercolani G, Dolciami M, Ciulla S, Celli V, Kuehn B, Piccioni MG, Giancotti A, Porpora MG, Catalano C, Manganaro L. Human placental microperfusion and microstructural assessment by intra-voxel incoherent motion MRI for discriminating intrauterine growth restriction: a pilot study. J Matern Fetal Neonatal Med 2022; 35:9667-9674. [PMID: 35291892 DOI: 10.1080/14767058.2022.2050365] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To evaluate the potential of Intravoxel Incoherent Motion (IVIM) Imaging in the quantification of placental micro-perfusion and microstructural features to identify and discriminate different forms of intrauterine growth restriction (IUGR) and normal fetuses pregnancies. METHODS Small for gestational age SGA (n = 8), fetal growth restriction FGR (n = 10), and normal (n = 49) pregnancies were included in the study. Placental Magnetic Resonance Imaging (MRI) was performed at 1.5 T using a diffusion-weighted sequence with 10 b-values. IVIM fractional perfusion (fp), diffusion (D), and pseudodiffusion (D*) were evaluated on the fetal and maternal placental sides. Correlations between IVIM parameters, Gestational Age (GA), Birth Weight (BW), and the presence or absence of prenatal fetoplacental Doppler abnormalities at the US were investigated in SGA, FGR, and normal placentae. RESULTS fp and D* of the placental fetal side discriminate between SGA and FGR (p = .021; p = .036, respectively), showing lower values in FGR. SGA showed an intermediate perfusion pattern in terms of fp and D* compared to FGR and normal controls. In the intrauterine growth restriction group (SGA + FGR), a significant positive correlation was found between fp and BW (p < .002) in the fetal placenta and a significant negative correlation was found between D and GA in both the fetal (p < .0009) and maternal (p < .006) placentas. CONCLUSIONS Perfusion IVIM parameters fp and D* may be useful to discriminate different micro-vascularization patterns in IUGR being helpful to detect microvascular subtle impairment even in fetuses without any sign of US Doppler impairment in utero. Moreover, fp may predict fetuses' body weight in intrauterine growth restriction pregnancies. The diffusion IVIM parameter D may reflect more rapid microstructural rearrangement of the placenta due to aging processes in the IUGR group than in normal controls.
Collapse
Affiliation(s)
- Amanda Antonelli
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Silvia Capuani
- Physics Department, CNR Institute for Complex Systems (ISC), "Sapienza" University of Rome, Rome, Italy
| | - Giada Ercolani
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Miriam Dolciami
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Sandra Ciulla
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Veronica Celli
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | | | - Maria Grazia Piccioni
- Department of Gynaecological-Obstetrical and Urological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Antonella Giancotti
- Department of Gynaecological-Obstetrical and Urological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Maria Grazia Porpora
- Department of Gynaecological-Obstetrical and Urological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Lucia Manganaro
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy
| |
Collapse
|
5
|
Segev M, Djurabayev B, Katorza E, Yaniv G, Hoffmann C, Shrot S. 3.0 Tesla normative diffusivity in 3rd trimester fetal brain. Neuroradiology 2021; 64:1249-1254. [PMID: 34820712 DOI: 10.1007/s00234-021-02863-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Apparent diffusion coefficient (ADC) values in the developing fetus provide valuable information on the diagnosis and prognosis of prenatal brain pathologies. Normative ADC data has been previously established in 1.5 T MR scanners but lacking in 3.0 T scanners. Our objective was to measure ADC values in various brain areas in a cohort of normal singleton fetuses scanned in a 3.0 T MR scanner. METHODS DWI (diffusion-weighted imaging) was performed in 47 singleton fetuses with normal or questionably abnormal results on sonography followed by normal structural MR imaging. ADC values were measured in cerebral lobes (frontal, parietal, temporal lobes), basal ganglia, and pons. Regression analysis was used to examine gestational age-related changes in regional ADC. RESULTS Median gestational age was 30.1 weeks (range, 26-34 weeks). There was a significant effect of region on ADC values, whereby ADC values were highest in cerebral lobes (parietal > frontal > temporal lobes), compared with basal ganglia. The lowest values were found in the pons. On regression analysis, there was a decrease in ADC values in basal ganglia and pons with increasing gestational age. ADC values in frontal, parietal, and temporal lobes were stable in our cohort. CONCLUSION Regional brain ADC values in 3.0 T scanners are comparable with previously reported values in 1.5 T scanners, with similar changes over gestational age. Using 3.0 T scanners is increasing worldwide. For fetal imaging, establishing normal ADC values is critical as DWI enables a sensitive and quantitative technique to evaluate normal and abnormal brain development.
Collapse
Affiliation(s)
- Maria Segev
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel. .,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Bella Djurabayev
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel
| | - Eldad Katorza
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Antenatal Diagnostic Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Gal Yaniv
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Chen Hoffmann
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shai Shrot
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| |
Collapse
|
6
|
Ren JY, Ji H, Zhu M, Dong SZ. DWI in Brains of Fetuses with Congenital Heart Disease: A Case-Control MR Imaging Study. AJNR Am J Neuroradiol 2021; 42:2040-2045. [PMID: 34475195 DOI: 10.3174/ajnr.a7267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/23/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Abnormal ADC values are seen in ischemic brain lesions such as acute or chronic hypoxia. We aimed to assess whether ADC values in the developing brain measured by in utero DWI were different in fetuses with congenital heart disease compared with healthy controls. MATERIALS AND METHODS In utero DWI was performed in 50 fetuses with congenital heart disease and 100 healthy controls at a similar gestational age. Pair-wise ADC values of the ROIs were manually delineated on each side of the frontal and periatrial WM and in the basal ganglia, thalamus, and cerebellar hemisphere, as well as a single measurement in the pons. RESULTS Fetuses with congenital heart disease had significantly lower ADC values in frontal and periatrial WM and the pons than controls (all P < .05) in the early stages of pregnancy. However, ADC values in the thalamus were higher for fetuses with congenital heart disease than for controls (gestational age, ≥26 weeks). For ADC values in the cerebellar hemisphere, there was no obvious significance between cases and controls (P = .07) in the late stages of pregnancy. Basal ganglia ADC values were consistently not significantly different between the 2 groups during the early and late stages of pregnancy (P = .47; .21). CONCLUSIONS Abnormal brain diffusivity can be detected using in utero DWI in fetuses with congenital heart disease. Abnormal ADC values found at a mean gestational age of 26 weeks suggest structural changes, which may provide an early indicator of the impact of congenital heart disease on the developing brain.
Collapse
Affiliation(s)
- J-Y Ren
- From the Department of Radiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, P.R. China
| | - H Ji
- From the Department of Radiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, P.R. China
| | - M Zhu
- From the Department of Radiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, P.R. China
| | - S-Z Dong
- From the Department of Radiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, P.R. China
| |
Collapse
|
7
|
Brain fetal magnetic resonance imaging to evaluate maturation of normal white matter during the third trimester of pregnancy. Pediatr Radiol 2021; 51:1826-1838. [PMID: 34019102 DOI: 10.1007/s00247-021-05064-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/02/2020] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Quantitative magnetic resonance imaging (MRI) could improve the estimation of fetal brain maturation and the interpretation of white matter signal intensity in pathological conditions. OBJECTIVE To investigate T2-based and diffusion-weighted imaging (DWI) measurements for the evaluation of fetal brain maturation during the last trimester of pregnancy. MATERIALS AND METHODS One hundred sixty-eight fetal brain MRIs were retrospectively analyzed (age range: 28-37 weeks of gestation) after ensuring that none of the children developed psychomotor or cognitive impairment (median follow-up: 4.7 years). Bilateral regions of interest were drawn on the frontal, occipital, parietal and temporal lobes from T2-W imaging and DWI, when available, to evaluate signal intensity and apparent diffusion coefficient (ADC) values. Ratios were calculated with two references (pons or thalamus and cerebrospinal fluid) to standardize signal intensities. Reproducibility was evaluated with intraclass correlation coefficients (ICCs) and Bland-Altman plots. Correlations with gestational age were evaluated with univariate and multivariate linear regressions. RESULTS T2 measurements were achieved in all cases, and DWI was available in 37 cases. Measurements and ratios were reproducible in eight localizations (i.e. intra- and interobserver ICCs >0.5): frontal T2/thalamus, parietal T2/thalamus, occipital T2/pons, parietal ADC/thalamus, occipital ADC/pons, temporal ADC/pons, occipital ADC and temporal ADC. The frontal T2/thalamus and parietal T2/thalamus correlated with gestational age (P<0.0001 and P=0.014, respectively). In the multivariate modeling, frontal T2/thalamus remained an independent predictor of the gestational age (P<0.0001). CONCLUSION The frontal T2/thalamus ratio emerged as a potential additional biomarker of fetal brain maturation during the last trimester of pregnancy.
Collapse
|
8
|
Apparent diffusion coefficient of different areas of brain in foetuses with intrauterine growth restriction. Pol J Radiol 2020; 85:e301-e308. [PMID: 32685065 PMCID: PMC7361370 DOI: 10.5114/pjr.2020.96950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 04/28/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose This study aimed to compare the apparent diffusion coefficient (ADC) values of different brain areas between two groups of intrauterine growth restricted (IUGR) foetuses and control cases. Material and methods A total of 38 foetuses with IUGR and 18 normal control foetuses with similar gestational age were compared using a 3T magnetic resonance scanner. IUGR cases included 23 foetuses with clinical severity signs (group A) and 15 foetuses without clinical severity signs (group B). ADC values were measured in different brain regions and compared among groups. Foetuses with structural brain abnormalities were excluded from the study. Results All foetuses had normal foetal structural brain anatomy. Head circumference (HC) < 5% was more common in IUGR group A compared to IUGR group B (56.5% vs. 13.3%, p < 0.0001). In comparison to the normal group, the ADC values in IUGR foetuses were significantly lower in cerebellar hemispheres (CH) (1.239 vs. 1.280.5 × 10-3 mm2/s, p = 0.045), thalami (1.205 vs. 1.285 × 10-3 mm2/s, p = 0.031) and caudate nucleus (CN) (1.319 vs. 1.394 × 10-3 mm2/s, p = 0.04). However, there were no significant differences in ADC values between IUGR subtypes. Among all brain regions, pons had the lowest ADC values. Conclusions ADC values of thalami, CN, and CH were significantly lower in IUGR than control foetuses, while there was no significant difference among IUGR groups. Further studies are needed to evaluate the prognostic value of ADC changes in IUGR foetuses.
Collapse
|
9
|
Hooker JD, Khan MA, Farkas AB, Lirette ST, Joyner DA, Gordy DP, Storrs JM, Roda MS, Bofill JA, Smith AD, James JR. Third-trimester in utero fetal brain diffusion tensor imaging fiber tractography: a prospective longitudinal characterization of normal white matter tract development. Pediatr Radiol 2020; 50:973-983. [PMID: 32399686 DOI: 10.1007/s00247-020-04639-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/30/2019] [Accepted: 02/11/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND White matter is responsible for inter-neuronal connections throughout the brain that are a driving force in cognitive development. Diffusion tensor imaging (DTI) fiber tractography has been used to evaluate white matter development in the fetal brain; however, longitudinal studies of DTI fiber tractography to assess white matter development in the third trimester are lacking. OBJECTIVE To characterize in utero longitudinal changes in the fetal brain DTI fiber tracts of normal third-trimester fetuses. MATERIALS AND METHODS For this single-center prospective longitudinal observational pilot study, we recruited 28 pregnant females with normal third-trimester pregnancies who had routine prenatal ultrasound. MRI of the in utero fetal brain was performed with a Siemens 1.5-tesla (T) Espree scanner at 31 weeks, 33 weeks and 36 weeks of gestation, with 14 DTI tractography parameters quantified in 7 brain regions using DTI-studio version 2.4 (Johns Hopkins University, Baltimore, MD; n=98 measurements). We used multilevel mixed models to examine the relationship between longitudinal changes in DTI measurements and between 98 DTI measurements at 31 weeks and 4 routine fetal brain anatomical biometrics (n=392 assessments). RESULTS We observed statistically significant decreases in radial diffusivity and apparent diffusion coefficient in 13 of 14 brain regions from 31 weeks to 36 weeks of gestation (P<0.001 for all regions except the genu of the corpus callosum). Significant decreases in radial diffusivity from weeks 33 to 36 and weeks 31 to 36 were seen in the corticospinal tracts, centrum semiovale, posterior limb of the internal capsule, and crus cerebri (P<0.001 for all). When considering all possible combinations of DTI fiber tract measurements and the routine morphological fetal brain biometrics, only 6% (24/392) had a significant association (P<0.05), indicating relative independence of the DTI fiber tract measurements from anatomical biometrics. CONCLUSION In utero longitudinal changes in fetal brain DTI fiber tractography are quantifiable in normal third-trimester fetuses and are largely independent of morphological brain changes.
Collapse
Affiliation(s)
- Jeffrey D Hooker
- Department of Radiology, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS, 39216, USA.
| | - Majid A Khan
- Department of Radiology, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Amy B Farkas
- Department of Radiology, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS, 39216, USA
| | - Seth T Lirette
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - David A Joyner
- Department of Radiology, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS, 39216, USA
| | - David P Gordy
- Department of Radiology, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS, 39216, USA
| | - Judd M Storrs
- Department of Radiology, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS, 39216, USA
| | - Manohar S Roda
- Department of Radiology, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS, 39216, USA
| | - James A Bofill
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Andrew D Smith
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Judy R James
- Department of Radiology and Imaging Sciences, Indiana University Health University Hospital, Indianapolis, IN, USA
| |
Collapse
|
10
|
Evaluation of changes in myelination in the brain during infancy and childhood using ADC maps. JOURNAL OF SURGERY AND MEDICINE 2019. [DOI: 10.28982/josam.633584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
11
|
Yuan X, Yue C, Yu M, Chen P, Du P, Shao CH, Cheng SC, Bian RJ, Wang SY, Wang W, Cui GB. Fetal brain development at 25-39 weeks gestational age: A preliminary study using intravoxel incoherent motion diffusion-weighted imaging. J Magn Reson Imaging 2019; 50:899-909. [PMID: 30677192 DOI: 10.1002/jmri.26667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The fetal brain developmental changes of water diffusivity and perfusion has not been extensively explored. PURPOSE/HYPOTHESIS To evaluate the fetal brain developmental changes of water diffusivity and perfusion using intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI). STUDY TYPE Prospective. POPULATION Seventy-nine normal singleton fetuses were scanned without sedation of healthy pregnant women. FIELD STRENGTH/SEQUENCE 5 T MRI/T1 /2 -weighted image and IVIM-DWI. ASSESSMENT Pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) values were calculated in the frontal (FWM), temporal (TWM), parietal (PWM), and occipital white matter (OWM) as well as cerebellar hemisphere (CH), basal ganglia region (BGR), thalamus (TH), and pons using an IVIM model. STATISTICAL TESTS One-way analysis of variable (ANOVA) followed by Bonferroni post-hoc multiple comparison was employed to reveal the difference of IVIM parameters among the investigated brain regions. The linear and the nonlinear polynomial regression analyses were utilized to reveal the correlation between gestational age (GA) and IVIM parameters. RESULTS There were significant differences in both D (F(7,623) = 96.64, P = 0.000) and f values (F(7,623) = 2.361, P = 0.0219), but not D* values among the varied brain regions. D values from TWM (r2 = 0.1402, P = 0.0002), PWM (r2 = 0.2245, P = 0.0002), OWM (r2 = 0.2519, P = 0.0002), CH (r2 = 0.2245, P = 0.0002), BGR (r2 = 0.3393, P = 0.0001), TH (r2 = 0.1259, P = 0.0001), and D* value from pons (r2 = 0.2206, P = 0.0002) were significantly correlated with GA using linear regression analysis. Quadratic regression analysis led to results similar to those using the linear regression model. DATA CONCLUSION IVIM-DWI parameters may indicate fetal brain developmental alterations but the conclusion is far from reached due to the not as high-powered correlation between IVIM parameters and GA. LEVEL OF EVIDENCE 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:899-909.
Collapse
Affiliation(s)
- Xiao Yuan
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Shaanxi, China
| | - Cui Yue
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Shaanxi, China
| | - Mei Yu
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Shaanxi, China
| | - Ping Chen
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Shaanxi, China
| | - Pang Du
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Shaanxi, China
| | - Chang-Hua Shao
- Student Brigade, Fourth Military Medical University (Air Force Medical University), Shaanxi, China
| | - Si-Chao Cheng
- Student Brigade, Fourth Military Medical University (Air Force Medical University), Shaanxi, China
| | - Ren-Jie Bian
- Student Brigade, Fourth Military Medical University (Air Force Medical University), Shaanxi, China
| | | | - Wen Wang
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Shaanxi, China
| | - Guang-Bin Cui
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Shaanxi, China
| |
Collapse
|
12
|
Korostyshevskaya AM, Prihod'ko IY, Savelov AA, Yarnykh VL. Direct comparison between apparent diffusion coefficient and macromolecular proton fraction as quantitative biomarkers of the human fetal brain maturation. J Magn Reson Imaging 2019; 50:52-61. [PMID: 30635965 DOI: 10.1002/jmri.26635] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/15/2018] [Accepted: 12/17/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Apparent diffusion coefficient (ADC) is known as a quantitative biomarker of prenatal brain maturation. Fast macromolecular proton fraction (MPF) mapping is an emerging method for quantitative assessment of myelination that was recently adapted to fetal MRI. PURPOSE To compare the capability of ADC and MPF to quantify the normal fetal brain development. STUDY TYPE Prospective. POPULATION Forty-two human fetuses in utero (gestational age [GA] = 27.7 ± 6.0, range 20-38 weeks). FIELD STRENGTH/SEQUENCE 1.5 T; diffusion-weighted single-shot echo-planar spin-echo with five b-values for ADC mapping; spoiled multishot echo-planar gradient-echo with T1 , proton density, and magnetization transfer contrast weightings for single-point MPF mapping. ASSESSMENT Two operators measured ADC and MPF in the medulla, pons, cerebellum, thalamus, and frontal, occipital, and temporal cerebral white matter (WM). STATISTICAL TESTS Mixed repeated-measures analysis of variance (ANOVA) with the factors of pregnancy trimester and brain structure; Pearson correlation coefficient (r); Hotelling-Williams test to compare strengths of correlations. RESULTS From the 2nd to 3rd trimester, ADC significantly decreased in the thalamus and cerebellum (P < 0.005). MPF significantly increased in the medulla, pons, thalamus, and cerebellum (P < 0.005). Cerebral WM had significantly higher ADC and lower MPF compared with the medulla and pons in both trimesters. MPF (r range 0.83, 0.89, P < 0.001) and ADC (r range -0.43, -0.75, P ≤ 0.004) significantly correlated with GA and each other (r range -0.32, -0.60, P ≤ 0.04) in the medulla, pons, thalamus, and cerebellum. No significant correlations or distinctions between regions and trimesters were observed for cerebral WM (P range 0.1-0.75). Correlations with GA were significantly stronger for MPF compared with ADC in the medulla, pons, and cerebellum (Hotelling-Williams test, P < 0.003) and similar in the thalamus. Structure-averaged MPF and ADC values strongly correlated (r = 0.95, P < 0.001). DATA CONCLUSION MPF and ADC demonstrated qualitatively similar but quantitatively different spatiotemporal patterns. MPF appeared more sensitive to changes in the brain structures with prenatal onset of myelination. LEVEL OF EVIDENCE 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:52-61.
Collapse
Affiliation(s)
- Alexandra M Korostyshevskaya
- Institute "International Tomography Center" of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Irina Yu Prihod'ko
- Institute "International Tomography Center" of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Andrey A Savelov
- Institute "International Tomography Center" of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Vasily L Yarnykh
- University of Washington, Department of Radiology, Seattle, Washington, USA.,Research Institute of Biology and Biophysics, Tomsk State University, Tomsk, Russian Federation
| |
Collapse
|
13
|
Bültmann E, Mußgnug HJ, Zapf A, Hartmann H, Nägele T, Lanfermann H. Changes in brain microstructure during infancy and childhood using clinical feasible ADC-maps. Childs Nerv Syst 2017; 33:735-745. [PMID: 28364169 DOI: 10.1007/s00381-017-3391-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 03/17/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to examine age-related changes in apparent diffusion coefficient (ADC) during infancy and childhood using routine MRI data. METHODS A total of 112 investigations of patients aged 0 to 17.2 years showing a normal degree of myelination and no signal abnormalities on conventional MRI were retrospectively selected from our pool of pediatric MRI examinations at 1.5T. ADC maps based on our routinely included axial diffusion weighted sequence were created from the scanner. ADC values were measured in 35 different brain regions investigating normal age-related changes during the maturation of the human brain in infancy and childhood using clinical feasible sequences at 1.5T. RESULTS The relationship between ADC values and age in infancy and childhood can be described as an exponential function. With increasing age, the ADC values decrease significantly in all brain regions, especially during the first 2 years of life. Except in the peritrigonal white matter, no significant differences were found between both hemispheres. Between 0 and 2 years of life, no significant gender differences were detected. CONCLUSIONS Using ADC maps based on a routinely performed axial diffusion weighted sequence, it was possible first to describe the relationship between ADC values and age in infancy and childhood as exponential function in the whole brain and second to determine normative age-related ADC values in multiple brain regions.
Collapse
Affiliation(s)
- Eva Bültmann
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Hans Joachim Mußgnug
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Antonia Zapf
- Department of Medical Statistics, University Medical Center, Göttingen, Germany
| | - Hans Hartmann
- Clinic for Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Thomas Nägele
- Department of Diagnostic and Interventional Neuroradiology, Radiological University Hospital, University of Tübingen, Tübingen, Germany
| | - Heinrich Lanfermann
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| |
Collapse
|