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Prieto LJ, Ruiz Y, Pérez L, Bravo C, Aguado A, Alvarez-Mon M, Ortega MA, Marín C, De León-Luis J. The Brainstem-Vermis and Brainstem-Tentorium Angles in the Fetus: A Study of Their Reproducibility by Fetal Magnetic Resonance Imaging and Their Evolution Along the Gestation. Front Med (Lausanne) 2022; 9:878906. [PMID: 35692548 PMCID: PMC9178106 DOI: 10.3389/fmed.2022.878906] [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: 02/18/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
AimTo assess the reproducibility of brainstem-vermis (BV) and brainstem-tentorium (BT) angles measured by fetal Magnetic Resonance Imaging (MRI) during second half of pregnancy in normal and abnormal fetuses. Secondly, to assess reproducibility of two alternative methodologies to measure the brainstem-tentorium angle (BT1 and BT2) proposed by our group that could be more reliable in fetuses with posterior fossa fluid collection (PFFC) anomalies. Finally, to describe the evolution of BV and BT angles along gestation in normal fetuses.MethodsWe conducted a cross-sectional study of BV and BT angles obtained by MRI performed at our center, in 22 fetuses with PFFC and 8 fetuses without PFFC to calculate both angles’ reproducibility and the correlation between them and the gestational age.ResultsWe found good interobserver reproducibility for the BV, BT1 and BT2 angles (Intraclass correlation coefficient: 0.98; 0.89 and 0.88 for each of these angles, with p < 0.001). In patients with PFFC the BT angle could not always be measured. BT angle presented a positive relationship with gestational age (p = 0.002) but BV angle stayed stable. The measurements of BV, BT1, and BT2 angles can be reliably performed by MRI with good interobserver reproducibility.ConclusionBV angle stays stable during pregnancy, whereas BT angle tends to augment with gestational age.
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Affiliation(s)
- Laura Joigneau Prieto
- Department of Radiology, University Hospital Gregorio Marañón, Madrid, Spain
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Yolanda Ruiz
- Department of Radiology, University Hospital Gregorio Marañón, Madrid, Spain
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Laura Pérez
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, Madrid, Spain
- Health Research Institute Gregorio Marañón, Madrid, Spain
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, Madrid, Spain
| | - Coral Bravo
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, Madrid, Spain
- Health Research Institute Gregorio Marañón, Madrid, Spain
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, Madrid, Spain
| | - Alejandra Aguado
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, Madrid, Spain
- Health Research Institute Gregorio Marañón, Madrid, Spain
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, Madrid, Spain
| | - Melchor Alvarez-Mon
- Ramón y Cajal Institute of Healthcare Research (IRYCIS), Madrid, Spain
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Immune System Diseases-Rheumatology, Oncology Service an Internal Medicine (CIBEREHD), University Hospital Príncipe de Asturias, Alcala de Henares, Spain
| | - Miguel A. Ortega
- Ramón y Cajal Institute of Healthcare Research (IRYCIS), Madrid, Spain
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Cancer Registry and Pathology, Hospital Universitario Principe de Asturias, Alcala de Henares, Spain
- *Correspondence: Miguel A. Ortega,
| | - Carlos Marín
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, Madrid, Spain
- Health Research Institute Gregorio Marañón, Madrid, Spain
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, Madrid, Spain
| | - Juan De León-Luis
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, Madrid, Spain
- Health Research Institute Gregorio Marañón, Madrid, Spain
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, Madrid, Spain
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Khawam M, de Dumast P, Deman P, Kebiri H, Yu T, Tourbier S, Lajous H, Hagmann P, Maeder P, Thiran JP, Meuli R, Dunet V, Bach Cuadra M, Koob M. Fetal Brain Biometric Measurements on 3D Super-Resolution Reconstructed T2-Weighted MRI: An Intra- and Inter-observer Agreement Study. Front Pediatr 2021; 9:639746. [PMID: 34447726 PMCID: PMC8383736 DOI: 10.3389/fped.2021.639746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 06/07/2021] [Indexed: 11/27/2022] Open
Abstract
We present the comparison of two-dimensional (2D) fetal brain biometry on magnetic resonance (MR) images using orthogonal 2D T2-weighted sequences (T2WSs) vs. one 3D super-resolution (SR) reconstructed volume and evaluation of the level of confidence and concordance between an experienced pediatric radiologist (obs1) and a junior radiologist (obs2). Twenty-five normal fetal brain MRI scans (18-34 weeks of gestation) including orthogonal 3-mm-thick T2WSs were analyzed retrospectively. One 3D SR volume was reconstructed per subject based on multiple series of T2WSs. The two observers performed 11 2D biometric measurements (specifying their level of confidence) on T2WS and SR volumes. Measurements were compared using the paired Wilcoxon rank sum test between observers for each dataset (T2WS and SR) and between T2WS and SR for each observer. Bland-Altman plots were used to assess the agreement between each pair of measurements. Measurements were made with low confidence in three subjects by obs1 and in 11 subjects by obs2 (mostly concerning the length of the corpus callosum on T2WS). Inter-rater intra-dataset comparisons showed no significant difference (p > 0.05), except for brain axial biparietal diameter (BIP) on T2WS and for brain and skull coronal BIP and coronal transverse cerebellar diameter (DTC) on SR. None of them remained significant after correction for multiple comparisons. Inter-dataset intra-rater comparisons showed statistical differences in brain axial and coronal BIP for both observers, skull coronal BIP for obs1, and axial and coronal DTC for obs2. After correction for multiple comparisons, only axial brain BIP remained significantly different, but differences were small (2.95 ± 1.73 mm). SR allows similar fetal brain biometry as compared to using the conventional T2WS while improving the level of confidence in the measurements and using a single reconstructed volume.
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Affiliation(s)
- Marie Khawam
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Priscille de Dumast
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.,CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Pierre Deman
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.,CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Hamza Kebiri
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.,CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Thomas Yu
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland.,Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Sébastien Tourbier
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Hélène Lajous
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.,CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Patric Hagmann
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Philippe Maeder
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Jean-Philippe Thiran
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.,CIBM Center for Biomedical Imaging, Lausanne, Switzerland.,Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Reto Meuli
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Vincent Dunet
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Meritxell Bach Cuadra
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland.,CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Mériam Koob
- Department of Radiology, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
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