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Corroenne R, Grevent D, Mahallati H, Millischer AE, Gauchard G, Bussieres L, Kasprian G, Ville Y, Salomon LJ. Quantitative fetal MRI with diffusion tensor imaging in cases with 'short' corpus callosum. Ultrasound Obstet Gynecol 2024; 63:385-391. [PMID: 37676105 DOI: 10.1002/uog.27473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/11/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVES It has been suggested previously that the presence of Probst bundles (PB) in cases with a short corpus callosum (SCC) on diffusion tensor imaging (DTI) may help to differentiate between corpus callosal (CC) dysplasia and a variant of normal CC development. The objectives of this study were to compare DTI parameters between cases of SCC vs normal CC and between cases of SCC with PB (SCC-PB+) vs SCC without PB (SCC-PB-). METHODS This was a retrospective study of patients referred to the Necker Hospital in Paris, France, for magnetic resonance imaging (MRI) evaluation of an apparently isolated SCC detected by sonography between November 2016 and December 2022 (IRB: 00011928). MRI was performed using a 1.5-Tesla Signa system. T2-weighted axial and sagittal sequences of the fetal brain were used to measure the length and thickness of the CC. 16-direction DTI axial brain sequences were performed to identify the presence of PB and to generate quantitative imaging parameters (fractional anisotropy (FA) and apparent diffusion coefficient (ADC)) of the entire CC, genu, body and splenium. Cases in which other associated brain abnormalities were detected on MRI were excluded. Cases were matched for fetal gender and gestational age with controls in a 1:3 ratio. Control cases were normal fetuses included in the LUMIERE on the FETUS trial (NCT04142606) that underwent the same DTI evaluation of the brain. Comparisons between SCC and normal CC cases, and between SCC-PB+ and SCC-PB- cases were performed using ANOVA and adjusted for potential confounders using ANCOVA. RESULTS Twenty-two SCC cases were included and compared with 66 fetuses with a normal CC. In 10/22 (45.5%) cases of SCC, PB were identified. As expected, dimensions of the CC were significantly smaller in SCC compared with normal CC cases (all P < 0.01). In SCC-PB+ vs SCC-PB- cases, FA values were significantly lower in the entire CC (median, 0.21 (range, 0.19-0.24) vs 0.24 (range, 0.22-0.28); P < 0.01), genu (median, 0.21 (range, 0.15-0.29) vs 0.24 (range, 0.17-0.29); P = 0.04), body (median, 0.21 (range, 0.18-0.23) vs 0.23 (range, 0.21-0.27); P = 0.04) and splenium (median, 0.22 (range, 0.16-0.30) vs 0.25 (range, 0.20-0.29); P = 0.03). ADC values were significantly higher in the entire CC, genu and body in SCC-PB+ vs SCC-PB- cases (all P < 0.05). In SCC-PB+ cases, all FA values were significantly lower, and ADC values in the CC body were significantly higher compared with normal CC cases (all P < 0.05). In SCC-PB- cases, there was no significant difference in FA and ADC compared with normal CC cases (all P > 0.05). CONCLUSIONS Fetal DTI evaluation of the CC showed that FA values were significantly lower and ADC values tended to be significantly higher in SCC-PB+ compared with normal CC cases. This may highlight alterations of the white matter microstructure in SCC-PB+. In contrast, isolated SCC-PB- did not demonstrate significant changes in DTI parameters, strengthening the possibility that this is a normal CC variant. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- R Corroenne
- URP FETUS 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, APHP, Paris, France
| | - D Grevent
- URP FETUS 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Radiology, Necker-Enfants Malades Hospital, APHP, Paris, France
| | - H Mahallati
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - A-E Millischer
- Department of Radiology, Necker-Enfants Malades Hospital, APHP, Paris, France
| | - G Gauchard
- URP FETUS 7328 and LUMIERE Platform, University of Paris, Paris, France
| | - L Bussieres
- URP FETUS 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, APHP, Paris, France
| | - G Kasprian
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Y Ville
- URP FETUS 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, APHP, Paris, France
| | - L J Salomon
- URP FETUS 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, APHP, Paris, France
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Hadi E, Haddad L, Levy M, Gindes L, Hausman-Kedem M, Bassan H, Ben-Sira L, Libzon S, Kassif E, Hoffmann C, Leibovitz Z, Kasprian G, Lerman-Sagie T. Fetal intraventricular hemorrhage and periventricular hemorrhagic venous infarction: time for dedicated classification system. Ultrasound Obstet Gynecol 2024. [PMID: 38363592 DOI: 10.1002/uog.27613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Affiliation(s)
- E Hadi
- Diagnostic Ultrasound Unit, The Institute of Obstetrical and Gynecological Imaging, Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - L Haddad
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Ultrasound Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - M Levy
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel
| | - L Gindes
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Ultrasound Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
| | - M Hausman-Kedem
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - H Bassan
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Neurology and Development Center, Shamir Medical Center (Assaf Harofeh), Be'er Ya'akov, Israel
| | - L Ben-Sira
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Radiology, Division of Pediatric Radiology, Dana Children's Hospital, Tel- Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - S Libzon
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - E Kassif
- Diagnostic Ultrasound Unit, The Institute of Obstetrical and Gynecological Imaging, Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - C Hoffmann
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Neuroradiology Unit, Department of Diagnostic Radiology, Sheba Medical Center, Ramat Gan, Israel
| | - Z Leibovitz
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Obstetrics and Gynecology Ultrasound Unit, Bnai-Zion Medical Center, Haifa, Israel
| | - G Kasprian
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology, Medical University of Vienna, Vienna, Austria
| | - T Lerman-Sagie
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
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Stuempflen M, Taymourtash A, Kienast P, Schmidbauer VU, Schwartz E, Mitter C, Binder J, Prayer D, Kasprian G. Ganglionic eminence: volumetric assessment of transient brain structure utilizing fetal magnetic resonance imaging. Ultrasound Obstet Gynecol 2023; 62:405-413. [PMID: 37099530 DOI: 10.1002/uog.26232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/27/2023] [Accepted: 04/15/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE To provide quantitative magnetic resonance imaging (MRI) super-resolution-based three-dimensional volumetric reference data on the growth dynamics of the ganglionic eminence (GE) relative to cortical and total fetal brain volumes (TBV). METHODS This was a retrospective study of fetuses without structural central nervous system anomalies or other confounding comorbidities that were referred for fetal MRI. Super-resolution reconstructions of 1.5- and 3-Tesla T2-weighted images were generated. Semiautomatic segmentation of TBV and cortical volume and manual segmentation of the GE were performed. Cortical volume, TBV and GE volume were quantified and three-dimensional reconstructions were generated to visualize the developmental dynamics of the GE. RESULTS Overall, 120 fetuses that underwent 127 MRI scans at a mean gestational age of 27.23 ± 4.81 weeks (range, 20-37 weeks) were included. In the investigated gestational-age range, GE volume ranged from 74.88 to 808.75 mm3 and was at its maximum at 21 gestational weeks, followed by a linear decrease (R2 = 0.559) throughout the late second and third trimesters. A pronounced reduction in GE volume relative to cortical volume and TBV occurred in the late second trimester, with a decline in this reduction observed in the third trimester (R2 = 0.936 and 0.924, respectively). Three-dimensional rendering allowed visualization of a continuous change in the shape and size of the GE throughout the second and third trimesters. CONCLUSIONS Even small compartments of the fetal brain, which are not easily accessible by standardized two-dimensional modalities, can be assessed precisely by super-resolution processed fetal MRI. The inverse growth dynamics of GE volume compared with TBV and cortical volume reflects the transitory nature and physiological involution of this (patho-)physiologically important brain structure. The normal development and involution of the GE is mandatory for normal cortical development. Pathological changes of this transient organ precede impairment of cortical structures, and their detection may allow an earlier diagnosis of such anomalies. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M Stuempflen
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - A Taymourtash
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - P Kienast
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - V U Schmidbauer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - E Schwartz
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - C Mitter
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - J Binder
- Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - D Prayer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - G Kasprian
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
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Corroenne R, Grevent D, Kasprian G, Stirnemann J, Ville Y, Mahallati H, Salomon LJ. Corpus callosal reference ranges: systematic review of methodology of biometric chart construction and measurements obtained. Ultrasound Obstet Gynecol 2023; 62:175-184. [PMID: 36864530 DOI: 10.1002/uog.26187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/28/2023] [Accepted: 02/10/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE Adequate reference ranges of size of the corpus callosum (CC) are necessary to improve characterization of CC abnormalities and parental counseling. The objective of this study was to evaluate the methodology used in studies developing references charts for CC biometry. METHODS We conducted a systematic review of studies on fetal CC biometry using a set of predefined quality criteria of study design, statistical analysis and reporting methods. We included observational studies whose primary aim was to create ultrasound or magnetic resonance imaging charts for CC size in a normal population of fetuses. Studies were scored against a predefined set of independently agreed methodological criteria, and an overall quality score was given for each study. RESULTS Twelve studies met the inclusion criteria. Quality scores ranged between 17.4% and 95.7%. The greatest potential for bias was noted for the following items: sample selection and sample-size calculation, as only 17% of the studies were population-based and had consecutive or random recruitment of patients and with a justification of the sample size; number of measurements obtained for CC biometry, as only 17% of the studies performed more than one measurement per fetus and per scan; and description of characteristics of the study population, as only 8% of the studies clearly reported a minimum dataset of demographic characteristics. CONCLUSIONS Our review demonstrates substantial heterogeneity in methods and final biometric values of the fetal CC across the evaluated studies. The use of uniform methodology of the highest quality is essential in order to define a 'short' CC and provide appropriate parental counseling. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- R Corroenne
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, APHP, Paris, France
- EA Fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
| | - D Grevent
- EA Fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Radiology, Necker-Enfants Malades Hospital, APHP, Paris, France
| | - G Kasprian
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - J Stirnemann
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, APHP, Paris, France
- EA Fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
| | - Y Ville
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, APHP, Paris, France
- EA Fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
| | - H Mahallati
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - L J Salomon
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, APHP, Paris, France
- EA Fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
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5
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Nemec SF, Schwarz-Nemec U, Prayer D, Weber M, Bettelheim D, Kasprian G. Femur development in fetal growth restriction as observed on prenatal magnetic resonance imaging. Ultrasound Obstet Gynecol 2023; 61:601-609. [PMID: 36445348 DOI: 10.1002/uog.26133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/23/2022] [Accepted: 11/15/2022] [Indexed: 05/04/2023]
Abstract
OBJECTIVE To investigate human femur development in fetal growth restriction (FGR) by analyzing femur morphometrics and distal epimetaphyseal features on prenatal magnetic resonance imaging (MRI). METHODS This was a retrospective study of 111 fetuses (mean gestational age (GA), 27 + 2 weeks (range, 19-35 weeks)) with FGR associated with placental insufficiency without other major abnormalities and 111 GA-matched normal controls. On 1.5-Tesla echoplanar MRI, femur morphometrics, including diaphyseal length, epiphyseal length and epiphyseal width, were assessed. Using a previously reported grading system, epimetaphyseal features, including cartilaginous epiphyseal shape, metaphyseal shape and epiphyseal ossification, were analyzed qualitatively. To compare FGR cases and controls, the paired t-test was used to assess morphometrics, generalized estimating equations were used for epimetaphyseal features and time-to-event analysis was used to assess the visibility of epiphyseal ossification. RESULTS There were significant differences in femur morphometrics between FGR cases and controls (all parameters, P < 0.001), with bone shortening observed in FGR. No significant differences were found in the distribution of epimetaphyseal features between FGR cases and controls (epiphyseal shape, P = 0.341; metaphyseal shape, P = 0.782; epiphyseal ossification, P = 0.85). Epiphyseal ossification was visible at a median of 33.6 weeks in FGR cases and at 32.1 weeks in controls (P = 0.008). CONCLUSIONS On prenatal MRI, cases with FGR associated with placental insufficiency exhibit diaphyseal and epiphyseal shortening of the femur. However, FGR cases and normal controls share similarly graded distal epimetaphyseal features. Consequently, these features may not be appropriate MRI characteristics for the identification of FGR. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- S F Nemec
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - U Schwarz-Nemec
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - D Prayer
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - M Weber
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - D Bettelheim
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - G Kasprian
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
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Weissbach T, Massarwa A, Hadi E, Lev S, Haimov A, Katorza E, Brenner-Weissmann A, Krampl-Bettelheim E, Kasprian G, Sharon R, Achiron R, Weisz B, Kivilevitch Z, Kassif E. Early Fetal Corpus Callosum: Demonstrating Normal Growth and Detecting Pathologies in Early Pregnancy. AJNR Am J Neuroradiol 2023; 44:199-204. [PMID: 36657951 PMCID: PMC9891336 DOI: 10.3174/ajnr.a7757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/10/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND PURPOSE A malformed corpus callosum carries a risk for abnormal neurodevelopment. The advent of high-frequency transducers offers the opportunity to assess corpus callosum development in early pregnancy. The aim of the study was to construct a reference chart of the fetal corpus callosum length on ultrasound between 13 and 19 weeks of gestation and to prospectively examine growth patterns in pathologic cases. MATERIALS AND METHODS We performed a prospective cross-sectional study between 2020 and 2022 in well-dated, low-risk, singleton pregnancies between 13 and 19 weeks of gestation. A standardized image was obtained in the midsagittal plane. Imaging criteria were used as a confirmation of the early corpus callosum. Measurements were taken by 4 trained sonographers. Intra- and interobserver variability was assessed. Corpus callosum length in centiles were calculated for each gestational week. RESULTS One hundred eighty-seven fetuses were included in the study. All cases met inclusion criteria. At 13 weeks of gestation, the margins of the early corpus callosum were sufficiently clear to be measured in 80% (20/25) of fetuses. A cubic polynomial regression model best described the correlation between corpus length and gestational age. The correlation coefficient (r 2) was 0.929 (P < .001). Intra- and interobserver variability had high interclass correlation coefficients (>0.99). Presented is the earliest published case of agenesis of corpus callosum and a case of dysgenetic corpus callosum in Rubinstein-Taybi syndrome. CONCLUSIONS Provided is a nomogram of the early fetal corpus callosum. Applying imaging criteria helped to identify a case of complete agenesis of the corpus callosum as early as 14 weeks.
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Affiliation(s)
- T Weissbach
- From The Institute of Obstetrical and Gynecological Imaging (T.W., A.M., E.H., E. Katorza, A.B.-W., R.A., B.W., E. Kassif)
- Sackler School of Medicine (T.W., A.M., E.H., S.L., A.H., E. Katorza, A.B.-W., R.S., R.A., B.W., E. Kassif), Tel Aviv University, Tel Aviv, Israel
| | - A Massarwa
- From The Institute of Obstetrical and Gynecological Imaging (T.W., A.M., E.H., E. Katorza, A.B.-W., R.A., B.W., E. Kassif)
- Sackler School of Medicine (T.W., A.M., E.H., S.L., A.H., E. Katorza, A.B.-W., R.S., R.A., B.W., E. Kassif), Tel Aviv University, Tel Aviv, Israel
| | - E Hadi
- From The Institute of Obstetrical and Gynecological Imaging (T.W., A.M., E.H., E. Katorza, A.B.-W., R.A., B.W., E. Kassif)
- Sackler School of Medicine (T.W., A.M., E.H., S.L., A.H., E. Katorza, A.B.-W., R.S., R.A., B.W., E. Kassif), Tel Aviv University, Tel Aviv, Israel
| | - S Lev
- Department of Obstetrics and Gynecology (S.L., A.H.)
- Sackler School of Medicine (T.W., A.M., E.H., S.L., A.H., E. Katorza, A.B.-W., R.S., R.A., B.W., E. Kassif), Tel Aviv University, Tel Aviv, Israel
| | - A Haimov
- Department of Obstetrics and Gynecology (S.L., A.H.)
- Sackler School of Medicine (T.W., A.M., E.H., S.L., A.H., E. Katorza, A.B.-W., R.S., R.A., B.W., E. Kassif), Tel Aviv University, Tel Aviv, Israel
| | - E Katorza
- From The Institute of Obstetrical and Gynecological Imaging (T.W., A.M., E.H., E. Katorza, A.B.-W., R.A., B.W., E. Kassif)
- Sackler School of Medicine (T.W., A.M., E.H., S.L., A.H., E. Katorza, A.B.-W., R.S., R.A., B.W., E. Kassif), Tel Aviv University, Tel Aviv, Israel
| | - A Brenner-Weissmann
- From The Institute of Obstetrical and Gynecological Imaging (T.W., A.M., E.H., E. Katorza, A.B.-W., R.A., B.W., E. Kassif)
- Sackler School of Medicine (T.W., A.M., E.H., S.L., A.H., E. Katorza, A.B.-W., R.S., R.A., B.W., E. Kassif), Tel Aviv University, Tel Aviv, Israel
| | | | - G Kasprian
- Department of Biomedical Imaging and Image-Guided Therapy (G.K.), Medical University of Vienna, Vienna, Austria
| | - R Sharon
- Department of Neurology (R.S.), Sheba Medical Center, Tel Hashomer, Israel
- Sackler School of Medicine (T.W., A.M., E.H., S.L., A.H., E. Katorza, A.B.-W., R.S., R.A., B.W., E. Kassif), Tel Aviv University, Tel Aviv, Israel
| | - R Achiron
- From The Institute of Obstetrical and Gynecological Imaging (T.W., A.M., E.H., E. Katorza, A.B.-W., R.A., B.W., E. Kassif)
- Sackler School of Medicine (T.W., A.M., E.H., S.L., A.H., E. Katorza, A.B.-W., R.S., R.A., B.W., E. Kassif), Tel Aviv University, Tel Aviv, Israel
| | - B Weisz
- From The Institute of Obstetrical and Gynecological Imaging (T.W., A.M., E.H., E. Katorza, A.B.-W., R.A., B.W., E. Kassif)
- Sackler School of Medicine (T.W., A.M., E.H., S.L., A.H., E. Katorza, A.B.-W., R.S., R.A., B.W., E. Kassif), Tel Aviv University, Tel Aviv, Israel
| | - Z Kivilevitch
- Women's Ultrasound Unit (Z.K.), Maccabi Health Services, Negev Medical Center, Beer-Sheva, Israel
| | - E Kassif
- From The Institute of Obstetrical and Gynecological Imaging (T.W., A.M., E.H., E. Katorza, A.B.-W., R.A., B.W., E. Kassif)
- Sackler School of Medicine (T.W., A.M., E.H., S.L., A.H., E. Katorza, A.B.-W., R.S., R.A., B.W., E. Kassif), Tel Aviv University, Tel Aviv, Israel
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Prayer D, Malinger G, De Catte L, De Keersmaecker B, Gonçalves LF, Kasprian G, Laifer-Narin S, Lee W, Millischer AE, Platt L, Prayer F, Pugash D, Salomon LJ, Sanz Cortes M, Stuhr F, Timor-Tritsch IE, Tutschek B, Twickler D, Raine-Fenning N. ISUOG Practice Guidelines (updated): performance of fetal magnetic resonance imaging. Ultrasound Obstet Gynecol 2023; 61:278-287. [PMID: 36722431 PMCID: PMC10107509 DOI: 10.1002/uog.26129] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 05/03/2023]
Affiliation(s)
- D Prayer
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - G Malinger
- Division of Ultrasound in Obstetrics & Gynecology, Lis Maternity Hospital, Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - L De Catte
- Department of Obstetrics & Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - B De Keersmaecker
- Department of Obstetrics & Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - L F Gonçalves
- Fetal Imaging, William Beaumont Hospital, Royal Oak and Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - G Kasprian
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - S Laifer-Narin
- Division of Ultrasound and Fetal MRI, Columbia University Medical Center - New York Presbyterian Hospital, New York, NY, USA
| | - W Lee
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Pavilion for Women, Houston, TX, USA
| | - A-E Millischer
- Radiodiagnostics Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France
| | - L Platt
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - F Prayer
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - D Pugash
- Department of Radiology, University of British Columbia, Vancouver, Canada; Department of Obstetrics and Gynecology, BC Women's Hospital, Vancouver, Canada
| | - L J Salomon
- Department of Obstetrics, Hôpital Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, Université Paris Descartes, Paris, France
| | - M Sanz Cortes
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Pavilion for Women, Houston, TX, USA
| | - F Stuhr
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - I E Timor-Tritsch
- Division of Obstetrical & Gynecological Ultrasound, NYU Grossmann School of Medicine, New York, NY, USA
| | - B Tutschek
- Department of Obstetrics & Gynecology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Prenatal Zurich, Zürich, Switzerland
| | - D Twickler
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - N Raine-Fenning
- Department of Child Health, Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK; Nurture Fertility, The Fertility Partnership, Nottingham, UK
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Schmidbauer VU, Yildirim MS, Dovjak GO, Weber M, Diogo MC, Milos RI, Giordano V, Prayer F, Stuempflen M, Goeral K, Buchmayer J, Klebermass-Schrehof K, Berger A, Prayer D, Kasprian G. Synthetic MR Imaging-Based WM Signal Suppression Identifies Neonatal Brainstem Pathways in Vivo. AJNR Am J Neuroradiol 2022; 43:1817-1823. [PMID: 36396336 DOI: 10.3174/ajnr.a7710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND PURPOSE Multidynamic multiecho sequence-based imaging enables investigators to reconstruct multiple MR imaging contrasts on the basis of a single scan. This study investigated the feasibility of synthetic MRI-based WM signal suppression (syWMSS), a synthetic inversion recovery approach in which a short TI suppresses myelin-related signals, for the identification of early myelinating brainstem pathways. MATERIALS AND METHODS Thirty-one cases of neonatal MR imaging, which included multidynamic multiecho data and conventionally acquired T1- and T2-weighted sequences, were analyzed. The multidynamic multiecho postprocessing software SyMRI was used to generate syWMSS data (TR/TE/TI = 3000/5/410 ms). Two raters discriminated early myelinating brainstem pathways (decussation of the superior cerebellar peduncle, medial lemniscus, central tegmental tract, and medial longitudinal fascicle [the latter 3 assessed at the level of the pons]) on syWMSS data and reference standard contrasts. RESULTS On the basis of syWMSS data, the decussation of the superior cerebellar peduncle (31/31); left/right medial lemniscus (31/31; 30/31); left/right central tegmental tract (19/31; 20/31); and left/right medial longitudinal fascicle (30/31) were reliably identified by both raters. On the basis of T1-weighted contrasts, the decussation of the superior cerebellar peduncle (14/31); left/right medial lemniscus (22/31; 16/31); left/right central tegmental tract (1/31); and left/right medial longitudinal fascicle (9/31; 8/31) were reliably identified by both raters. On the basis of T2-weighted contrasts, the decussation of the superior cerebellar peduncle (28/31); left/right medial lemniscus (16/31; 12/31); left/right central tegmental tract (23/31; 18/31); and left/right medial longitudinal fascicle (15/31; 14/31) were reliably identified by both raters. CONCLUSIONS syWMSS data provide a feasible imaging technique with which to study early myelinating brainstem pathways. MR imaging approaches that use myelin signal suppression contribute to a more sensitive assessment of myelination patterns at early stages of cerebral development.
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Affiliation(s)
- V U Schmidbauer
- From the Department of Biomedical Imaging and Image-Guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., R.-I.M., F.P., M.S., D.P., G.K.)
| | - M S Yildirim
- From the Department of Biomedical Imaging and Image-Guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., R.-I.M., F.P., M.S., D.P., G.K.)
| | - G O Dovjak
- From the Department of Biomedical Imaging and Image-Guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., R.-I.M., F.P., M.S., D.P., G.K.)
| | - M Weber
- From the Department of Biomedical Imaging and Image-Guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., R.-I.M., F.P., M.S., D.P., G.K.)
| | - M C Diogo
- Department of Neuroradiology (M.C.D.), Hospital Garcia de Orta, Almada, Portugal
| | - R-I Milos
- From the Department of Biomedical Imaging and Image-Guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., R.-I.M., F.P., M.S., D.P., G.K.)
| | - V Giordano
- Comprehensive Center for Pediatrics (V.G., K.G., J.B., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria
| | - F Prayer
- From the Department of Biomedical Imaging and Image-Guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., R.-I.M., F.P., M.S., D.P., G.K.)
| | - M Stuempflen
- From the Department of Biomedical Imaging and Image-Guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., R.-I.M., F.P., M.S., D.P., G.K.)
| | - K Goeral
- Comprehensive Center for Pediatrics (V.G., K.G., J.B., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria
| | - J Buchmayer
- Comprehensive Center for Pediatrics (V.G., K.G., J.B., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria
| | - K Klebermass-Schrehof
- Comprehensive Center for Pediatrics (V.G., K.G., J.B., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria
| | - A Berger
- Comprehensive Center for Pediatrics (V.G., K.G., J.B., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria
| | - D Prayer
- From the Department of Biomedical Imaging and Image-Guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., R.-I.M., F.P., M.S., D.P., G.K.)
| | - G Kasprian
- From the Department of Biomedical Imaging and Image-Guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., R.-I.M., F.P., M.S., D.P., G.K.)
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Corroenne R, Arthuis C, Kasprian G, Mahallati H, Ville Y, Millischer Bellaiche AE, Henry C, Grevent D, Salomon LJ. Diffusion tensor imaging of fetal brain: principles, potential and limitations of promising technique. Ultrasound Obstet Gynecol 2022; 60:470-476. [PMID: 35561129 DOI: 10.1002/uog.24935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/24/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Human brain development is a complex process that begins in the third week of gestation. During early development, the fetal brain undergoes dynamic morphological changes. These changes result from events such as neurogenesis, neuronal migration, synapse formation, axonal growth and myelination. Disruption of any of these processes is thought to be responsible for a wide array of different pathologies. Recent advances in magnetic resonance imaging, especially diffusion-weighted imaging and diffusion tensor imaging (DTI), have enabled characterization and evaluation of brain development in utero. In this review, aimed at practitioners involved in fetal medicine and high-risk pregnancies, we provide a comprehensive overview of fetal DTI studies focusing on characterization of early normal brain development as well as evaluation of brain pathology in utero. We also discuss the reliability and limitations of fetal brain DTI. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- R Corroenne
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, APHP, Paris, France
- EA FETUS 7328 and LUMIERE Platform, University of Paris, Paris, France
| | - C Arthuis
- EA FETUS 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Obstetrics, University Hospital of Nantes, Nantes, France
| | - G Kasprian
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - H Mahallati
- Department of Radiology, University of Calgary, Calgary, Canada
| | - Y Ville
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, APHP, Paris, France
| | | | - C Henry
- EA FETUS 7328 and LUMIERE Platform, University of Paris, Paris, France
| | - D Grevent
- EA FETUS 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Radiology, Necker-Enfants Malades Hospital, APHP, Paris, France
| | - L J Salomon
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, APHP, Paris, France
- EA FETUS 7328 and LUMIERE Platform, University of Paris, Paris, France
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Jengojan S, Sorgo P, Bodner G, Kasprian G. Novel Tomographic Imaging of Peripheral Nerves with High-Resolution Ultrasonography Compared with High-Field MR (Tractography). Semin Musculoskelet Radiol 2022. [DOI: 10.1055/s-0042-1750645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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11
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Schmidbauer VU, Yildirim MS, Dovjak GO, Goeral K, Buchmayer J, Weber M, Diogo MC, Giordano V, Mayr-Geisl G, Prayer F, Stuempflen M, Lindenlaub F, List V, Glatter S, Rauscher A, Stuhr F, Lindner C, Klebermass-Schrehof K, Berger A, Prayer D, Kasprian G. Different from the Beginning: WM Maturity of Female and Male Extremely Preterm Neonates-A Quantitative MRI Study. AJNR Am J Neuroradiol 2022; 43:611-619. [PMID: 35332014 PMCID: PMC8993206 DOI: 10.3174/ajnr.a7472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/25/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE Former preterm born males are at higher risk for neurodevelopmental disabilities compared with female infants born at the same gestational age. This retrospective study investigated sex-related differences in the maturity of early myelinating brain regions in infants born <28 weeks' gestational age using diffusion tensor- and relaxometry-based MR imaging. MATERIALS AND METHODS Quantitative MR imaging sequence acquisitions were analyzed in a sample of 35 extremely preterm neonates imaged at term-equivalent ages. Quantitative MR imaging metrics (fractional anisotropy; ADC [10-3mm2/s]; and T1-/T2-relaxation times [ms]) of the medulla oblongata, pontine tegmentum, midbrain, and the right/left posterior limbs of the internal capsule were determined on diffusion tensor- and multidynamic, multiecho sequence-based imaging data. ANCOVA and a paired t test were used to compare female and male infants and to detect hemispheric developmental asymmetries. RESULTS Seventeen female (mean gestational age at birth: 26 + 0 [SD, 1 + 4] weeks+days) and 18 male (mean gestational age at birth: 26 + 1 [SD, 1 + 3] weeks+days) infants were enrolled in this study. Significant differences were observed in the T2-relaxation time (P = .014) of the pontine tegmentum, T1-relaxation time (P = .011)/T2-relaxation time (P = .024) of the midbrain, and T1-relaxation time (P = .032) of the left posterior limb of the internal capsule. In both sexes, fractional anisotropy (P [♀] < .001/P [♂] < .001) and ADC (P [♀] = .017/P [♂] = .028) differed significantly between the right and left posterior limbs of the internal capsule. CONCLUSIONS The combined use of various quantitative MR imaging metrics detects sex-related and interhemispheric differences of WM maturity. The brainstem and the left posterior limb of the internal capsule of male preterm neonates are more immature compared with those of female infants at term-equivalent ages. Sex differences in WM maturation need further attention for the personalization of neonatal brain imaging.
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Affiliation(s)
- V U Schmidbauer
- From the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
| | - M S Yildirim
- From the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
| | - G O Dovjak
- From the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
| | - K Goeral
- Comprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
| | - J Buchmayer
- Comprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
| | - M Weber
- From the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
| | - M C Diogo
- Department of Neuroradiology (M.C.D.), Hospital Garcia de Orta, Almada, Portugal
| | - V Giordano
- Comprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
| | - G Mayr-Geisl
- Department of Neurosurgery (G.M.-G.), Medical University of Vienna, Vienna, Austria
| | - F Prayer
- From the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
| | - M Stuempflen
- From the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
| | - F Lindenlaub
- From the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
| | - V List
- Comprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
| | - S Glatter
- Comprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
| | - A Rauscher
- Department of Pediatrics (A.R.), University of British Columbia, Vancouver, British Columbia, Canada
| | - F Stuhr
- From the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
| | - C Lindner
- From the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
| | - K Klebermass-Schrehof
- Comprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
| | - A Berger
- Comprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
| | - D Prayer
- From the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
| | - G Kasprian
- From the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
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12
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Di Mascio D, Khalil A, Rizzo G, Kasprian G, Caulo M, Manganaro L, Odibo AO, Flacco ME, Giancotti A, Buca D, Liberati M, Timor-Tritsch IE, D'Antonio F. Reference ranges for fetal brain structures using magnetic resonance imaging: systematic review. Ultrasound Obstet Gynecol 2022; 59:296-303. [PMID: 34405927 DOI: 10.1002/uog.23762] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/19/2021] [Accepted: 08/05/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate the methodology of studies reporting reference ranges for fetal brain structures on magnetic resonance imaging (MRI). METHODS MEDLINE, EMBASE, CINAHL and the Web of Science databases were searched electronically up to 31 December 2020 to identify studies investigating biometry and growth of the fetal brain and reporting reference ranges for brain structures using MRI. The primary aim was to evaluate the methodology of these studies. A list of 26 quality criteria divided into three domains, including 'study design', 'statistical and reporting methods' and 'specific aspects relevant to MRI', was developed and applied to evaluate the methodological appropriateness of each of the included studies. The overall quality score of a study, ranging between 0 and 26, was defined as the sum of scores awarded for each quality criterion and expressed as a percentage (the lower the percentage, the higher the risk of bias). RESULTS Fifteen studies were included in this systematic review. The overall mean quality score of the studies evaluated was 48.7%. When focusing on each domain, the mean quality score was 42.0% for 'study design', 59.4% for 'statistical and reporting methods' and 33.3% for 'specific aspects relevant to MRI'. For the 'study design' domain, sample size calculation and consecutive enrolment of women were the items found to be at the highest risk of bias. For the 'statistical and reporting methods' domain, the presence of regression equations for mean and SD for each measurement, the number of measurements taken for each variable and the presence of postnatal assessment information were the items found to be at the highest risk of bias. For the 'specific aspects relevant to MRI' domain, whole fetal brain assessment was not performed in any of the included studies and was therefore considered to be the item at the highest risk of bias. CONCLUSIONS Most of the previously published studies reporting fetal brain reference ranges on MRI are highly heterogeneous and have low-to-moderate quality in terms of methodology, which is similar to the findings reported for ultrasound studies. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- D Di Mascio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - A Khalil
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - G Rizzo
- Division of Maternal and Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy
- Department of Obstetrics and Gynecology, The First I.M. Sechenov Moscow State Medical University, Moscow, Russia
| | - G Kasprian
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - M Caulo
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. D'Annunzio' University, Chieti, Italy
| | - L Manganaro
- Department of Radiology, Sapienza University of Rome, Rome, Italy
| | - A O Odibo
- Division of Maternal-Fetal Medicine, University of South Florida, Tampa, FL, USA
| | - M E Flacco
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - A Giancotti
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - D Buca
- Center for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - M Liberati
- Center for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - I E Timor-Tritsch
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, NY, USA
| | - F D'Antonio
- Center for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
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Seidl‐Mlczoch E, Kasprian G, Ba‐ssalamah A, Stuempflen M, Kitzmueller E, Muin DA, Zimpfer D, Prayer D, Michel‐behnke I, Ulm B. Characterization of phenotypic spectrum of fetal heterotaxy syndrome by combining ultrasound and magnetic resonance imaging. Ultrasound Obstet Gynecol 2021; 58:837-845. [PMID: 34097330 PMCID: PMC9299896 DOI: 10.1002/uog.23705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/27/2021] [Accepted: 05/28/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Heterotaxy or isomerism of the atrial appendages is a congenital disorder with variable presentation, associated with both cardiac and non-cardiac anomalies, which may have a serious impact on fetal outcome. The aim of this exploratory study was to assess the value of fetal magnetic resonance imaging (MRI), as a complementary tool to ultrasound, for describing the morphological spectrum encountered in heterotaxy. METHODS This retrospective study included 27 fetuses that underwent fetal MRI following prenatal suspicion of heterotaxy on ultrasound from 1998 to 2019 in a tertiary referral center. Heterotaxy was classified as left atrial isomerism (LAI) or right atrial isomerism (RAI) based on fetal echocardiography (FE) examination. In addition to routine prenatal ultrasound, fetal MRI was offered routinely to enhance the diagnosis of non-cardiac anomalies, which might have been missed on ultrasound. Prenatal findings on ultrasound, FE and MRI were reviewed systematically and compared with those of postnatal imaging and autopsy reports. RESULTS Twenty-seven fetuses with heterotaxy and cardiovascular pathology, of which 19 (70%) had LAI and eight (30%) had RAI, were included. Seven (7/19 (37%)) fetuses with LAI had normal intracardiac anatomy, whereas all fetuses with RAI had a cardiac malformation. All 27 fetuses had non-cardiac anomalies on fetal MRI, including situs and splenic anomalies. In 12/19 (63%) fetuses with LAI, a specific abnormal configuration of the liver was observed on MRI. In three fetuses, fetal MRI revealed signs of total anomalous pulmonary venous connection obstruction. An abnormal bronchial tree pattern was suspected on prenatal MRI in 6/19 (32%) fetuses with LAI and 3/8 (38%) fetuses with RAI. CONCLUSIONS Visualization on MRI of non-cardiac anomalies in fetuses with suspected heterotaxy is feasible and can assist the complex diagnosis of this condition, despite its limitations. This modality potentially enables differentiation of less severe cases from more complex ones, which may have a poorer prognosis. Fetal MRI can assist in prenatal counseling and planning postnatal management. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- E. Seidl‐Mlczoch
- Pediatric Heart Center, Department of Pediatrics and Adolescent Medicine, Division of Pediatric CardiologyMedical University of ViennaViennaAustria
| | - G. Kasprian
- Department of Biomedical Imaging and Image‐guided Therapy, Division of Neuroradiology and Musculoskeletal RadiologyMedical University of Vienna, ViennaAustria
| | - A. Ba‐ssalamah
- Department of Biomedical Imaging and Image‐guided Therapy, Division of Neuroradiology and Musculoskeletal RadiologyMedical University of Vienna, ViennaAustria
| | - M. Stuempflen
- Department of Biomedical Imaging and Image‐guided Therapy, Division of Neuroradiology and Musculoskeletal RadiologyMedical University of Vienna, ViennaAustria
| | - E. Kitzmueller
- Pediatric Heart Center, Department of Pediatrics and Adolescent Medicine, Division of Pediatric CardiologyMedical University of ViennaViennaAustria
| | - D. A. Muin
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Fetomaternal MedicineMedical University of Vienna, ViennaAustria
| | - D. Zimpfer
- Department of Cardiac Surgery, Pediatric Heart Center ViennaMedical University of Vienna, ViennaAustria
| | - D. Prayer
- Department of Biomedical Imaging and Image‐guided Therapy, Division of Neuroradiology and Musculoskeletal RadiologyMedical University of Vienna, ViennaAustria
| | - I. Michel‐behnke
- Pediatric Heart Center, Department of Pediatrics and Adolescent Medicine, Division of Pediatric CardiologyMedical University of ViennaViennaAustria
| | - B. Ulm
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Fetomaternal MedicineMedical University of Vienna, ViennaAustria
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14
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Schmidbauer VU, Dovjak GO, Yildirim MS, Mayr-Geisl G, Weber M, Diogo MC, Gruber GM, Prayer F, Milos RI, Stuempflen M, Ulm B, Binder J, Bettelheim D, Kiss H, Prayer D, Kasprian G. Mapping Human Fetal Brain Maturation In Vivo Using Quantitative MRI. AJNR Am J Neuroradiol 2021; 42:2086-2093. [PMID: 34503947 DOI: 10.3174/ajnr.a7286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 07/19/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND PURPOSE On the basis of a single multidynamic multiecho sequence acquisition, SyMRI generates a variety of quantitative image data that can characterize tissue-specific properties. The aim of this retrospective study was to evaluate the feasibility of SyMRI for the qualitative and quantitative assessment of fetal brain maturation. MATERIALS AND METHODS In 52 fetuses, multidynamic multiecho sequence acquisitions were available. SyMRI was used to perform multidynamic multiecho-based postprocessing. Fetal brain maturity was scored qualitatively on the basis of SyMRI-generated MR imaging data. The results were compared with conventionally acquired T1-weighted/T2-weighted contrasts as a standard of reference. Myelin-related changes in T1-/T2-relaxation time/relaxation rate, proton density, and MR imaging signal intensity of the developing fetal brain stem were measured. A Pearson correlation analysis was used to detect correlations between the following: 1) the gestational age at MR imaging and the fetal brain maturity score, and 2) the gestational age at MR imaging and the quantitative measurements. RESULTS SyMRI provided images of sufficient quality in 12/52 (23.08%) (range, 23 + 6-34 + 0) fetal multidynamic multiecho sequence acquisitions. The fetal brain maturity score positively correlated with gestational age at MR imaging (SyMRI: r = 0.915, P < .001/standard of reference: r = 0.966, P < .001). Myelination-related changes in the T2 relaxation time/T2 relaxation rate of the medulla oblongata significantly correlated with gestational age at MR imaging (T2-relaxation time: r = -0.739, P = .006/T2-relaxation rate: r = 0.790, P = .002). CONCLUSIONS Fetal motion limits the applicability of multidynamic multiecho-based postprocessing. However, SyMRI-generated image data of sufficient quality enable the qualitative assessment of maturity-related changes of the fetal brain. In addition, quantitative T2 relaxation time/T2 relaxation rate mapping characterizes myelin-related changes of the brain stem prenatally. This approach, if successful, opens novel possibilities for the evaluation of structural and biochemical aspects of fetal brain maturation.
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Affiliation(s)
- V U Schmidbauer
- From the Departments of Biomedical Imaging and Image-Guided Therapy (V.U.S., G.O.D., M.S.Y., M.W., M.C.D., F.P., R.-I.M., M.S., D.P. G.K)
| | - G O Dovjak
- From the Departments of Biomedical Imaging and Image-Guided Therapy (V.U.S., G.O.D., M.S.Y., M.W., M.C.D., F.P., R.-I.M., M.S., D.P. G.K)
| | - M S Yildirim
- From the Departments of Biomedical Imaging and Image-Guided Therapy (V.U.S., G.O.D., M.S.Y., M.W., M.C.D., F.P., R.-I.M., M.S., D.P. G.K)
| | | | - M Weber
- From the Departments of Biomedical Imaging and Image-Guided Therapy (V.U.S., G.O.D., M.S.Y., M.W., M.C.D., F.P., R.-I.M., M.S., D.P. G.K)
| | - M C Diogo
- From the Departments of Biomedical Imaging and Image-Guided Therapy (V.U.S., G.O.D., M.S.Y., M.W., M.C.D., F.P., R.-I.M., M.S., D.P. G.K)
| | - G M Gruber
- Department of Anatomy and Biomechanics (G.M.G.), Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | - F Prayer
- From the Departments of Biomedical Imaging and Image-Guided Therapy (V.U.S., G.O.D., M.S.Y., M.W., M.C.D., F.P., R.-I.M., M.S., D.P. G.K)
| | - R-I Milos
- From the Departments of Biomedical Imaging and Image-Guided Therapy (V.U.S., G.O.D., M.S.Y., M.W., M.C.D., F.P., R.-I.M., M.S., D.P. G.K)
| | - M Stuempflen
- From the Departments of Biomedical Imaging and Image-Guided Therapy (V.U.S., G.O.D., M.S.Y., M.W., M.C.D., F.P., R.-I.M., M.S., D.P. G.K)
| | - B Ulm
- Obstetrics and Gynecology (B.U., J.B., D.B., H.K.), Medical University of Vienna, Vienna, Austria
| | - J Binder
- Obstetrics and Gynecology (B.U., J.B., D.B., H.K.), Medical University of Vienna, Vienna, Austria
| | - D Bettelheim
- Obstetrics and Gynecology (B.U., J.B., D.B., H.K.), Medical University of Vienna, Vienna, Austria
| | - H Kiss
- Obstetrics and Gynecology (B.U., J.B., D.B., H.K.), Medical University of Vienna, Vienna, Austria
| | - D Prayer
- From the Departments of Biomedical Imaging and Image-Guided Therapy (V.U.S., G.O.D., M.S.Y., M.W., M.C.D., F.P., R.-I.M., M.S., D.P. G.K)
| | - G Kasprian
- From the Departments of Biomedical Imaging and Image-Guided Therapy (V.U.S., G.O.D., M.S.Y., M.W., M.C.D., F.P., R.-I.M., M.S., D.P. G.K)
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Tomschik M, Horner E, Kasprian G, Dorfer C, Roessler K. P14.34 Long-term seizure outcomes and tumor recurrence after glioneural tumor surgery: A single-center retrospective cohort. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
BACKGROUND
Gangliogliomas (GG) and dysembryoplastic neuroepithelial tumors (DNET) are glioneural tumors associated with treatment refractory seizures, especially in younger patients. Because there is a relative paucity of data on which factors predispose patients for recurrences, we analyzed our own cohort treated over the last 25 years.
MATERIAL AND METHODS
We performed a retrospective analysis of all patients undergoing resection of a glioneural tumor with a minimum follow up of one year. Surgery type, histological findings, and seizure outcome were extracted from patient records. Recurrence was defined as new tumor lesions in previously unremarkable parenchyma or tumor growth of a residual lesion. We performed a Mann-Whitney-U test to determine statistical significance of differences in continuous variables and Fisher’s exact test in categorical.
RESULTS
In total, 109 patients were operated between March 1994 to March and followed for a median of 62.4 months (range 12–281 months). The average age of patients at the time of surgery was 21.2 years with 60 patients belonging to the pediatric population. Complete lesionectomies were the goal in 72 cases, extended resections in 10, and partial resection due to proximity of eloquent areas was performed in 27 cases. 77 tumors were classified histologically as a GG and 32 as a DNET. The temporal lobe was the most common site of origin with 65 tumors (59.6%) being found there. On postoperative MRI, complete resection was achieved in 76 cases. Local tumor recurrences were seen in 14 patients (12 GG and 2 DNET), 9 of which occurred in patients with apparently complete resection. Overall, only one malignant transformation of a GG was observed. Age at surgery was significantly lower for patients with later recurrence (11.9 yrs vs. 22.6 yrs for patients without recurrence, p=0.0047). A second surgery was performed in 11 patients with previously incomplete resections (33%) and 7 patients with complete resection (9.2%), p=0.0038. 95 patients (87.2%) had preoperative seizures for a median of 26 months before surgery. One year after surgery, a documented ILAE outcome was available for 90 of these patients and 63 (70%) were seizure free one year after surgery. While 45 patients with epilepsy (47.4%) had at least one seizure relapse after surgery - most often associated with AED withdrawal or tumor recurrence - medical therapy and repeat resection allowed 76 patients (80%) to be seizure free for over one year at their last follow up. Age at surgery was not a significant predictor of seizure freedom.
CONCLUSION
Glioneural tumors are highly epileptogenic but neurosurgical resection allows seizure freedom in the large majority of these patients. Tumor recurrences were more likely in younger patients and incomplete resections predisposed patients to need another surgery. Resection extent on MRI does not appear to be a reliable marker for future recurrence risk.
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Affiliation(s)
- M Tomschik
- Medical University of Vienna, Vienna, Austria
| | - E Horner
- Medical University of Vienna, Vienna, Austria
| | - G Kasprian
- Medical University of Vienna, Vienna, Austria
| | - C Dorfer
- Medical University of Vienna, Vienna, Austria
| | - K Roessler
- Medical University of Vienna, Vienna, Austria
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Diogo MC, Glatter S, Prayer D, Gruber GM, Bettelheim D, Weber M, Dovjak G, Seidl R, Kasprian G. Improved neurodevelopmental prognostication in isolated corpus callosal agenesis: fetal magnetic resonance imaging-based scoring system. Ultrasound Obstet Gynecol 2021; 58:34-41. [PMID: 32484578 PMCID: PMC8362015 DOI: 10.1002/uog.22102] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/07/2020] [Accepted: 05/18/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Corpus callosal agenesis (CCA) is one of the most common brain malformations and is generally associated with a good outcome when isolated. However, up to 25% of patients are at risk of neurodevelopmental delay, which currently available clinical and imaging parameters are inadequate to predict. The objectives of this study were to apply and validate a fetal magnetic resonance imaging (MRI) anatomical scoring system in a cohort of fetuses with isolated CCA and to evaluate the correlation with postnatal neurodevelopmental outcome. METHODS This was a retrospective cohort study of cases of prenatally diagnosed isolated CCA (as determined on ultrasound and MRI), with normal karyotype and with known postnatal neurodevelopmental outcome assessed by standardized testing. A fetal brain MRI anatomical scoring system based on seven categories (gyration, opercularization, temporal lobe symmetry, lamination, hippocampal position, basal ganglia and ventricular size) was developed and applied to the cohort; a total score of 0-11 points could be given, with a score of 0 representing normal anatomy. Images were scored independently by two neuroradiologists blinded to the outcome. For the purpose of assessing the correlation between fetal MRI score and neurodevelopmental outcome, neurodevelopmental test results were scored as follows: 0, 'below average' (poor outcome); 1, 'average'; and 2, 'above average' (good outcome). Spearman's rank coefficient was used to assess correlation, and inter-rater agreement in the assessment of fetal MRI score was calculated. RESULTS Twenty-one children (nine females (42.9%)) fulfilled the inclusion criteria. Thirty-seven fetal MRI examinations were evaluated. Mean gestational age was 28.3 ± 4.7 weeks (range, 20-38 weeks). All fetuses were delivered after 35 weeks' gestation with no perinatal complications. Fetal MRI scores ranged from 0 to 6 points, with a median of 3 points. Inter-rater agreement in fetal MRI score assessment was excellent (intraclass correlation coefficient, 0.959 (95% CI, 0.921-0.979)). Neurodevelopmental evaluation was performed on average at 2.6 ± 1.46 years (range, 0.5-5.8 years). There was a significant negative correlation between fetal MRI score and neurodevelopmental outcome score in the three areas tested: cognitive (ρ = -0.559, P < 0.0001); motor (ρ = -0.414, P = 0.012) and language (ρ = -0.565, P < 0.0001) skills. Using fetal MRI score cut-offs of ≤ 3 (good outcome) and ≥ 4 points (high risk for poor outcome), the correct prognosis could be determined in 20/21 (95.2% (95% CI, 77.3-99.2%)) cases. CONCLUSION By assessing structural features of the fetal brain on MRI, it may be possible to better stratify prenatally the risk of poor neurodevelopmental outcome in CCA patients. © 2020 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M. C. Diogo
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
- Neuroradiology DepartmentHospital Garcia de OrtaAlmadaPortugal
| | - S. Glatter
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric NeurologyMedical University of ViennaViennaAustria
| | - D. Prayer
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
| | - G. M. Gruber
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
- Department of Anatomy and BiomechanicsKarl Landsteiner University of Health SciencesKremsAustria
| | - D. Bettelheim
- Department of Gynecology and ObstetricsMedical University of ViennaViennaAustria
| | - M. Weber
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
| | - G. Dovjak
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
| | - R. Seidl
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric NeurologyMedical University of ViennaViennaAustria
| | - G. Kasprian
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
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17
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Glatter S, Kasprian G, Bettelheim D, Ulm B, Weber M, Seidl R, Prayer D, Diogo MC. Beyond Isolated and Associated: A Novel Fetal MR Imaging-Based Scoring System Helps in the Prenatal Prognostication of Callosal Agenesis. AJNR Am J Neuroradiol 2021; 42:782-786. [PMID: 33707281 DOI: 10.3174/ajnr.a7064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/10/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Although "corpus callosum agenesis" is an umbrella term for multiple entities, prenatal counseling is based reductively on the presence (associated) or absence (isolated) of additional abnormalities. Our aim was to test the applicability of a fetal MR neuroimaging score in a cohort of fetuses with prenatally diagnosed isolated corpus callosum agenesis and associated corpus callosum agenesis and correlate it with neurodevelopmental outcomes. MATERIALS AND METHODS We performed a single-center retrospective analysis of a cohort of cases of consecutive corpus callosum agenesis collected between January 2011 and July 2019. Cases were scored by 2 raters, and interater agreement was calculated. Outcome was assessed by standardized testing (Bayley Scales of Infant and Toddler Development, Kaufman Assessment Battery for Children) or a structured telephone interview and correlated with scores using 2-way ANOVA. RESULTS We included 137 cases (74 cases of isolated corpus callosum agenesis), imaged at a mean of 27 gestational weeks. Interrater agreement was excellent (0.98). Scores were higher in associated corpus callosum agenesis (P < .0001) without a significant score difference between complete and partial corpus callosum agenesis (P = .38). Outcome was assessed in 42 children with isolated corpus callosum agenesis and 9 with associated corpus callosum agenesis (mean age, 3.1 years). MR imaging scores correctly predicted developmental outcome in 90.7% of patients with isolated corpus callosum agenesis, improving neurodevelopmental risk stratification in corpus callosum agenesis. CONCLUSIONS The scoring system is very reproducible and can differentiate isolated corpus callosum agenesis and associated isolated corpus callosum agenesis (significantly higher scores) but not between partial and complete corpus callosum agenesis. Scores correlated with outcome in isolated corpus callosum agenesis, but there were too few associated postnatal cases of isolated corpus callosum agenesis to draw conclusions in this group.
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Affiliation(s)
- S Glatter
- From the Department of Radiology (S.G., G.K., M.W., D.P., M.C.D.), Division of Neuro- and Musculoskeletal Radiology
- Department of Pediatrics and Adolescent Medicine (S.G., R.S.), Division of Pediatric Neurology
| | - G Kasprian
- From the Department of Radiology (S.G., G.K., M.W., D.P., M.C.D.), Division of Neuro- and Musculoskeletal Radiology
| | - D Bettelheim
- Department of Gynecology and Obstetrics (D.B.), Medical University of Vienna, Vienna, Austria
- Department of Gynecology and Obstetrics (B.U., D.B.), Medical University of Vienna, Vienna, Austria
| | - B Ulm
- Department of Gynecology and Obstetrics (B.U., D.B.), Medical University of Vienna, Vienna, Austria
| | - M Weber
- From the Department of Radiology (S.G., G.K., M.W., D.P., M.C.D.), Division of Neuro- and Musculoskeletal Radiology
| | - R Seidl
- Department of Pediatrics and Adolescent Medicine (S.G., R.S.), Division of Pediatric Neurology
| | - D Prayer
- From the Department of Radiology (S.G., G.K., M.W., D.P., M.C.D.), Division of Neuro- and Musculoskeletal Radiology
| | - M C Diogo
- From the Department of Radiology (S.G., G.K., M.W., D.P., M.C.D.), Division of Neuro- and Musculoskeletal Radiology
- Neuroradiology Department (M.C.D.), Hospital Garcia de Orta, Portugal
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Affiliation(s)
- G O Dovjak
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - A Scharrer
- Clinical Institute for Pathology, Medical University of Vienna, Vienna, Austria
| | - C Haberler
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - D Prayer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - G Kasprian
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
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19
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Schmidbauer V, Dovjak G, Geisl G, Weber M, Diogo MC, Yildirim MS, Goeral K, Klebermass-Schrehof K, Berger A, Prayer D, Kasprian G. Impact of Prematurity on the Tissue Properties of the Neonatal Brain Stem: A Quantitative MR Approach. AJNR Am J Neuroradiol 2021; 42:581-589. [PMID: 33478940 DOI: 10.3174/ajnr.a6945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 10/14/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND PURPOSE Preterm birth interferes with regular brain development. The aim of this study was to investigate the impact of prematurity on the physical tissue properties of the neonatal brain stem using a quantitative MR imaging approach. MATERIALS AND METHODS A total of 55 neonates (extremely preterm [n = 30]: <28 + 0 weeks gestational age; preterm [n = 10]: 28 + 0-36 + 6 weeks gestational age; term [n = 15]: ≥37 + 0 weeks gestational age) were included in this retrospective study. In most cases, imaging was performed at approximately term-equivalent age using a standard MR protocol. MR data postprocessing software SyMRI was used to perform multidynamic multiecho sequence (acquisition time: 5 minutes, 24 seconds)-based MR postprocessing to determine T1 relaxation time, T2 relaxation time, and proton density. Mixed-model ANCOVA (covariate: gestational age at MR imaging) and the post hoc Bonferroni test were used to compare the groups. RESULTS There were significant differences between premature and term infants for T1 relaxation time (midbrain: P < .001; pons: P < .001; basis pontis: P = .005; tegmentum pontis: P < .001; medulla oblongata: P < .001), T2 relaxation time (midbrain: P < .001; tegmentum pontis: P < .001), and proton density (tegmentum pontis: P = .004). The post hoc Bonferroni test revealed that T1 relaxation time/T2 relaxation time in the midbrain differed significantly between extremely preterm and preterm (T1 relaxation time: P < .001/T2 relaxation time: P = .02), extremely preterm and term (T1 relaxation time/T2 relaxation time: P < .001), and preterm and term infants (T1 relaxation time: P < .001/T2 relaxation time: P = .006). CONCLUSIONS Quantitative MR parameters allow preterm and term neonates to be differentiated. T1 and T2 relaxation time metrics of the midbrain allow differentiation between the different stages of prematurity. SyMRI allows for a quantitative assessment of incomplete brain maturation by providing tissue-specific properties while not exceeding a clinically acceptable imaging time.
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Affiliation(s)
- V Schmidbauer
- Department of Biomedical Imaging and Image-Guided Therapy (V.S., G.D., G.G., M.W., M.C.D., M.S.Y., D.P., G.K.)
| | - G Dovjak
- Department of Biomedical Imaging and Image-Guided Therapy (V.S., G.D., G.G., M.W., M.C.D., M.S.Y., D.P., G.K.)
| | - G Geisl
- Department of Biomedical Imaging and Image-Guided Therapy (V.S., G.D., G.G., M.W., M.C.D., M.S.Y., D.P., G.K.)
| | - M Weber
- Department of Biomedical Imaging and Image-Guided Therapy (V.S., G.D., G.G., M.W., M.C.D., M.S.Y., D.P., G.K.)
| | - M C Diogo
- Department of Biomedical Imaging and Image-Guided Therapy (V.S., G.D., G.G., M.W., M.C.D., M.S.Y., D.P., G.K.)
| | - M S Yildirim
- Department of Biomedical Imaging and Image-Guided Therapy (V.S., G.D., G.G., M.W., M.C.D., M.S.Y., D.P., G.K.)
| | - K Goeral
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics (K.G., K.K.-S., A.B.), Comprehensive Center for Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - K Klebermass-Schrehof
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics (K.G., K.K.-S., A.B.), Comprehensive Center for Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - A Berger
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics (K.G., K.K.-S., A.B.), Comprehensive Center for Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - D Prayer
- Department of Biomedical Imaging and Image-Guided Therapy (V.S., G.D., G.G., M.W., M.C.D., M.S.Y., D.P., G.K.)
| | - G Kasprian
- Department of Biomedical Imaging and Image-Guided Therapy (V.S., G.D., G.G., M.W., M.C.D., M.S.Y., D.P., G.K.)
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Riederer F, Seiger R, Lanzenberger R, Pataraia E, Kasprian G, Michels L, Beiersdorf J, Kollias S, Czech T, Hainfellner J, Baumgartner C. Voxel-Based Morphometry-from Hype to Hope. A Study on Hippocampal Atrophy in Mesial Temporal Lobe Epilepsy. AJNR Am J Neuroradiol 2020; 41:987-993. [PMID: 32522839 DOI: 10.3174/ajnr.a6545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 03/18/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Automated volumetry of the hippocampus is considered useful to assist the diagnosis of hippocampal sclerosis in temporal lobe epilepsy. However, voxel-based morphometry is rarely used for individual subjects because of high rates of false-positives. We investigated whether an approach with high dimensional warping to the template and nonparametric statistics would be useful to detect hippocampal atrophy in patients with hippocampal sclerosis. MATERIALS AND METHODS We performed single-subject voxel-based morphometry with nonparametric statistics within the framework of Statistical Parametric Mapping to compare MRI from 26 well-characterized patients with temporal lobe epilepsy individually against a group of 110 healthy controls. The following statistical threshold was used: P < .05 corrected for multiple comparisons with family-wise error over the region of interest right and left hippocampus. RESULTS The sensitivity for the detection of atrophy related to hippocampal sclerosis was 0.92 (95% CI, 0.67-0.99) for the right hippocampus and 0.60 (0.31-0.83) for the left, and the specificity for volume changes was 0.98 (0.93-0.99). All clusters of decreased hippocampal volumes were correctly lateralized to the seizure focus. Hippocampal volume decrease was in accordance with neuronal cell loss on histology reports. CONCLUSIONS Nonparametric voxel-based morphometry is sensitive and specific for hippocampal atrophy in patients with mesial temporal lobe epilepsy and may be useful in clinical practice.
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Affiliation(s)
- F Riederer
- From the Hietzing Hospital with Neurological Center Rosenhügel & Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology (F.R., J.B., C.B.), Vienna, Austria .,Faculty of Medicine (F.R.), University of Zurich, Zurich, Switzerland
| | - R Seiger
- Neuroimaging Labs, Department of Psychiatry and Psychotherapy (R.S., R.L.)
| | - R Lanzenberger
- Neuroimaging Labs, Department of Psychiatry and Psychotherapy (R.S., R.L.)
| | | | | | - L Michels
- Clinic of Neuroradiology (L.M., S.K.), University Hospital Zurich, Zurich, Switzerland
| | - J Beiersdorf
- From the Hietzing Hospital with Neurological Center Rosenhügel & Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology (F.R., J.B., C.B.), Vienna, Austria
| | - S Kollias
- Clinic of Neuroradiology (L.M., S.K.), University Hospital Zurich, Zurich, Switzerland
| | | | - J Hainfellner
- and Institute of Neurology (J.H.), Medical University of Vienna, Vienna, Austria
| | - C Baumgartner
- From the Hietzing Hospital with Neurological Center Rosenhügel & Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology (F.R., J.B., C.B.), Vienna, Austria.,Medical Faculty (C.B.), Sigmund Freud Private University, Vienna, Austria
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Foesleitner O, Nenning KH, Bartha-Doering L, Baumgartner C, Pataraia E, Moser D, Schwarz M, Schmidbauer V, Hainfellner JA, Czech T, Dorfer C, Langs G, Prayer D, Bonelli S, Kasprian G. Reply. AJNR Am J Neuroradiol 2020; 41:E47-E48. [PMID: 32439648 DOI: 10.3174/ajnr.a6597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- O Foesleitner
- Departments of Biomedical Imaging and Image-Guided Therapy
| | - K-H Nenning
- Departments of Biomedical Imaging and Image-Guided Therapy
| | | | - C Baumgartner
- General Hospital Hietzing with Neurological Center RosenhuegelVienna, Austria
| | | | | | - M Schwarz
- Departments of Biomedical Imaging and Image-Guided Therapy
| | - V Schmidbauer
- Departments of Biomedical Imaging and Image-Guided Therapy
| | | | | | | | - G Langs
- Departments of Biomedical Imaging and Image-Guided Therapy
| | - D Prayer
- Departments of Biomedical Imaging and Image-Guided Therapy
| | | | - G Kasprian
- Departments of Biomedical Imaging and Image-Guided TherapyMedical University of ViennaVienna, Austria
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Foesleitner O, Nenning KH, Bartha-Doering L, Baumgartner C, Pataraia E, Moser D, Schwarz M, Schmidbauer V, Hainfellner JA, Czech T, Dorfer C, Langs G, Prayer D, Bonelli S, Kasprian G. Lesion-Specific Language Network Alterations in Temporal Lobe Epilepsy. AJNR Am J Neuroradiol 2020; 41:147-154. [PMID: 31896570 DOI: 10.3174/ajnr.a6350] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 10/21/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE Temporal lobe epilepsy, structural or nonlesional, may negatively affect language function. However, little is known about the lesion-specific influence on language networks. We hypothesized that different epileptogenic lesions are related to distinct alterations in the functional language connectome detected by fMRI. MATERIALS AND METHODS One hundred one patients with epilepsy due to mesiotemporal sclerosis (21 left, 22 right), low-grade mesiotemporal tumors (12 left), or nonlesional temporal lobe epilepsy (22 left, 24 right) and 22 healthy subjects performed 3T task-based language fMRI. Task-based activation maps (laterality indices) and functional connectivity analysis (global and connectivity strengths between language areas) were correlated with language scores. RESULTS Laterality indices based on fMRI activation maps failed to discriminate among patient groups. Functional connectivity analysis revealed the most extended language network alterations in left mesiotemporal sclerosis (involving the left temporal pole, left inferior frontal gyrus, and bilateral premotor areas). The other patient groups showed less extended but also predominantly ipsilesional network changes compared with healthy controls. Left-to-right hippocampal connectivity strength correlated positively with naming function (P = .01), and connectivity strength between the left Wernicke area and the left hippocampus was linked to verbal fluency scores (P = .01) across all groups. CONCLUSIONS Different pathologies underlying temporal lobe epilepsy are related to distinct alterations of the functional language connectome visualized by fMRI functional connectivity analysis. Network analysis allows new insights into language organization and provides possible imaging biomarkers for language function. These imaging findings emphasize the importance of a personalized treatment strategy in patients with epilepsy.
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Affiliation(s)
- O Foesleitner
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
| | - K-H Nenning
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
| | | | - C Baumgartner
- General Hospital Hietzing with Neurological Center Rosenhuegel (C.B.), Vienna, Austria
| | | | - D Moser
- Neurology (E.P., D.M., S.B.)
| | - M Schwarz
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
| | - V Schmidbauer
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
| | | | - T Czech
- Neurosurgery (T.C., C.D.), Medical University of Vienna, Vienna, Austria
| | - C Dorfer
- Neurosurgery (T.C., C.D.), Medical University of Vienna, Vienna, Austria
| | - G Langs
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
| | - D Prayer
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
| | | | - G Kasprian
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., M.S., V.S., G.L., D.P., G.K.)
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Seidl-Mlczoch E, Ulm B, Schatten G, Berger-Kulemann V, Michel-Behnke I, Kasprian G. The Multivane Sequence—A New Cardiac Tool in Fetal MRI. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Prayer F, Metzelder M, Krois W, Brugger PC, Gruber GM, Weber M, Scharrer A, Rokitansky A, Langs G, Prayer D, Unger E, Kasprian G. Three-dimensional reconstruction of defects in congenital diaphragmatic hernia: a fetal MRI study. Ultrasound Obstet Gynecol 2019; 53:816-826. [PMID: 30985045 PMCID: PMC6619026 DOI: 10.1002/uog.20296] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/30/2019] [Accepted: 04/10/2019] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To assess the clinical feasibility and validity of fetal magnetic resonance imaging (MRI)-based three-dimensional (3D) reconstruction to locate, classify and quantify diaphragmatic defects in congenital diaphragmatic hernia (CDH). METHODS This retrospective study included 46 cases of CDH which underwent a total of 69 fetal MRI scans (65 in-vivo and four postmortem) at the Medical University of Vienna during the period 1 January 2002 to 1 January 2017. Scans were performed between 16 and 38 gestational weeks using steady-state free precession, T2-weighted and T1-weighted sequences. MRI data were retrieved from the hospital database and manual segmentation of the diaphragm was performed with the open-source software, ITK-SNAP. The resulting 3D models of the fetal diaphragm and its defect(s) were validated by postmortem MRI segmentation and/or comparison of 3D model-based classification of the defect with a reference classification based on autopsy and/or surgery reports. Surface areas of the intact diaphragm and of the defect were measured and used to calculate defect-diaphragmatic ratios (DDR). The need for prosthetic patch repair and, in cases with repeated in-vivo fetal MRI scans, diaphragm growth dynamics, were analyzed based on DDR. RESULTS Fetal MRI-based manual segmentation of the diaphragm in CDH was feasible for all 65 (100%) of the in-vivo fetal MRI scans. Based on the 3D diaphragmatic models, one bilateral and 45 unilateral defects (n = 47) were further classified as posterolateral (23/47, 48.9%), lateral (7/47, 14.9%) or hemidiaphragmatic (17/47, 36.2%) defects, and none (0%) was classified as anterolateral. This classification of defect location was correct in all 37 (100%) of the cases in which this information could be verified. Nineteen cases had a follow-up fetal MRI scan; in five (26.3%) of these, the initial CDH classification was altered by the results of the second scan. Thirty-three fetuses underwent postnatal diaphragmatic surgical repair; 20 fetuses (all of those with DDR ≥ 54 and 88% of those with DDR > 30) received a diaphragmatic patch, while the other 13 underwent primary surgical repair. Individual DDRs at initial and at follow-up in-vivo fetal MRI correlated significantly (P < 0.001). CONCLUSIONS MRI-based 3D reconstruction of the fetal diaphragm in CDH has been validated to visualize, locate, classify and quantify the defect. Planning of postnatal surgery may be optimized by MRI-based prediction of the necessity for patch placement and the ability to personalize patch design based on 3D-printable templates. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- F. Prayer
- Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
| | - M. Metzelder
- Department of Surgery, Division of Pediatric SurgeryMedical University of ViennaViennaAustria
| | - W. Krois
- Department of Surgery, Division of Pediatric SurgeryMedical University of ViennaViennaAustria
| | - P. C. Brugger
- Center for Anatomy and Cell Biology, Department of AnatomyMedical University of ViennaViennaAustria
| | - G. M. Gruber
- Center for Anatomy and Cell Biology, Department of AnatomyMedical University of ViennaViennaAustria
| | - M. Weber
- Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
| | - A. Scharrer
- Department of PathologyMedical University of ViennaViennaAustria
| | - A. Rokitansky
- Department of Pediatric Surgery, Social Medical Centre EastDanube HospitalViennaAustria
| | - G. Langs
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
| | - D. Prayer
- Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
| | - E. Unger
- Center of Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
| | - G. Kasprian
- Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
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Knezović V, Kasprian G, Štajduhar A, Schwartz E, Weber M, Gruber GM, Brugger PC, Prayer D, Vukšić M. Underdevelopment of the Human Hippocampus in Callosal Agenesis: An In Vivo Fetal MRI Study. AJNR Am J Neuroradiol 2019; 40:576-581. [PMID: 30792247 DOI: 10.3174/ajnr.a5986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 01/14/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In subjects with agenesis of the corpus callosum, a variety of structural brain alterations is already present during prenatal life. Quantification of these alterations in fetuses with associated brain or body malformations (corpus callosum agenesis and other related anomalies) and so-called isolated cases may help to optimize the challenging prognostic prenatal assessment of fetuses with corpus callosum agenesis. This fetal MR imaging study aimed to identify differences in the size of the prenatal hippocampus between subjects with isolated corpus callosum agenesis, corpus callosum agenesis and other related anomalies, and healthy controls. MATERIALS AND METHODS Eighty-five in utero fetal brain MR imaging scans, (20-35 gestational weeks) were postprocessed using a high-resolution algorithm. On the basis of multiplanar T2-TSE sequences, 3D isovoxel datasets were generated, and both hippocampi and the intracranial volume were segmented. RESULTS Hippocampal volumes increased linearly with gestational weeks in all 3 groups. One-way ANOVA demonstrated differences in hippocampal volumes between control and pathologic groups (isolated corpus callosum agenesis: left, P = .02; right, P = .04; corpus callosum agenesis and other related anomalies: P < .001). Differences among the pathologic groups were also present for both sides. Intracranial volume and right and left hippocampal volume ratios were different between corpus callosum agenesis cases and controls (P < .001). When we corrected for intracranial volume, no differences were found between corpus callosum agenesis and other associated anomalies and isolated corpus callosum agenesis (left, P = .77; right, P = .84). Hippocampal size differences were more pronounced at a later gestational age. CONCLUSIONS Callosal agenesis apparently interferes with the normal process of hippocampal formation and growth, resulting in underdevelopment, which could account for certain learning and memory deficits in individuals with agenesis of the corpus callosum in later life.
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Affiliation(s)
- V Knezović
- From the Croatian Institute for Brain Research (V.K., A.Š., M.V.), School of Medicine, University of Zagreb, Zagreb, Croatia
| | - G Kasprian
- Department of Biomedical Imaging and Image-Guided Therapy (G.K., E.S., M.W., D.P.)
| | - A Štajduhar
- From the Croatian Institute for Brain Research (V.K., A.Š., M.V.), School of Medicine, University of Zagreb, Zagreb, Croatia
| | - E Schwartz
- Department of Biomedical Imaging and Image-Guided Therapy (G.K., E.S., M.W., D.P.)
| | - M Weber
- Department of Biomedical Imaging and Image-Guided Therapy (G.K., E.S., M.W., D.P.)
| | - G M Gruber
- Division of Anatomy (G.M.G., P.C.B.), Centre for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - P C Brugger
- Division of Anatomy (G.M.G., P.C.B.), Centre for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - D Prayer
- Department of Biomedical Imaging and Image-Guided Therapy (G.K., E.S., M.W., D.P.)
| | - M Vukšić
- From the Croatian Institute for Brain Research (V.K., A.Š., M.V.), School of Medicine, University of Zagreb, Zagreb, Croatia
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Dovjak GO, Brugger PC, Gruber GM, Song JW, Weber M, Langs G, Bettelheim D, Prayer D, Kasprian G. Prenatal assessment of cerebellar vermian lobulation: fetal MRI with 3-Tesla postmortem validation. Ultrasound Obstet Gynecol 2018; 52:623-630. [PMID: 28782259 DOI: 10.1002/uog.18826] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 07/13/2017] [Accepted: 07/17/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To optimize the imaging assessment of fetal hindbrain malformations, this observational magnetic resonance imaging (MRI) study aimed to assess whether fetal vermian lobulation can be quantified accurately and whether the relative growth of vermian lobules is uniform. METHODS This retrospective study included singleton fetuses which underwent T2-weighted MRI in vivo with a 1.5-Tesla (T) scanner or within 24 h postmortem with a 3-T scanner between January 2007 and November 2016 at the Medical University of Vienna. We included only those showing normal structural brain development on ultrasound and MRI and which had image quality appropriate for quantitative analysis, i.e. good image quality and a precise midsagittal slice. Fetal brains were segmented and, for all discernible vermian lobules, we determined the mean relative area contribution (MRAC, the proportion of the lobule relative to the total vermian area, in terms of number of voxels). Inter- and intrarater measurement variability of a representative selection (21 cases) was determined by intraclass correlation coefficient (ICC) for voxel-based differences. A linear regression model was used to assess the correlation between the relative size of each vermian lobule (i.e. MRAC) and gestational age. RESULTS A total of 78 fetuses scanned in vivo aged 18-32 gestational weeks and seven fetuses scanned postmortem aged 16-30 weeks had a precise midsagittal slice and image quality sufficient for quantitative analysis. After 22 weeks of gestation, seven of the nine known vermian lobules could be discriminated reliably. The MRAC showed a mean ± SD difference of only 2.89 ± 3.01% between in-vivo and postmortem measurements. The ICC of voxel-based interrater differences was mean ± SD, 0.91 ± 0.05 and the intrarater ICC was 0.95 ± 0.03. Growth of cerebellar lobules was non-uniform: the MRAC of culmen and DFT (declive + folium + tuber) increased with gestational age, whereas that of lingula, centralis, pyramis and nodulus decreased. The growth of the uvula showed no significant correlation with gestational age. CONCLUSIONS Fetal vermian lobulation can be assessed accurately and reliably after 22 weeks on precise midsagittal sequences with 1.5-T T2-weighted MRI. Fetal vermian lobules show non-uniform growth, with expansion of DFT and culmen at the expense of the other vermian lobules. Evaluation and elucidation of vermian lobulation in normal fetuses should enable better characterization of fetuses with hindbrain malformations. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- G O Dovjak
- Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - P C Brugger
- Center for Anatomy and Cell Biology, Department of Anatomy, Medical University of Vienna, Vienna, Austria
| | - G M Gruber
- Center for Anatomy and Cell Biology, Department of Anatomy, Medical University of Vienna, Vienna, Austria
| | - J W Song
- Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, New Haven, CT, USA
| | - M Weber
- Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - G Langs
- Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - D Bettelheim
- Department of Obstetrics and Fetomaternal Medicine, Medical University of Vienna, Vienna, Austria
| | - D Prayer
- Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - G Kasprian
- Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
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Affiliation(s)
- O Foesleitner
- Departments of Biomedical Imaging and Image-Guided Therapy
| | - K-H Nenning
- Departments of Biomedical Imaging and Image-Guided Therapy
| | | | - M Feucht
- Department of Pediatrics and Adolescent Medicine
| | | | | | | | - D Prayer
- Departments of Biomedical Imaging and Image-Guided Therapy Medical University of Vienna Vienna, Austria
| | - G Kasprian
- Departments of Biomedical Imaging and Image-Guided Therapy Medical University of Vienna Vienna, Austria
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Foesleitner O, Nenning KH, Traub-Weidinger T, Feucht M, Bonelli S, Czech T, Dorfer C, Prayer D, Kasprian G. Assessing Corticospinal Tract Asymmetry in Unilateral Polymicrogyria. AJNR Am J Neuroradiol 2018; 39:1530-1535. [PMID: 29954815 DOI: 10.3174/ajnr.a5715] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 05/02/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Asymmetry of the corticospinal tract in congenital lesions is a good prognostic marker for preserved motor function after hemispherectomy. This study aimed to assess this marker and provide a clinically feasible approach in selected cases of unilateral polymicrogyria. MATERIALS AND METHODS Corticospinal tract asymmetry of 9 patients with unilateral polymicrogyria substantially affecting the central region was retrospectively assessed on axial T1WI and DTI. Volumes of the brain stem and thalamus and DTI parameters of the internal capsule were measured. Two neuroradiologists independently rated the right-left asymmetry at 4 levels along the corticospinal tract. DTI tractography was used to determine the motor cortex within polymicrogyria, with task-based functional MR imaging available in 3/9 cases. RESULTS Visual assessment of the brain stem asymmetry showed excellent correlation with quantitative measures on both T1WI and color-coded DTI maps (P = .007 and P = .023). Interrater reliability regarding structural and DTI-based corticospinal tract asymmetry was best at the midbrain (Cohen κ = 0.77, P = .018). Three patients underwent functional hemispherectomy with postsurgical stable motor function, all showing marked corticospinal tract asymmetry preoperatively. Following the DTI-based corticospinal tract trajectories allowed identifying the presumed primary motor region within the dysplastic cortex in 9/9 patients, confirmed by functional MR imaging in 3/3 cases. CONCLUSIONS Visual assessment of corticospinal tract asymmetry in unilateral polymicrogyria involving the motor cortex is most reliable with T1WI and color-coded DTI maps at the level of the midbrain. Pronounced asymmetry predicts preserved motor function after hemispherectomy. DTI-based tractography can be used as a guidance tool to the motor cortex within polymicrogyria.
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Affiliation(s)
- O Foesleitner
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., T.T.-W., D.P., G.K.)
| | - K-H Nenning
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., T.T.-W., D.P., G.K.)
| | - T Traub-Weidinger
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., T.T.-W., D.P., G.K.)
| | - M Feucht
- Pediatrics and Adolescent Medicine (M.F.)
| | | | - T Czech
- Neurosurgery (T.C., C.D.), Medical University of Vienna, Vienna, Austria
| | - C Dorfer
- Neurosurgery (T.C., C.D.), Medical University of Vienna, Vienna, Austria
| | - D Prayer
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., T.T.-W., D.P., G.K.)
| | - G Kasprian
- From the Departments of Biomedical Imaging and Image-Guided Therapy (O.F., K.-H.N., T.T.-W., D.P., G.K.)
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Mlczoch E, Gruber G, Dekan S, Michel-Behnke I, Worda C, Salzer-Muhar U, Prayer D, Kasprian G. Congenital Heart Disease and the Placenta: Preliminary Results from a Fetal MRI Program. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1599046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- E. Mlczoch
- Department of Pediatric Cardiology, Medical University of Vienna, Vienna, Austria
| | - G. Gruber
- Medical University of Vienna, Vienna, Austria
| | - S. Dekan
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - I. Michel-Behnke
- Paediatric Heart Center, Medical University of Vienna, Vienna, Austria
| | - C. Worda
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - U. Salzer-Muhar
- Paediatric Heart Center, Medical University of Vienna, Vienna, Austria
| | - D. Prayer
- Department of Neuroradiology, Medical University of Vienna, Vienna, Austria
| | - G. Kasprian
- Department of Neuroradiology, Medical University of Vienna, Vienna, Austria
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Abstract
The purpose of this article is to provide an overview of the possibilities for fetal magnetic resonance imaging (MRI) in the evaluation of the fetal brain. For brain pathologies, fetal MRI is usually performed when an abnormality is detected by previous prenatal ultrasound, and is, therefore, an important adjunct to ultrasound. The most commonly suspected brain pathologies referred to fetal MRI for further evaluation are ventriculomegaly, missing corpus callosum, and abnormalities of the posterior fossa. We will briefly discuss the most common indications for fetal brain MRI, as well as recent advances.
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Affiliation(s)
- C Weisstanner
- Department of Radiology, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
| | - G Kasprian
- Department of Radiology, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - G M Gruber
- Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Vienna, Austria
| | - P C Brugger
- Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Vienna, Austria
| | - D Prayer
- Department of Radiology, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Grisold A, Weber C, Hainfellner J, Gisslinger H, Kasprian G, Auff E, Sycha T, Grisold W. MRI negative meningeal myeloma with abducens nerve palsies responding to intrathecal chemotherapy. J Neurol Sci 2014; 347:359-60. [PMID: 25456462 DOI: 10.1016/j.jns.2014.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 09/22/2014] [Accepted: 10/03/2014] [Indexed: 10/24/2022]
Abstract
Meningeal involvement of multiple myeloma is rare. A patient with multiple myeloma presented with bilateral abducens nerve palsies. In the MRI neither lytic skull lesions nor meningeal enhancement could be found. The diagnosis was based on CSF studies and cytology. A neurologic remission was achieved with intrathecal chemotherapy.
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Affiliation(s)
- A Grisold
- Department of Neurology, Medical University of Vienna, Austria.
| | - C Weber
- Department of Neurology, Medical University of Vienna, Austria
| | - J Hainfellner
- Institute of Neurology, Medical University of Vienna, Austria
| | - H Gisslinger
- Department of Internal Medicine, Medical University of Vienna, Austria
| | - G Kasprian
- Department of Radiology, Medical University of Vienna, Austria
| | - E Auff
- Department of Neurology, Medical University of Vienna, Austria
| | - T Sycha
- Department of Neurology, Medical University of Vienna, Austria
| | - W Grisold
- Department of Neurology, Kaiser Franz Josef Hospital of Vienna, Austria
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Furtner J, Schöpf V, Schewzow K, Kasprian G, Weber M, Woitek R, Asenbaum U, Preusser M, Marosi C, Hainfellner JA, Widhalm G, Wolfsberger S, Prayer D. Arterial spin-labeling assessment of normalized vascular intratumoral signal intensity as a predictor of histologic grade of astrocytic neoplasms. AJNR Am J Neuroradiol 2013; 35:482-9. [PMID: 23945226 DOI: 10.3174/ajnr.a3705] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Pulsed arterial spin-labeling is a noninvasive MR imaging perfusion method performed with the use of water in the arterial blood as an endogenous contrast agent. The purpose of this study was to determine the inversion time with the largest difference in normalized intratumoral signal intensity between high-grade and low-grade astrocytomas. MATERIALS AND METHODS Thirty-three patients with gliomas, histologically classified as low-grade (n = 7) or high-grade astrocytomas (n = 26) according to the World Health Organization brain tumor classification, were included. A 3T MR scanner was used to perform pulsed arterial spin-labeling measurements at 8 different inversion times (370 ms, 614 ms, 864 ms, 1114 ms, 1364 ms, 1614 ms, 1864 ms, and 2114 ms). Normalized intratumoral signal intensity was calculated, which was defined by the signal intensity ratio of the tumor and the contralateral normal brain tissue for all fixed inversion times. A 3-way mixed ANOVA was used to reveal potential differences in the normalized vascular intratumoral signal intensity between high-grade and low-grade astrocytomas. RESULTS The difference in normalized vascular intratumoral signal intensity between high-grade and low-grade astrocytomas obtained the most statistically significant results at 370 ms (P = .003, other P values ranged from .012-.955). CONCLUSIONS The inversion time by which to differentiate high-grade and low-grade astrocytomas by use of normalized vascular intratumoral signal intensity was 370 ms in our study. The normalized vascular intratumoral signal intensity values at this inversion time mainly reflect the labeled intra-arterial blood bolus and therefore could be referred to as normalized vascular intratumoral signal intensity. Our data indicate that the use of normalized vascular intratumoral signal intensity values allows differentiation between low-grade and high-grade astrocytomas and thus may serve as a new, noninvasive marker for astrocytoma grading.
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Affiliation(s)
- J Furtner
- From the Department of Biomedical Imaging and Image-Guided Therapy (J.F., V.S., G.K., M.W., R.W., U.A., D.P.)
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Kollndorfer K, Fischmeister FPS, Kasprian G, Prayer D, Schöpf V. A systematic investigation of the invariance of resting-state network patterns: is resting-state fMRI ready for pre-surgical planning? Front Hum Neurosci 2013; 7:95. [PMID: 23532457 PMCID: PMC3607808 DOI: 10.3389/fnhum.2013.00095] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 03/07/2013] [Indexed: 11/28/2022] Open
Abstract
Objectives: Measurements of resting-state networks (RSNs) have been used to investigate a wide range of diseases, such as dementia or epilepsy. This raises the question whether this method could also serve as a pre-surgical planning tool. Generating reliable functional connectivity patterns is of crucial importance, particularly for pre-surgical planning, as these patterns may directly affect the outcome. Methods: This study investigated the reproducibility of four commonly used resting-state conditions: fixation of a black crosshair on a white screen; fixation of the center of a black screen; eyes-closed and fixation of the words “Entspann dich!” (Engl., “relax”). Ten healthy, right-handed male subjects (mean age, 25 years; SD 2) participated in the experiment. The spatial overlap for different RSNs across the four conditions was calculated. Results: The spatial overlap across all four conditions was calculated for each seed region on a single subject and at the group level. Activation maps at the single-subject and group levels were highly stable, especially for the reading network (RNW). The lowest consistency measures were found for the visual network (VIN). At the single-subject level spatial overlap values ranged from 0.31 (VIN) to 0.45 (RNW). Conclusion: These findings suggest that RSN measurements are a reliable tool to assess language-related networks in clinical settings. Generally, resting-state conditions showed comparable activation patterns, therefore no specific conditions appears to be preferable.
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Affiliation(s)
- K Kollndorfer
- Department of Radiology, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna Vienna, Austria
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Abstract
Fetal magnetic resonance imaging (MRI) has become an established clinical adjunct for the in-vivo evaluation of human brain development. Normal fetal brain maturation can be studied with MRI from the 18th week of gestation to term and relies primarily on T2-weighted sequences. Recently diffusion-weighted sequences have gained importance in the structural assessment of the fetal brain. Diffusion-weighted imaging provides quantitative information about water motion and tissue microstructure and has applications for both developmental and destructive brain processes. Advanced magnetic resonance techniques, such as spectroscopy, might be used to demonstrate metabolites that are involved in brain maturation, though their development is still in the early stages. Using fetal MRI in addition to prenatal ultrasound, morphological, metabolic, and functional assessment of the fetus can be achieved. The latter is not only based on observation of fetal movements as an indirect sign of activity of the fetal brain but also on direct visualization of fetal brain activity, adding a new component to fetal neurology. This article provides an overview of the MRI methods used for fetal neurologic evaluation, focusing on normal and abnormal early brain development.
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Affiliation(s)
- M Mailath-Pokorny
- Medical University of Vienna, Department of Obstetrics and Gynecology, Vienna, Austria.
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Schöpf V, Kasprian G, Schwindt J, Kollndorfer K, Prayer D. Visualization of resting-state networks in utero. Ultrasound Obstet Gynecol 2012; 39:487-488. [PMID: 22344934 DOI: 10.1002/uog.11119] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- V Schöpf
- Department of Radiology, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.
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Nemec SF, Nemec U, Weber M, Kasprian G, Brugger PC, Krestan CR, Rotmensch S, Rimoin DL, Graham JM, Prayer D. Male sexual development in utero: testicular descent on prenatal magnetic resonance imaging. Ultrasound Obstet Gynecol 2011; 38:688-694. [PMID: 21337441 DOI: 10.1002/uog.8964] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To visualize in utero male fetal testicular descent on magnetic resonance imaging (MRI) and to correlate it with gestational age. METHODS This retrospective study included 202 MRI examination results of 199 male fetuses (17-39 gestational weeks) with normal anatomy or minor congenital abnormalities, following suspicion of anomalies on prenatal ultrasound examination. Using a 1.5-Tesla unit, multiplanar T2-weighted sequences were applied using a standard protocol to image and identify the scrotal content. The relative frequencies of unilateral and bilateral testicular descent were calculated and correlated with gestational age. RESULTS Between 17 and 25 gestational weeks, neither unilateral nor bilateral testicular descent was visualized on MRI. Testicular descent was first observed at 25 + 4 weeks, in 7.7% of cases. 12.5% of 27-week fetuses showed unilateral descent and 50% showed bilateral descent. Bilateral descent was observed in 95.7% of cases, on average, from 30 to 39 weeks. CONCLUSIONS Our results chart the time course of testicular descent on prenatal MRI, which may be helpful in the identification of normal male sexual development and in the diagnosis of congenital abnormalities, including the early detection of cryptorchidism.
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Affiliation(s)
- S F Nemec
- Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, Vienna, Austria.
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Nemec SF, Nemec U, Weber M, Rotmensch S, Brugger PC, Kasprian G, Krestan CR, Rimoin DL, Graham JM, Prayer D. Female external genitalia on fetal magnetic resonance imaging. Ultrasound Obstet Gynecol 2011; 38:695-700. [PMID: 21584884 DOI: 10.1002/uog.8973] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To characterize the normal development of the female external genitalia on fetal magnetic resonance imaging (MRI). METHODS This retrospective study included MRI examinations of 191 female fetuses (20-36 gestational weeks) with normal anatomy or minor abnormalities, following suspicion of anomalies on prenatal ultrasound examination. Using a 1.5-Tesla unit, the bilabial diameter was measured on T2-weighted sequences. Statistical description, as well as correlation and regression analyses, was used to evaluate bilabial diameter in relation to gestational age. MRI measurements were compared with published ultrasound data. The morphological appearance and signal intensities of the external genitalia were also assessed. RESULTS Mean bilabial diameters, with 95% CIs and percentiles, were defined. The bilabial diameter as a function of gestational age was expressed by the regression equation: bilabial diameter = - 11.336 + 0.836 × (gestational age in weeks). The correlation coefficient, r = 0.782, was statistically significant (P < 0.001). Bilabial diameter on MRI was not significantly different from that on ultrasound (P < 0.001). In addition, on MRI we observed changes in morphology of the external genitalia and in signal intensities with increasing gestational age. CONCLUSIONS We have provided a reference range of fetal bilabial diameter on MRI, which, in addition to ultrasound findings, may be helpful in the identification of genital anomalies.
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Affiliation(s)
- S F Nemec
- Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University Vienna, Vienna, Austria.
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Nemec SF, Kasprian G, Brugger PC, Bettelheim D, Amann G, Nemec U, Rotmensch S, Graham JM, Rimoin DL, Lachman RS, Prayer D. Abnormalities of the upper extremities on fetal magnetic resonance imaging. Ultrasound Obstet Gynecol 2011; 38:559-567. [PMID: 21308835 DOI: 10.1002/uog.8949] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE In view of the increasing use of fetal magnetic resonance imaging (MRI) as an adjunct to prenatal ultrasonography, we sought to demonstrate the visualization of upper extremity abnormalities and associated defects on MRI, with regard to fetal outcomes and compared with ultrasound imaging. METHODS This retrospective study included 29 fetuses with upper extremity abnormalities visualized with fetal MRI following suspicious ultrasound findings and confirmed by postnatal assessment or autopsy. On a 1.5-Tesla unit, dedicated sequences were applied to image the extremities. Central nervous system (CNS) and extra-CNS anomalies were assessed to define extremity abnormalities as isolated or as complex, with associated defects. Fetal outcome was identified from medical records. MRI and ultrasound findings, when available, were compared. RESULTS Isolated upper extremity abnormalities were found in three (10.3%) fetuses. In 26 (89.7%) fetuses complex abnormalities, including postural extremity disorders (21/26) and structural extremity abnormalities (15/26), were demonstrated. Associated defects involved: face (15/26); musculoskeletal system (14/26); thorax and cardio/pulmonary system (12/26); lower extremities (12/26); brain and skull (10/26); and abdomen (8/26). Of the 29 cases, 18 (62.1%) pregnancies were delivered and 11 (37.9%) were terminated. MRI and US findings were compared in 27/29 cases: the diagnosis was concordant in 14 (51.9%) of these cases, and additional findings were made on MRI in 13/27 (48.1%) cases. CONCLUSIONS Visualization of upper extremity abnormalities on fetal MRI enables differentiation between isolated defects and complex ones, which may be related to poor fetal prognosis. MRI generally confirms the ultrasound diagnosis, and may provide additional findings in certain cases.
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Affiliation(s)
- S F Nemec
- Medical Genetics Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA.
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Schöpf V, Kasprian G, Brugger PC, Prayer D. Watching the fetal brain at 'rest'. Int J Dev Neurosci 2011; 30:11-7. [PMID: 22044604 DOI: 10.1016/j.ijdevneu.2011.10.006] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 10/17/2011] [Accepted: 10/18/2011] [Indexed: 12/30/2022] Open
Abstract
Functional magnetic resonance imaging (fMRI) has allowed insights into the spatiotemporal distribution of human brain networks. According to the neurophysiological property of the fetal brain to generate spontaneous activity, we aimed to determine the feasibility of investigating the maturation of intrinsic networks, beginning at gestational week 20 in healthy human fetuses by combining resting-state fMRI and an analytical approach, independent component analysis (ICA). In this study, functional images of 16 fetuses with morphologically normal brain development, from 20 to 36 gestational weeks of age, were acquired on a 1.5T unit (Philips Medical Systems, Best, The Netherlands) using single-shot, gradient-recalled echo-planar imaging. After preprocessing (motion correction, brain extraction), images were analyzed using single-subject ICA. We visualized a bilateral occipital network and medial and lateral prefrontal activity pattern that involved the future Brodmann areas 9-11. Furthermore, there was one either predominantly right (3/7 cases) or left (4/7 cases) hemispheric lateralized network that involved the superior temporal cortical regions (Brodmann areas 22 and 39). Frequency oscillations were in the range of 0.01-0.06Hz for all networks. This study shows that resting-state networks (RSNs) are shaped and are detectable in utero. Further investigations of resting-state measurements in the fetus may therefore allow developmental brain activity monitoring and may provide insights into early brain function.
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Affiliation(s)
- V Schöpf
- Department of Radiology, Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Austria.
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Seidel S, Kasprian G, Furtner J, Schöpf V, Essmeister M, Sycha T, Auff E, Prayer D. Mirror Therapy in Lower Limb Amputees – A Look Beyond Primary Motor Cortex Reorganization. ROFO-FORTSCHR RONTG 2011; 183:1051-7. [DOI: 10.1055/s-0031-1281768] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Schmid M, Kasprian G, Kuessel L, Messerschmidt A, Brugger PC, Prayer D. Effect of antenatal corticosteroid treatment on the fetal lung: a magnetic resonance imaging study. Ultrasound Obstet Gynecol 2011; 38:94-98. [PMID: 21308834 DOI: 10.1002/uog.8948] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To investigate the effect of antenatal corticosteroid treatment on the fetal lung using magnetic resonance imaging. METHODS Prospective evaluation of 30 consecutive singleton pregnancies that received antenatal corticosteroid treatment (12 mg betamethasone i.m. on admission and 24 h later) because of threatened preterm birth. Fetal lungs were assessed using T2-weighted single-shot fast spin-echo images of a whole-body 1.5-T superconducting unit twice: less than 24 h and more than 48 h after the first course of betamethasone. Lung volumes and lung-liver signal-intensity ratios were compared between the two time points. RESULTS Nine patients had to be excluded from the analysis because they did not complete the study protocol as required. Ten female and 11 male fetuses with a gestational age between 23.4 and 32.6 weeks were included in the final analysis. The mean gestational age of included fetuses was 27.5 ± 2.8 weeks. Using a linear regression model, a significant influence of gestational age on ln fetal lung volume (r(2)=0.414; P<0.0001) and lung-liver signal-intensity ratios (r(2)=0.271, P<0.0001) was found. Between the two evaluated time points, a significant increase in lung-liver signal-intensity ratios (2.34 ± 0.72 vs. 3.22 ± 1.12, P<0.0001), but not in mean lung volumes (46.6 ± 20.7 cm(3) vs. 48.8 ± 16.0 cm(3) , P=0.292), was observed. CONCLUSION We demonstrate a significant increase in lung-liver signal-intensity ratios after antenatal corticosteroid treatment for induction of lung maturation which most likely reflects changing properties of the fetal lung parenchyma. This could potentially be useful in non-invasively assessing the effect of antenatal corticosteroid treatment on the lungs of fetuses at risk for preterm birth.
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Affiliation(s)
- M Schmid
- Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Vienna, Austria.
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Messerschmidt A, Baschat A, Linduska N, Kasprian G, Brugger PC, Bauer A, Weber M, Prayer D. Magnetic resonance imaging of the placenta identifies placental vascular abnormalities independently of Doppler ultrasound. Ultrasound Obstet Gynecol 2011; 37:717-722. [PMID: 21105016 DOI: 10.1002/uog.8891] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/06/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To evaluate the relationship between placental vascular pathology detected by prenatal magnetic resonance imaging (MRI) and perinatal outcome. METHODS This was a retrospective, hospital-based, cross-sectional study in which all fetal MRI examinations of singleton pregnancies with vascular placental pathology (i.e. infarction with/without hemorrhage, subchorionic thrombi/hemorrhages, intervillous thrombi/hemorrhages, or retroplacental hematoma) in the period 2002-2007 were included. The extent of the pathology was expressed as a percentage of the total placental volume. Abnormalities of umbilical artery Doppler ultrasound examinations within 7 days between MRI and ultrasound examination were noted. Death in utero or postnatally was the primary outcome. Gestational age at MRI and at birth and the occurrence of intrauterine growth restriction (IUGR) were noted. Logistic regression analysis was performed to assess the impact of gestational age at MRI, extent of the vascular lesion and presence of pathological Doppler ultrasound measurements on the prediction of mortality. RESULTS Fifty-nine structurally normal singleton pregnancies with placental vascular abnormalities were included in the analysis. Mortality rate was 36%; among the survivors, 87% were born before 37 + 0 gestational weeks and 50% suffered from IUGR. In 55% of the pregnancies pathological umbilical artery Doppler findings were identified, of which 27% were non-survivors. Mortality was predicted by earlier gestational age at fetal MRI for placental pathology (P < 0.05) and increasing extent of the vascular lesion (P < 0.05), but not by the presence of pathological Doppler ultrasound data. Accuracy of the prediction was 82%, sensitivity was 67% and specificity 89%. CONCLUSION MRI-detected vascular placental pathologies may help to identify pregnancies at risk for adverse outcome and fetal death independently of umbilical artery Doppler status.
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Affiliation(s)
- A Messerschmidt
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
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Kasprian G, Prayer D. Fetale Gehirnentwicklung. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1278933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mitter C, Kasprian G, Brugger PC, Prayer D. Three-dimensional visualization of fetal white-matter pathways in utero. Ultrasound Obstet Gynecol 2011; 37:252-253. [PMID: 21264986 DOI: 10.1002/uog.8899] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- C Mitter
- Department of Radiology, Medical University of Vienna, Vienna, Austria
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Kasprian G, Langs G, Brugger PC, Bittner M, Weber M, Arantes M, Prayer D. The Prenatal Origin of Hemispheric Asymmetry: An In Utero Neuroimaging Study. Cereb Cortex 2010; 21:1076-83. [DOI: 10.1093/cercor/bhq179] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schmidt M, Kasprian G, Hold A, Pona I, Aszmann O, Frey M. LP24: THE VALUE OF DIFFUSION TENSOR TRACTOGRAPHY IN THE MANAGEMENT OF PERIPHERAL NERVE TUMORS. Plast Reconstr Surg 2010. [DOI: 10.1097/01.prs.0000387219.01574.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Schmid M, Kasprian G, Hachemian N, Balassy C, Blaicher W, Prayer D. Der Einfluss des maternalen Raucherstatus auf die Entwicklung des fetalen Lungenvolumens – eine in vivo MRT Studie. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1254947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Seidel S, Kasprian G, Leutmezer F, Prayer D, Auff E. Disruption of nigrostriatal and cerebellothalamic pathways in dopamine responsive Holmes' tremor. J Neurol Neurosurg Psychiatry 2009; 80:921-3. [PMID: 18450789 DOI: 10.1136/jnnp.2008.146324] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Holmes' tremor is an unusual combination of rest, postural and kinetic tremor of the extremities. Medical treatment of this condition still remains unsatisfactory. The case of a 20-year-old female patient is reported who developed right-sided Holmes' tremor 9 months after a left-sided, cavernoma induced midbrain/pontine haemorrhage at the age of 16 years. Beta-CIT single photon emission computed tomography revealed abolished dopamine transporter activity in the left basal ganglia and striatum, in accordance with missing ipsilateral tegmento-frontal connectivity (medial forebrain bundle), demonstrated by diffusion tensor MRI. Tractography showed reduced fibre connectivity of the superior and middle cerebellar peduncles on the lesioned side. Administration of pramipexole and L-DOPA led to a clinically significant reduction in tremor severity. In conclusion, our results support the notion that Holmes' tremor was a result of diminished striatal dopaminergic input in our patient.
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Affiliation(s)
- S Seidel
- Department of Neurology, Medical University Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
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Hachemian N, Brugger P, Weber M, Kasprian G, Bettelheim D, Prayer D. Die Entwicklung des fetalen menschlichen Innenohrs in der MRT. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1225093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Messerschmidt A, Helmer H, Kasprian G, Brugger PC, Pollak A, Prayer D. The Value of Fetal MRI in the Prediction of Lethal Pulmonary Hypoplasia after Preterm Premature Rupture of Membranes. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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