Camille Letissier1, Amandine Crombé2,3, Lydie Chérier1, Jean Delmas1, Jean-François Chateil4,5. 1. Department of Pediatric Radiology, Pellegrin Hospital, CHU Bordeaux, Place Amélie Raba-Léon, Bordeaux, France. 2. Department of Diagnostic and Interventional Oncologic Imaging, Institut Bergonié, Bordeaux, France. 3. Université de Bordeaux, Bordeaux, France. 4. Department of Pediatric Radiology, Pellegrin Hospital, CHU Bordeaux, Place Amélie Raba-Léon, Bordeaux, France. jean-francois.chateil@chu-bordeaux.fr. 5. Centre de Résonance Magnétique des Systèmes Biologiques, UMR 5536, Centre National de la Recherche Scientifique, Université de Bordeaux, F-33076, Bordeaux, France. jean-francois.chateil@chu-bordeaux.fr.
Abstract
BACKGROUND: Quantitative magnetic resonance imaging (MRI) could improve the estimation of fetal brain maturation and the interpretation of white matter signal intensity in pathological conditions. OBJECTIVE: To investigate T2-based and diffusion-weighted imaging (DWI) measurements for the evaluation of fetal brain maturation during the last trimester of pregnancy. MATERIALS AND METHODS: One hundred sixty-eight fetal brain MRIs were retrospectively analyzed (age range: 28-37 weeks of gestation) after ensuring that none of the children developed psychomotor or cognitive impairment (median follow-up: 4.7 years). Bilateral regions of interest were drawn on the frontal, occipital, parietal and temporal lobes from T2-W imaging and DWI, when available, to evaluate signal intensity and apparent diffusion coefficient (ADC) values. Ratios were calculated with two references (pons or thalamus and cerebrospinal fluid) to standardize signal intensities. Reproducibility was evaluated with intraclass correlation coefficients (ICCs) and Bland-Altman plots. Correlations with gestational age were evaluated with univariate and multivariate linear regressions. RESULTS: T2 measurements were achieved in all cases, and DWI was available in 37 cases. Measurements and ratios were reproducible in eight localizations (i.e. intra- and interobserver ICCs >0.5): frontal T2/thalamus, parietal T2/thalamus, occipital T2/pons, parietal ADC/thalamus, occipital ADC/pons, temporal ADC/pons, occipital ADC and temporal ADC. The frontal T2/thalamus and parietal T2/thalamus correlated with gestational age (P<0.0001 and P=0.014, respectively). In the multivariate modeling, frontal T2/thalamus remained an independent predictor of the gestational age (P<0.0001). CONCLUSION: The frontal T2/thalamus ratio emerged as a potential additional biomarker of fetal brain maturation during the last trimester of pregnancy.
BACKGROUND: Quantitative magnetic resonance imaging (MRI) could improve the estimation of fetal brain maturation and the interpretation of white matter signal intensity in pathological conditions. OBJECTIVE: To investigate T2-based and diffusion-weighted imaging (DWI) measurements for the evaluation of fetal brain maturation during the last trimester of pregnancy. MATERIALS AND METHODS: One hundred sixty-eight fetal brain MRIs were retrospectively analyzed (age range: 28-37 weeks of gestation) after ensuring that none of the children developed psychomotor or cognitive impairment (median follow-up: 4.7 years). Bilateral regions of interest were drawn on the frontal, occipital, parietal and temporal lobes from T2-W imaging and DWI, when available, to evaluate signal intensity and apparent diffusion coefficient (ADC) values. Ratios were calculated with two references (pons or thalamus and cerebrospinal fluid) to standardize signal intensities. Reproducibility was evaluated with intraclass correlation coefficients (ICCs) and Bland-Altman plots. Correlations with gestational age were evaluated with univariate and multivariate linear regressions. RESULTS: T2 measurements were achieved in all cases, and DWI was available in 37 cases. Measurements and ratios were reproducible in eight localizations (i.e. intra- and interobserver ICCs >0.5): frontal T2/thalamus, parietal T2/thalamus, occipital T2/pons, parietal ADC/thalamus, occipital ADC/pons, temporal ADC/pons, occipital ADC and temporal ADC. The frontal T2/thalamus and parietal T2/thalamus correlated with gestational age (P<0.0001 and P=0.014, respectively). In the multivariate modeling, frontal T2/thalamus remained an independent predictor of the gestational age (P<0.0001). CONCLUSION: The frontal T2/thalamus ratio emerged as a potential additional biomarker of fetal brain maturation during the last trimester of pregnancy.
Entities:
Keywords:
Diffusion-weighted magnetic resonance imaging; Fetal brain development; Fetus; Magnetic resonance imaging; T2-weighted magnetic resonance imaging; White matter
Authors: Serena J Counsell; Nigel L Kennea; Amy H Herlihy; Joanna M Allsop; Michael C Harrison; Frances M Cowan; Joseph V Hajnal; Bridget Edwards; A David Edwards; Mary A Rutherford Journal: AJNR Am J Neuroradiol Date: 2003-09 Impact factor: 3.825
Authors: V Dangouloff-Ros; C-J Roux; G Boulouis; R Levy; N Nicolas; C Lozach; D Grevent; F Brunelle; N Boddaert; O Naggara Journal: AJNR Am J Neuroradiol Date: 2019-10-17 Impact factor: 3.825