Volumetric MRI study of the intrauterine growth restriction fetal brain

• Published in: European radiology Vol. 27; no. 5; pp. 2110 - 2118
• Main Authors: Polat, A., Barlow, S., Ber, R., Achiron, R., Katorza, E.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-05-2017; Springer Nature B.V
• Subjects: Biomarkers; Biometrics; Biometry - methods; Brain; Brain - diagnostic imaging; Brain - embryology; Brain - pathology; Case-Control Studies; Cerebellum - embryology; Cerebellum - pathology; Diagnostic Radiology; Female; Fetal Growth Retardation - diagnostic imaging; Fetal Growth Retardation - pathology; Fetuses; Gestational Age; Humans; Imaging; Internal Medicine; Interventional Radiology; Magnetic Resonance; Magnetic Resonance Imaging - methods; Medicine; Medicine & Public Health; Neuroradiology; Pregnancy; Prenatal Diagnosis - methods; Radiology; Ratios; Reproducibility of Results; Retrospective Studies; Ultrasonic imaging; Ultrasound; Veins & arteries; Tel Aviv Israel; Israel; Cerebellum; Brain; IUGR; MRI; Embryonic and fetal development
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-016-4502-4

Objectives
Intrauterine growth restriction (IUGR) is a pathologic fetal condition known to affect the fetal brain regionally and associated with future neurodevelopmental abnormalities. This study employed MRI to assess in utero regional brain volume changes in IUGR fetuses compared to controls.
Methods
Retrospectively, using MRI images of fetuses at 30–34 weeks gestational age, a total of 8 brain regions—supratentorial brain and cavity, cerebral hemispheres, temporal lobes and cerebellum—were measured for volume in 13 fetuses with IUGR due to placental insufficiency and in 21 controls. Volumes and their ratios were assessed for difference using regression models. Reliability was assessed by intraclass correlation coefficients (ICC) between two observers.
Results
In both groups, all structures increase in absolute volume during that gestation period, and the rate of cerebellar growth is higher compared to that of supratentorial structures. All structures’ absolute volumes were significantly smaller for the IUGR group. Cerebellar to supratentorial ratios were found to be significantly smaller (
P
 < 0.05) for IUGR compared to controls. No other significant ratio differences were found. ICC showed excellent agreement.
Conclusions
The cerebellar to supratentorial volume ratio is affected in IUGR fetuses. Additional research is needed to assess this as a radiologic marker in relation to long-term outcome.
Key Points
• IUGR is a pathologic fetal condition affecting the brain
• IUGR is associated with long-term neurodevelopmental abnormalities; fetal characterization is needed
• This study aimed to evaluate regional brain volume differences in IUGR
• Cerebellar to supratentorial volume ratios were smaller in IUGR fetuses
• This finding may play a role in long-term development of IUGR fetuses