Magnetic resonance imaging and tractography of sensorimotor tracts in fetuses with intraventricular hemorrhage: feasibility and added prognostic value.

IF 6.1 1区医学 Q1 ACOUSTICS Ultrasound in Obstetrics & Gynecology Pub Date : 2024-11-01 Epub Date: 2024-10-15 DOI:10.1002/uog.29109

E Hadi, T Dorittke, P Kienast, J Binder, S Glatter, A Hershko-Klement, T Lerman-Sagie, D Prayer, G Kasprian

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Abstract

Objectives: To assess the feasibility, characteristics and prognostic value of prenatal visualization of the corticospinal tracts (CSTs) using diffusion-weighted magnetic resonance imaging (MRI)-based tractography in fetuses with intraventricular hemorrhage (IVH).

Methods: This was a retrospective single-center cohort study of singleton fetuses diagnosed with IVH on MRI from January 2011 to December 2018. The left and right CSTs were reconstructed according to an in-utero diffusion tensor imaging sequence using a multi-region of interest (ROI) deterministic tractography approach. The CSTs were segmented by two polygonal ROI: at the level of the posterior limb of the internal capsule and the crus cerebri. The morphology and integrity of the CSTs were assessed visually. Internal capsule and crus cerebri apparent diffusion coefficient and fractional anisotropy values were measured. Postnatal motor function data were obtained from the parents using the functional status scale.

Results: A total of 35 fetuses with IVH (mean ± SD gestational age, 29.1 ± 5.1 (range, 19.9-38.9) weeks) were included in the analysis. Parenchymal involvement on T2-weighted sequences was demonstrated in 19 (54%) of the cohort. CST involvement correlated significantly with the presence of parenchymal damage on T2-weighted imaging (P = 0.02). Among liveborn cases, the rate of motor impairment was 14% (1/7) in children with intact CSTs compared with 100% (5/5) in cases in which the CSTs were impaired (P = 0.015).

Conclusions: Fetal corticospinal tractography is feasible technically and offers valuable prognostic information. It enhances parental counseling by providing insights into potential motor outcome, underscoring its utility in complementing fetal neurosonography in cases of prenatal IVH. © 2024 The Author(s). 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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脑室内出血胎儿感觉运动束的磁共振成像和束描：可行性和附加预后价值。

目的评估基于弥散加权磁共振成像（MRI）的皮质脊髓束（CST）产前可视化在脑室内出血（IVH）胎儿中的可行性、特征和预后价值：这是一项回顾性单中心队列研究，研究对象是2011年1月至2018年12月期间经磁共振成像确诊为IVH的单胎胎儿。根据宫内弥散张量成像序列，采用多感兴趣区（ROI）确定性束成像方法重建了左右CST。CST由两个多边形ROI分割：内囊后缘水平和大脑嵴水平。对 CST 的形态和完整性进行了目测评估。测量内囊和大脑嵴表观扩散系数和分数各向异性值。使用功能状态量表从父母处获得产后运动功能数据：共有35名IVH胎儿（平均胎龄为29.1 ± 5.1（范围19.9-38.9）周）被纳入分析。19例（54%）胎儿的T2加权序列显示实质受累。CST受累与T2加权成像出现实质损害有明显相关性（P = 0.02）。在活产病例中，CST完好的患儿运动障碍率为14%（1/7），而CST受损的患儿运动障碍率为100%（5/5）（P = 0.015）：胎儿皮质脊髓束造影在技术上是可行的，并能提供有价值的预后信息。结论：胎儿皮质脊髓束造影在技术上是可行的，并能提供有价值的预后信息，它通过提供对潜在运动结果的洞察力来加强对父母的咨询，强调了其在产前 IVH 病例中补充胎儿神经超声的实用性。©2024作者：谭俊妇产科超声》由 John Wiley & Sons Ltd 代表国际妇产科超声学会出版。

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来源期刊

Ultrasound in Obstetrics & Gynecology 医学-妇产科学

CiteScore

12.30

自引率

14.10%

发文量

891

审稿时长

1 months

期刊介绍： Ultrasound in Obstetrics & Gynecology (UOG) is the official journal of the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) and is considered the foremost international peer-reviewed journal in the field. It publishes cutting-edge research that is highly relevant to clinical practice, which includes guidelines, expert commentaries, consensus statements, original articles, and systematic reviews. UOG is widely recognized and included in prominent abstract and indexing databases such as Index Medicus and Current Contents.