Magnetic resonance imaging of skull and brain parameters in fetuses with intrauterine growth restriction

Abstract

Objective: To compare fetuses with intrauterine growth restriction (IUGR) and those with normal growth, in terms of skull and brain measurements obtained by magnetic resonance imaging (MRI). Materials and Methods: This was a prospective cohort study including 26 single fetuses (13 with IUGR and 13 with normal growth), evaluated from 26 to 38 weeks of gestation. Using MRI, we measured skull and brain biparietal diameters (BPDs); skull and brain occipitofrontal diameters (OFDs); corpus callosum length and area; transverse cerebellar diameter; extracerebral cerebrospinal fluid (eCSF); and right and left interopercular distances (IODs). Results: The following were significantly smaller in IUGR fetuses than in control fetuses: skull BPD (76.9 vs. 78.2 mm; p = 0.0029); brain BPD (67.8 vs. 71.6 mm; p = 0.0064); skull OFD (93.6 vs. 95 mm; p = 0.0010); eCSF (5.5 vs. 8.2 mm; p = 0.0003); right IOD (9.8 vs. 13.9 mm; p = 0.0023); and left IOD (11.8 vs. 16.3 mm; p = 0.0183). The skull BPD/eCSF, brain BPD/eCSF, skull OFD/eCSF, and brain OFD/eCSF ratios were also lower in IUGR fetuses. Conclusion: IUGR fetuses had smaller OFD and BPD, both skull and brain, and less eCSF when compared to normal growth fetuses.

Quantification of Intracranial Structures Volume in Fetuses Using 3-D Volumetric MRI: Normal Values at 19 to 37 Weeks' Gestation

“…Currently, ultrasound (US) biometry is the reference standard for assessing fetal brain development (Griffiths et al, 2017 ). With regard to the central nervous system (CNS), indirect indicators of fetal brain development are used routinely by measurement of two-dimensional (2-D) parameters (De Oliveira Júnior et al, 2021 ), such as biparietal diameter (BPD) and head circumference (HC) (Ruiz et al, 2017 ; Kline-Fath, 2019 ; Sibbald et al, 2021 ). However, BPD and HC can only be compared with the size of the head, including the skull, and the sizes of the brain and detailed study of different intracranial structures cannot be performed (Fried et al, 2021 ).…”

Applicability of the Magnetic Resonance Technique during the Gestational Period: a narrative review

“…The percentage of studies that addressed the use of magnetic resonance imaging for the evaluation of fetal brain alterations was 29.16% and the articles that presented studies specifically on the gestational consequences of Zika Virus infection corresponded to 12.50% of the total number of studies analyzed. Evaluation of the fetal skeleton [4] Ventriculomegaly [15] Changes in the development of the spine and spinal cord [18] COVID-19 [11] Preeclampsia and brain development [9] Abdominal Malformations (1) [12] Abdominal Malformations (2) [21] Oral teratoma [19] Brain Measurements / Uterine Growth Restriction [20] Hydatidiform spring [22] Brain malformations caused by Zika Virus [14] Placental changes [6] 3D Reconstructions Prototypes [23] 22 Microcephaly related to congenital Zika virus infection [24] 23 Changes in the Central Nervous System (microcephaly) related to congenital Zika virus infection [25] It was observed that 8.34% of the articles discussed placental problems, malformations and uterine pathologies, abdominal malformations, head, and neck diseases, in addition to 3D prototyping. Still, 4.16% of the studies studied non-obstetric indications for maternal MRI, hydatidiform mole, fetal skeletal structure, in addition to alterations in the development of the fetal spine and spinal cord (Table 2).…”

“…The neurological deficits associated with IUGR appear to be the result of brain reorganization, as suggested by studies showing differences between babies with and without IUGR in terms of brain metabolism, morphology, and connections, as well as neurological microstructure. Although ultrasonography is the primary modality for evaluating the fetus, ultrasound scans have limited ability to detect these types of abnormalities [20].…”

Alterations on magnetic resonance imaging of the neonatal brain: correlations with prenatal risk factors and transfontanellar ultrasound findings

“…In addition, MRI can assess cerebellar lesions, which may also be associated with a higher risk of neurological abnormalities (11) . Despite those advantages, there is as yet no consensus regarding which neuroimaging examination should be performed, when it should be performed, and what its prognostic value is (11)(12)(13)(14)(15) .…”