Development and Validation of a Semiquantitative Brain Maturation Score on Fetal MR Images: Initial Results

Vossough, Arastoo; Limperopoulos, Catherine; Putt, Mary; Plessis, Adré J. du; Schwab, Peter J.; Wu, Jue; Gee, James C.; Licht, Daniel J.

doi:10.1148/radiol.13111715

Cited by 22 publications

(23 citation statements)

References 30 publications

(45 reference statements)

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“…A single fetal total maturation score (fTMS) was calculated by summing up 6 semiquantitative subscores characterizing various visual sulcation observations, the extent and location of myelination, and evolution of the germinal matrix. 16 We found that the folding measures obtained by the proposed framework were in high agreement with the average visual fTMS (Fig 2). …”

Section: Resultssupporting

confidence: 60%

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Assessment of MRI-Based Automated Fetal Cerebral Cortical Folding Measures in Prediction of Gestational Age in the Third Trimester

Awate

Licht

et al. 2015

American Journal of Neuroradiology

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BACKGROUND AND PURPOSE Traditional methods of dating a pregnancy based on history or sonographic assessment have a large variation in the third trimester. We aimed to assess the ability of various quantitative measures of brain cortical folding on MR imaging in determining fetal gestational age in the third trimester. MATERIALS AND METHODS We evaluated 8 different quantitative cortical folding measures to predict gestational age in 33 healthy fetuses by using T2-weighted fetal MR imaging. We compared the accuracy of the prediction of gestational age by these cortical folding measureswiththeaccuracyofpredictionbybrainvolumemeasurementandbyapreviouslyreportedsemiquantitativevisualscaleofbrain maturity. Regression models were constructed, and measurement biases and variances were determined via a cross-validation procedure. RESULTS The cortical folding measures are accurate in the estimation and prediction of gestational age (mean of the absolute error, 0.43 ± 0.45 weeks) and perform better than (P = .024) brain volume (mean of the absolute error, 0.72 ± 0.61 weeks) or sonography measures (SDs approximately 1.5 weeks, as reported in literature). Prediction accuracy is comparable with that of the semiquantitative visual assessment score (mean, 0.57 ± 0.41 weeks). CONCLUSIONS Quantitative cortical folding measures such as global average curvedness can be an accurate and reliable estimator of gestational age and brain maturity for healthy fetuses in the third trimester and have the potential to be an indicator of brain-growth delays for at-risk fetuses and preterm neonates.

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Section: Resultssupporting

confidence: 60%

“…A cohort of 33 healthy fetuses with high-resolution reconstructed MRI was included in this study, of which 10 subjects were female and 23 were male. The cohort has been previously reported in studies of normative brain development 16 but has not been used to estimate gestational age.…”

Section: Methodsmentioning

confidence: 99%

Assessment of MRI-Based Automated Fetal Cerebral Cortical Folding Measures in Prediction of Gestational Age in the Third Trimester

Awate

Licht

et al. 2015

American Journal of Neuroradiology

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“…Ventricular size was measured at the atrial level. The fetal total maturation score (fTMS), which is a validated semiquantitative fetal brain maturation score using various cortical sulcation, myelination, and germinal matrix subscores [1] , was used to provide a measurement of brain maturity on the fetal MR images.…”

Section: Novel Insightsmentioning

confidence: 99%

Fetal Magnetic Resonance Imaging Findings in Prenatal Zika Virus Infection

Sanín-Blair¹,

Gutiérrez-Márquez

Herrera

et al. 2017

Fetal Diagn Ther

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Brain lesions and malformations have been described on ultrasonography of prenatal Zika infection; however, there are scarce reports about fetal magnetic resonance (MR) findings. We report 3 cases of fetuses with confirmed intrauterine Zika virus infection evaluated by ultrasound and fetal MR. Various morphometric measurements were assessed and brain maturation was calculated with the fetal total maturation score. Fetuses with prenatal Zika virus infection showed retardation in brain maturation indexes evaluated by fetal MR. Brain calcifications were demonstrated by neurosonography in all cases, while fetal MR characterized the specific type of cortical development malformation.

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“…We prospectively enrolled healthy volunteers with singleton pregnancies and a normal pregnancy history, with normal clinical laboratory and ultrasound studies during the current pregnancy [12,25,[27][28][29] . Exclusion criteria included multiple gestations, known or suspected genetic or chromosomal abnormalities, as well as any maternal contraindication for MRI, including physical (e.g., metal implants) or psychosocial (e.g., claustrophobia) contraindications.…”

Section: Patientsmentioning

confidence: 99%

Cerebrospinal Fluid and Parenchymal Brain Development and Growth in the Healthy Fetus

Andescavage¹,

duPlessis

McCarter

et al. 2016

Dev Neurosci

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Objective: The objective of this study was to apply quantitative magnetic resonance imaging to characterize absolute cerebrospinal fluid (CSF) development, as well as its relative development to fetal brain parenchyma in the healthy human fetus. Design: We created three-dimensional high-resolution reconstructions of the developing brain for healthy fetuses between 18 and 40 weeks' gestation, segmented the parenchymal and CSF spaces, and calculated the volumes for the lateral, third, and fourth ventricles; extra-axial CSF space; and the cerebrum, cerebellum, and brainstem. From these data, we constructed normograms of the resulting volumes according to gestational age and described the relative development of CSF to fetal brain parenchyma. Results: Each CSF space demonstrated major increases in volumetric growth during the second half of gestation: third ventricle (23-fold), extra-axial CSF (11-fold), fourth ventricle (8-fold), and lateral ventricle (2-fold). Total CSF volume was related to total brain volume (p < 0.01), as was lateral ventricle to cerebral volume (p < 0.01); however, the fourth ventricle was not related to cerebellar or brainstem volume (p = 0.18-0.19). Relevance: Abnormalities of the CSF spaces are the most common anomalies of neurologic development detected on fetal screening using neurosonography. Normative values of absolute CSF volume, as well as relative growth in comparison to intracranial parenchyma, provide valuable insight into normal fetal neurodevelopment. These data may provide important biomarkers of early deviations from normal growth, better distinguish between benign variants and early disease, and serve as reference standards for postnatal growth and development in the premature infant.

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Development and Validation of a Semiquantitative Brain Maturation Score on Fetal MR Images: Initial Results

Cited by 22 publications

References 30 publications

Assessment of MRI-Based Automated Fetal Cerebral Cortical Folding Measures in Prediction of Gestational Age in the Third Trimester

Assessment of MRI-Based Automated Fetal Cerebral Cortical Folding Measures in Prediction of Gestational Age in the Third Trimester

Fetal Magnetic Resonance Imaging Findings in Prenatal Zika Virus Infection

Cerebrospinal Fluid and Parenchymal Brain Development and Growth in the Healthy Fetus

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