Magnetic resonance imaging of normal and pathologic fetal brain

Resta, M.; Burdi, N.; Medicamento, N.

doi:10.1007/s003810050201

Cited by 12 publications

(13 citation statements)

References 14 publications

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“…The largest field of application for foetal MR is neurological imaging, because it is used not only to assess cerebral development [43][44][45][46][47][48] but also as a means of diagnosing central nervous system diseases [49] (agenesia of the corpus callosum [50], hydrocephalus [51], cerebral ischaemia [52], neural tube defects [53], schizencephaly [54] and abnormalities of the posterior cranial fossa [55]); however, MR is now also used to study other foetal anatomical districts, such as the lungs [56], liver [57], neck [58] and urogenital system [59].…”

Section: Mrmentioning

confidence: 99%

Patient safety issues in magnetic resonance imaging: state of the art

2007

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The presence of a static magnetic field (Bo), a radiofrequency field (RF), a dynamic gradient which varies in time and loud noises during an MR examination could increase patient risk. Specifically, a magnetic field could interfere with ferromagnetic material leading to one of the following five dangerous interactions: 1) projectile effect, 2) twisting, 3) burning, 4) artefacts and 5) device malfunction. The projectile effect is when an object is attracted by the magnet with the risk, as reported in literature, of hitting the patient, operators and/or the instrument. Objects which typically can undergo this effect are oxygen and helium cylinders, IV stands, cleaning trolleys, chairs, lamp holders, scissors, forceps, clampers, traction weights, monitoring instruments, and especially metallic splinters within the patient. Twisting (torsion) typically occurs with cerebral vascular clamps and cochlear implants. If parts of implants are involved a malfunction may result. Burns can be caused when electrically conductive material is introduced within the magnet, for example, ECG electrodes, monitoring cables and coils which are in contact with the patient's skin, as well as tattoos and eye-liners that contain iron-oxides. Artefacts can be induced by RF emission of implanted devices which can be mistaken for noise of the receiving coil. Implanted devices can induce signal voids which mask or simulate pathologies. Electrical or mechanical malfunction of implanted devices includes pacemakers which can stimulate inappropriately or at an elevated frequency yielding a distorted ECG with altered T-waves. The risk for patients can be reduced by specific educational programs within individual radiology departments which include other specializations and external referring physicians with the aim of developing a standardized safety protocol.

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Section: Mrmentioning

confidence: 99%

Patient safety issues in magnetic resonance imaging: state of the art

2007

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“…Until recently, most magnetic resonance imaging (MRI) studies of the fetal brain have concentrated on structure rather than function Resta et al, 1998;Sonigo et al, 1998;Vimercati et al, 1999]. These have provided important information on neuro-anatomical development but limited information regarding the functional development of the fetal brain.…”

Section: Introductionmentioning

confidence: 99%

Fetal brain activity in response to a visual stimulus

Fulford

Vadeyar

Dodampahala

et al. 2003

Human Brain Mapping

101

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Previous studies have demonstrated the use of functional magnetic resonance imaging (fMRI) to assess fetal brain activity. To extend these studies, a fetal fMRI experiment using a visual stimulus has been performed at 0.5 T. This used a block fMRI paradigm with a bright, constant-intensity light source being shone at the maternal abdomen for 8 sec followed by 16 sec of darkness. This was repeated typically 40 times on nine subjects all of whom were greater than 36 weeks gestational age. Of these, one could not be analysed due to motion, three did not show significant activation, and five showed significant activation (P < 0.0085). In all cases, activation was localised within the frontal cortex. Exact localisation was difficult but this may correspond to the frontal eye fields and dorsolateral prefontal cortex. In no cases was significant activation present within the occipital region as would have been expected and was observed in 2/8 adult subjects. Hum. Brain Mapping 20:239-245, 2003.

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“…Brain and spine organogenesis, as well as cranial and spinal bone involvement, are completed early on and are definitely formed since the end of the first trimester. However, their aspects undergo major changes with time, mostly affecting the brain and endocranial cisterns 14,15,29,31,32,40,43 (figure 1). The description of different patterns of CNS malformation is classically presented following the different embryologic stages.…”

Section: Discussionmentioning

confidence: 99%

“…Literature reports on fetal MRI date back to the '80s, but studies were limited because MRI systems required too long sequence times at that age, and invasive fetal curarization was needed to reduce movement artefacts [1][2][3][4][5][6][7] . In the early '90s, breath hold gradient echo (GRE) sequences obviated the need for fetal curarization and interest in fetal MRI started to grow [7][8][9][10][11][12][13][14][15][16][17][18] . A major impulse came when ultrafast sequences (HASTE Half Fourier Single Shot Turbo Spin Echo and similar) were introduced.…”

Section: Introductionmentioning

confidence: 99%

Fetal Magnetic Resonance Imaging in Holoprosencephaly, Agenesis of Corpus Callosum and Chiari II Malformation

Resta¹,

Burdi²,

Donatelli³

2006

Rivista di Neuroradiologia

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We describe our experience based on 177 fetal MRI examinations performed in the last ten years, focusing on fetal brain anatomy and fetal brain anomalies, namely oloprosencephaly, agenesis of corpus callosum and Chiari II malformation. Magnetic resonance imaging (MRI) has been proposed as an alternative technique when an expert sonologist requires an in-depth morphological approach. However, there were few literature reports in the 1980s and early 1990s because of both the invasive technique of fetal curarization and later the technical difficulties of MRI “breath holding” sequences. Interest in fetal MRI increased in the late 1990s and many papers appeared after the introduction of MRI ultrafast sequences. Ultrasonography remains the first choice for investigation in pregnancy and technological progress in this diagnostic area with overall 3D ultrasound imaging has led to more accurate indications for fetal MRI in cerebral malformations. The main contribution of fetal MRI imaging is a clear “educational” demonstration of classic malformative patterns of the major pathologies, thanks to spectacular images. We conclude that fetal MRI examination is impressive but substantially unnecessary in the three malformative pathologies considered and in all major malformations. Current use of fetal brain MRI should be reserved for more subtle malformations like neuronal migration disorders, ventriculomegaly of the early second trimester of pregnancy and similar conditions where ultrasound is still ineffective.

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Magnetic resonance imaging of normal and pathologic fetal brain

Cited by 12 publications

References 14 publications

Patient safety issues in magnetic resonance imaging: state of the art

Patient safety issues in magnetic resonance imaging: state of the art

Fetal brain activity in response to a visual stimulus

Fetal Magnetic Resonance Imaging in Holoprosencephaly, Agenesis of Corpus Callosum and Chiari II Malformation

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