The diagnosis of hemimegalencephaly using in utero MRI

The assessment of fetal brain growth in diabetic pregnancy using in utero magnetic resonance imaging

“…By comparison, in utero magnetic resonance (iuMR) imaging provides a comprehensive crosssectional evaluation which has been shown to be superior in the assessment of the fetal brain and the detection of abnormalities. [13][14][15][16] Recent advances in iuMR imaging, in particular, rapid T2 weighted three-dimensional (3D) volume sequences, have allowed detailed assessment of the fetal brain, 17 facilitating estimation of brain volume (distinct from skull measurements) and the ability to assess brain maturity in terms of gyration/sulcation. No data currently exists regarding brain volumes and the rate of fetal brain growth during third trimester pregnancy in DM.…”

Etiological diagnostic tools to elucidate ‘isolated’ ventriculomegaly

“…Unilateral ventriculomegaly should not be considered to be specific to clastic lesions, since it can be encountered also in association with malformative entities such as hemimegalencephaly, which is characterized by both unilateral ventriculomegaly and dysmorphism of the dilated ventricle ( Figure S1) 18,19 , and exceptional cases of congenital stenosis of the foramen of Monroe ( Figure S2 system, from the supratentorial structures to the infracerebellar cisterna. Pathologies generating ventriculomegaly between the diencephalon and posterior fossa, including the aqueduct of Sylvius at the level of the mesencephalon, are often overlooked 21 .…”

“…Unilateral ventriculomegaly should not be considered to be specific to clastic lesions, since it can be encountered also in association with malformative entities such as hemimegalencephaly, which is characterized by both unilateral ventriculomegaly and dysmorphism of the dilated ventricle (Figure S1), and exceptional cases of congenital stenosis of the foramen of Monroe (Figure S2).…”

Magnetic resonance imaging of the fetal brain

“…3,5,6,8,9,[15][16][17][18][19] It provides excellent delineation of cerebral anatomy and requires a total acquisition time of <1 second per image. On our 1.5T MR scanner system (Achieva XR 1.5T; Philips Medical Systems, Best, Netherlands), SSFSE T2-weighted sequences in the axial, coronal, and sagittal plane of the fetal brain are acquired, with 25 slices in 35 seconds, resolution at 0.79 x 0.79 x 3.2 mm, 0.3 mm gap, long echo train length (ETL) of 227 and relatively short repetition time (TR) of 1450 ms, and use of the driven equilibrium pulse to enhance T2 contrast with a shorter TR.…”

“…3,8,15,21,22 Other advanced techniques are also being developed and may provide functional and physiological information, including fetal MR spectroscopy, diffusion tensor imaging, and functional imaging, 7,8,[23][24][25][26][27][28][29][30] although their development is still at an early stage.…”