title: Multidimensional analysis of fetal posterior fossa in health and disease.
abstract: Fetal magnetic resonance imaging (MRI) is now routinely used to further investigate cerebellar malformations detected with ultrasound. However, the lack of 2D and 3D biometrics in the current literature hinders the detailed characterisation and classification of cerebellar anomalies. The main objectives of this fetal neuroimaging study were to provide normal posterior fossa growth trajectories during the second and third trimesters of pregnancy via semi-automatic segmentation of reconstructed fetal brain MR images and to assess common cerebellar malformations in comparison with the reference data. Using a 1.5-T MRI scanner, 143 MR images were obtained from 79 normal control and 53 fetuses with posterior fossa abnormalities that were grouped according to the severity of diagnosis on visual MRI inspections. All quantifications were performed on volumetric datasets, and supplemental outcome information was collected from the surviving infants. Normal growth trajectories of total brain, cerebellar, vermis, pons and fourth ventricle volumes showed significant correlations with 2D measurements and increased in second-order polynomial trends across gestation (Pearson r, p < 0.05). Comparison of normal controls to five abnormal cerebellum subgroups depicted significant alterations in volumes that could not be detected exclusively with 2D analysis (MANCOVA, p < 0.05). There were 15 terminations of pregnancy, 8 neonatal deaths, and a spectrum of genetic and neurodevelopmental outcomes in the assessed 24 children with cerebellar abnormalities. The given posterior fossa biometrics enhance the delineation of normal and abnormal cerebellar phenotypes on fetal MRI and confirm the advantages of utilizing advanced neuroimaging tools in clinical fetal research.
authors.affiliation: Imaging Sciences Department, MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital Campus, London, W12 0NN, UK. deniz.vatansever10@imperial.ac.uk
authors.forename: Deniz
authors.initials: D
authors.lastname: Vatansever
authors.forename: Vanessa
authors.initials: V
authors.lastname: Kyriakopoulou
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Allsop
authors.forename: Matthew
authors.initials: M
authors.lastname: Fox
authors.forename: Andrew
authors.initials: A
authors.lastname: Chew
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Hajnal
authors.forename: Mary A
authors.initials: MA
authors.lastname: Rutherford
mesh_terms: D000328:Adult; D002526:Cerebellar Diseases / Q000473:pathology*; D002531:Cerebellum / Q000002:abnormalities / Q000473:pathology*; D002648:Child; D003388:Cranial Fossa, Posterior / Q000002:abnormalities / Q000473:pathology*; D005260:Female; D005333:Fetus / Q000000981:diagnostic imaging / Q000473:pathology*; D005865:Gestational Age; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011859:Radiography; D016216:Ultrasonography, Prenatal / Q000379:methods; D055815:Young Adult
references.citation: J Child Neurol. 2011 Dec;26(12):1483-92
references.pmid: 21954430
references.citation: Int J Dev Neurosci. 2011 Aug;29(5):529-36
references.pmid: 21530634
references.citation: Circulation. 2010 Jan 5;121(1):26-33
references.pmid: 20026783
references.citation: J Matern Fetal Neonatal Med. 2007 Aug;20(8):581-7
references.pmid: 17674275
references.citation: Neuroimage. 2012 Jan 16;59(2):1560-70
references.pmid: 21907811
references.citation: Brain. 2009 Dec;132(Pt 12):3199-230
references.pmid: 19933510
references.citation: Am J Obstet Gynecol. 2012 Feb;206(2):173.e1-8
references.pmid: 22055336
references.citation: Curr Opin Pediatr. 2006 Dec;18(6):621-7
references.pmid: 17099360
references.citation: Ultrasound Obstet Gynecol. 2012 Mar;39(3):279-87
references.pmid: 22081472
references.citation: Ultrasound Obstet Gynecol. 2009 Feb;33(2):173-81
references.pmid: 19172662
references.citation: Radiology. 2011 Jan;258(1):229-35
references.pmid: 20980451
references.citation: Dev Med Child Neurol. 2011 Dec;53(12):1128-34
references.pmid: 22066826
references.citation: Curr Opin Obstet Gynecol. 2009 Apr;21(2):180-6
references.pmid: 19996870
references.citation: Prenat Diagn. 2007 Jun;27(6):495-501
references.pmid: 17367101
references.citation: Cerebellum. 2006;5(3):199-205
references.pmid: 16997751
references.citation: Cerebellum. 2012 Jun;11(2):531-42
references.pmid: 21901523
references.citation: Neuroimage. 2006 Nov 1;33(2):463-70
references.pmid: 16938471
references.citation: Cerebellum. 2012 Sep;11(3):761-70
references.pmid: 22198870
references.citation: Curr Opin Neurobiol. 2008 Feb;18(1):12-9
references.pmid: 18513948
references.citation: Pediatr Radiol. 2010 Jun;40(6):1038-45
references.pmid: 20432023
references.citation: Am J Obstet Gynecol. 2006 Apr;194(4):1070-6
references.pmid: 16580298
references.citation: Ultrasound Obstet Gynecol. 1998 Jan;11(1):30-8
references.pmid: 9511193
references.citation: IEEE Trans Med Imaging. 2007 Jul;26(7):967-80
references.pmid: 17649910
references.citation: Ultrasound Obstet Gynecol. 2005 Nov;26(6):622-7
references.pmid: 16254881
references.citation: Brain. 2007 Oct;130(Pt 10):2646-60
references.pmid: 17872929
references.citation: Dev Neurobiol. 2008 May;68(6):700-11
references.pmid: 18383541
references.citation: Cereb Cortex. 2014 Aug;24(8):2141-50
references.pmid: 23508710
references.citation: Ultrasound Q. 2007 Sep;23(3):211-23
references.pmid: 17805192
references.citation: Prenat Diagn. 2006 Aug;26(8):707-10
references.pmid: 16764010
references.citation: Cerebellum. 2010 Sep;9(3):272-83
references.pmid: 20387026
references.citation: Dev Med Child Neurol. 2009 Apr;51(4):256-67
references.pmid: 19191827
references.citation: Semin Fetal Neonatal Med. 2005 Oct;10(5):411-20
references.pmid: 15985392
references.citation: Int J Comput Assist Radiol Surg. 2011 May;6(3):329-39
references.pmid: 20625848
references.citation: Am J Psychiatry. 2007 Apr;164(4):647-55
references.pmid: 17403979
references.citation: Pediatr Radiol. 2005 Feb;35(2):124-40
references.pmid: 15565345
references.citation: Ultrasound Med Biol. 2009 Aug;35(8):1284-9
references.pmid: 19540660
references.citation: Prenat Diagn. 2012 Jan;32(1):75-82
references.pmid: 22367673
references.citation: J Magn Reson Imaging. 2008 Apr;27(4):840-5
references.pmid: 18302203
references.citation: Semin Ultrasound CT MR. 2011 Jun;32(3):228-41
references.pmid: 21596278
references.citation: Ultrasound Med Biol. 2000 Jul;26(6):981-8
references.pmid: 10996698
references.citation: Arch Gynecol Obstet. 2007 Nov;276(5):487-90
references.pmid: 17453222
references.citation: Neuroimage. 2006 Jul 1;31(3):1116-28
references.pmid: 16545965
references.citation: Ultrasound Obstet Gynecol. 2012 Jun;39(6):625-31
references.pmid: 22173885
references.citation: J Neurosci. 2009 Jul 1;29(26):8586-94
references.pmid: 19571149
references.citation: AJR Am J Roentgenol. 2007 Jul;189(1):145-51
references.pmid: 17579164
references.citation: Arch Gynecol Obstet. 2007 Jan;275(1):5-11
references.pmid: 16847630
references.citation: Dev Med Child Neurol. 2011 May;53(5):409-16
references.pmid: 21418200
references.citation: Clin Perinatol. 2009 Sep;36(3):513-30
references.pmid: 19732611