title: MR venography of the fetal brain using susceptibility weighted imaging.
abstract: OBJECTIVE
  To evaluate the feasibility of performing fetal brain magnetic resonance venography using susceptibility weighted imaging (SWI).
  
  
  METHODS
  After obtaining informed consent, pregnant women in the second and third trimester were imaged using a modified SWI sequence. Fetal SWI acquisition was repeated when fetal or maternal motion was encountered. The median and maximum number of times an SWI sequence was repeated was four and six respectively. All SWI image data were systematically evaluated by a pediatric neuroradiologist for image quality using an ordinal scoring scheme: 1. diagnostic; 2. diagnostic with artifacts; and 3. nondiagnostic. The best score in an individual fetus was used for further statistical analysis. Visibility of venous vasculature was also scored using a dichotomous variable. A subset of SWI data was re-evaluated by the first and independently by a second pediatric neuroradiologist. Kappa coefficients were computed to assess intra-rater and inter-rater reliability.
  
  
  RESULTS
  SWI image data from a total of 22 fetuses were analyzed. Median gestational age and interquartile range of the fetuses imaged were 32 (29.9-34.9) weeks. In 68.2% of the cases (n = 15), there was no artifact; 22.7% (n = 5) had minor artifacts and 9.1% (n = 2) of the data was of nondiagnostic quality. Cerebral venous vasculature was visible in 86.4% (n = 19) of the cases. Substantial agreement (Kappa = 0.73; 95% confidence interval 0.44-1.00)) was observed for intra-rater reliability and moderate agreement (Kappa = 0.48; 95% confidence interval 0.19-0.77) was observed for inter-rater reliability.
  
  
  CONCLUSIONS
  It is feasible to perform fetal brain venography in humans using SWI.
authors.affiliation: Department of Radiology, Wayne State University, Detroit, Michigan, USA.
authors.forename: Jaladhar
authors.initials: J
authors.lastname: Neelavalli
authors.forename: Swati
authors.initials: S
authors.lastname: Mody
authors.forename: Lami
authors.initials: L
authors.lastname: Yeo
authors.forename: Pavan Kumar
authors.initials: PK
authors.lastname: Jella
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Korzeniewski
authors.forename: Sheena
authors.initials: S
authors.lastname: Saleem
authors.forename: Yashwanth
authors.initials: Y
authors.lastname: Katkuri
authors.forename: Ray O
authors.initials: RO
authors.lastname: Bahado-Singh
authors.forename: Sonia S
authors.initials: SS
authors.lastname: Hassan
authors.forename: E Mark
authors.initials: EM
authors.lastname: Haacke
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Moriah E
authors.initials: ME
authors.lastname: Thomason
mesh_terms: D002550:Cerebral Veins / Q000033:anatomy & histology* / Q000196:embryology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D010690:Phlebography / Q000379:methods*; D011296:Prenatal Diagnosis / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: cerebral; fetal imaging; gradient echo; phase; pregnancy; veins