Center for MR-Research, University Children's Hospital Zürich, Zürich, Switzerland.
Neuroscience Center Zürich, University of Zürich, Zürich, Switzerland.
Eur Radiol Exp. 2021 Jun 17;5(1):23. doi: 10.1186/s41747-021-00219-z.
Magnetic resonance imaging (MRI) has become an essential diagnostic modality for congenital disorders of the central nervous system. Recent advancements have transformed foetal MRI into a clinically feasible tool, and in an effort to find predictors of clinical outcomes in spinal dysraphism, foetal MRI began to unveil its potential. The purpose of our review is to introduce MRI techniques to experts with diverse backgrounds, who are involved in the management of spina bifida. We introduce advanced foetal MRI postprocessing potentially improving the diagnostic work-up. Importantly, we discuss how postprocessing can lead to a more efficient utilisation of foetal or neonatal MRI data to depict relevant anatomical characteristics. We provide a critical perspective on how structural, diffusion and metabolic MRI are utilised in an endeavour to shed light on the correlates of impaired development. We found that the literature is consistent about the value of MRI in providing morphological cues about hydrocephalus development, hindbrain herniation or outcomes related to shunting and motor functioning. MRI techniques, such as foetal diffusion MRI or diffusion tractography, are still far from clinical use; however, postnatal studies using these methods revealed findings that may reflect early neural correlates of upstream neuronal damage in spinal dysraphism.
磁共振成像(MRI)已成为中枢神经系统先天性疾病的重要诊断方式。近年来的技术进步使胎儿 MRI 成为一种可行的临床工具,为了寻找脊柱裂临床结局的预测因子,胎儿 MRI 开始展现其潜力。我们的综述旨在向从事脊柱裂管理的具有不同背景的专家介绍 MRI 技术。我们介绍了先进的胎儿 MRI 后处理方法,这些方法可能会改善诊断工作流程。重要的是,我们讨论了后处理如何能够更有效地利用胎儿或新生儿 MRI 数据来描绘相关的解剖特征。我们批判性地探讨了结构、扩散和代谢 MRI 在阐明发育障碍相关因素方面的应用。我们发现,文献一致认为 MRI 在提供有关脑积水发育、后脑疝或与分流和运动功能相关结果的形态学线索方面具有价值。胎儿扩散 MRI 或扩散张量成像等 MRI 技术仍远未应用于临床;然而,使用这些方法的产后研究揭示了一些发现,这些发现可能反映了脊柱裂中上游神经元损伤的早期神经相关性。