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二维和三维胎儿脑 MRI 生物测量与疑似小头畸形和大头畸形胎儿神经发育结局的相关性。

Correlation between 2D and 3D Fetal Brain MRI Biometry and Neurodevelopmental Outcomes in Fetuses with Suspected Microcephaly and Macrocephaly.

机构信息

From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel

Department of Obstetrics and Gynecology (S.F., E.K.), Sheba Medical Center, Tel-Hashomer, Israel.

出版信息

AJNR Am J Neuroradiol. 2021 Oct;42(10):1878-1883. doi: 10.3174/ajnr.A7225. Epub 2021 Aug 12.

Abstract

BACKGROUND AND PURPOSE

Definitions of fetal microcephaly and macrocephaly are debatable. A better understanding of their long-term prognoses would help guide parental education and counseling. This study aimed to explore the correlation between 2D and 3D fetal brain MR imaging biometry results and the long-term neurodevelopmental outcomes.

MATERIALS AND METHODS

This analysis is a historical cohort study. Fetal brain biometry was measured on 2D and 3D MR imaging using a volumetric MR imaging semiautomated algorithm. We measured and assessed the following brain structures: the supratentorial brain volume and cerebellar volume and cerebellar volume/supratentorial brain volume ratio, in addition to commonly used 2D brain MR imaging biometric variables, including occipitofrontal diameter, biparietal diameter, and transcerebellar diameter. Microcephaly was defined as ≤ 3rd percentile; and macrocephaly, as ≥ 97th percentile, corresponding to -2 SDs and +2 SDs. The neurodevelopmental outcome of this study cohort was evaluated using the Vineland-II Adaptive Behavior Scales, and the measurements were correlated to the Vineland standard scores.

RESULTS

A total of 70 fetuses were included. No significant correlation was observed between the Vineland scores and either the supratentorial brain volume, cerebellar volume, or supratentorial brain volume/cerebellar volume ratio in 3D or 2D MR imaging measurements, after correction for multiple comparisons. No differences were found among fetuses with macrocephaly, normocephaly, or microcephaly regarding the median Vineland standard scores.

CONCLUSIONS

Provided there is normal brain structure on MR imaging, the developmental milestone achievements in early years are unrelated to 2D and 3D fetal brain MR imaging biometry, in the range of measurements depicted in this study.

摘要

背景与目的

胎儿小头畸形和大头畸形的定义存在争议。更好地了解其长期预后将有助于指导家长教育和咨询。本研究旨在探讨二维和三维胎儿脑磁共振成像生物测量结果与长期神经发育结局之间的相关性。

材料与方法

本分析为一项历史性队列研究。使用容积磁共振成像半自动算法在二维和三维磁共振成像上测量胎儿脑生物计量。我们测量并评估了以下脑结构:大脑幕上容积和小脑容积以及小脑容积/大脑幕上容积比,以及常用的二维脑磁共振成像生物计量变量,包括枕额径、双额径和颅后窝直径。小头畸形定义为≤第 3 百分位数;大头畸形定义为≥第 97 百分位数,对应于-2 SD 和+2 SD。本研究队列的神经发育结局采用 Vineland-II 适应行为量表进行评估,并将测量值与 Vineland 标准分数相关联。

结果

共纳入 70 例胎儿。经多重比较校正后,在三维或二维磁共振成像测量中,大脑幕上容积、小脑容积或大脑幕上容积/小脑容积比与 Vineland 评分之间均无显著相关性。在大头畸形、正常头围和小头畸形的胎儿中,中位数 Vineland 标准评分之间无差异。

结论

在磁共振成像显示正常脑结构的情况下,在本研究测量范围内,2 维和 3 维胎儿脑磁共振成像生物计量学与早期发育里程碑的成就无关。

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本文引用的文献

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Fetal brain biometry in isolated mega cisterna magna: MRI and US study.孤立性巨大后颅窝池胎儿脑测量:MRI 和 US 研究。
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Fetal microcephaly.胎儿小头畸形
BMJ. 2018 Jun 4;361:k2232. doi: 10.1136/bmj.k2232.
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Volumetric Brain MRI Study in Fetuses with Congenital Heart Disease.容积脑 MRI 在先天性心脏病胎儿中的研究。
AJNR Am J Neuroradiol. 2018 Jun;39(6):1164-1169. doi: 10.3174/ajnr.A5628. Epub 2018 Apr 19.
8
Volume of Structures in the Fetal Brain Measured with a New Semiautomated Method.使用新半自动方法测量胎儿脑内结构容积。
AJNR Am J Neuroradiol. 2017 Nov;38(11):2193-2198. doi: 10.3174/ajnr.A5349. Epub 2017 Aug 24.

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