Ambwani Gaurav, Shi Zhongjie, Luo Kehuan, Jeong Jeong-Won, Tan Sidhartha
University of St. Andrews School of Medicine, St. Andrews, UK.
Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA.
Dev Neurosci. 2025;47(1):55-67. doi: 10.1159/000539212. Epub 2024 May 6.
Our laboratory has been exploring the MRI detection of fetal brain injury, which previously provided a prognostic biomarker for newborn hypertonia in an animal model of cerebral palsy (CP). The biomarker relies on distinct patterns of diffusion-weighted imaging-defined apparent diffusion coefficient (ADC) in fetal brains during uterine hypoxia-ischemia (H-I). Despite the challenges posed by small brains and tissue acquisition, our objective was to differentiate between left and right brain ADC changes.
A novel aspect involved utilizing three-dimensional rendering techniques to refine ADC measurements within spheroids encompassing fetal brain tissue. 25-day gestation age of rabbit fetuses underwent global hypoxia due to maternal uterine ischemia.
Successful differentiation of left and right brain regions was achieved in 28% of the fetal brains. Ordinal analysis revealed predominantly higher ADC on the left side compared to the right at baseline and across the entire time series. During H-I and reperfusion-reoxygenation, the right side exhibited a favored percentage change. Among these fetal brains, 73% exhibited the ADC pattern predictive of hypertonia. No significant differences between left and right sides were observed in patterns predicting hypertonia, except for one timepoint during H-I. This study also highlights a balance between left-sided and right-sided alterations within the population.
This study emphasizes the importance of investigating laterality and asymmetric hemispheric lesions for early diagnosis of brain injury, leading to CP. The technological limitations in obtaining a clear picture of the entire fetal brain for every fetus mirror the challenges encountered in human studies.
Our laboratory has been exploring the MRI detection of fetal brain injury, which previously provided a prognostic biomarker for newborn hypertonia in an animal model of cerebral palsy (CP). The biomarker relies on distinct patterns of diffusion-weighted imaging-defined apparent diffusion coefficient (ADC) in fetal brains during uterine hypoxia-ischemia (H-I). Despite the challenges posed by small brains and tissue acquisition, our objective was to differentiate between left and right brain ADC changes.
A novel aspect involved utilizing three-dimensional rendering techniques to refine ADC measurements within spheroids encompassing fetal brain tissue. 25-day gestation age of rabbit fetuses underwent global hypoxia due to maternal uterine ischemia.
Successful differentiation of left and right brain regions was achieved in 28% of the fetal brains. Ordinal analysis revealed predominantly higher ADC on the left side compared to the right at baseline and across the entire time series. During H-I and reperfusion-reoxygenation, the right side exhibited a favored percentage change. Among these fetal brains, 73% exhibited the ADC pattern predictive of hypertonia. No significant differences between left and right sides were observed in patterns predicting hypertonia, except for one timepoint during H-I. This study also highlights a balance between left-sided and right-sided alterations within the population.
This study emphasizes the importance of investigating laterality and asymmetric hemispheric lesions for early diagnosis of brain injury, leading to CP. The technological limitations in obtaining a clear picture of the entire fetal brain for every fetus mirror the challenges encountered in human studies.
我们的实验室一直在探索胎儿脑损伤的磁共振成像（MRI）检测方法，该方法先前在脑瘫（CP）动物模型中为新生儿高张力提供了一种预后生物标志物。该生物标志物依赖于子宫内缺氧缺血（H-I）期间胎儿大脑中扩散加权成像定义的表观扩散系数（ADC）的不同模式。尽管存在胎儿脑体积小和组织采集方面的挑战，但我们的目标是区分左右脑ADC的变化。
一个新的方面是利用三维渲染技术来优化包含胎儿脑组织的球体中的ADC测量。25日龄的兔胎儿由于母体子宫缺血而经历了全身性缺氧。
28%的胎儿脑成功实现了左右脑区域的区分。序数分析显示，在基线和整个时间序列中，左侧的ADC主要高于右侧。在H-I和再灌注-复氧期间，右侧表现出更有利的百分比变化。在这些胎儿脑中，73%表现出预测高张力的ADC模式。在预测高张力的模式中，除了H-I期间的一个时间点外，左右两侧未观察到显著差异。这项研究还突出了群体中左右侧改变之间的平衡。
本研究强调了研究脑损伤导致CP的左右侧性和不对称半球病变对于早期诊断的重要性。在为每个胎儿获取整个胎儿脑的清晰图像时所面临的技术限制反映了人类研究中遇到的挑战。
我们的实验室一直在探索胎儿脑损伤的磁共振成像（MRI）检测方法，该方法先前在脑瘫（CP）动物模型中为新生儿高张力提供了一种预后生物标志物。该生物标志物依赖于子宫内缺氧缺血（H-I）期间胎儿大脑中扩散加权成像定义的表观扩散系数（ADC）的不同模式。尽管存在胎儿脑体积小和组织采集方面的挑战，但我们的目标是区分左右脑ADC的变化。
一个新的方面是利用三维渲染技术来优化包含胎儿脑组织的球体中的ADC测量。25日龄的兔胎儿由于母体子宫缺血而经历了全身性缺氧。
28%的胎儿脑成功实现了左右脑区域的区分。序数分析显示，在基线和整个时间序列中，左侧的ADC主要高于右侧。在H-I和再灌注-复氧期间，右侧表现出更有利的百分比变化。在这些胎儿脑中，73%表现出预测高张力的ADC模式。在预测高张力的模式中，除了H-I期间的一个时间点外，左右两侧未观察到显著差异。这项研究还突出了群体中左右侧改变之间的平衡。
本研究强调了研究脑损伤导致CP的左右侧性和不对称半球病变对于早期诊断的重要性。在为每个胎儿获取整个胎儿脑的清晰图像时所面临的技术限制反映了人类研究中遇到的挑战。
