Xue Jinfeng, Xue Jinluan, Ru Yanhui, Zhang Ge, Yin Hong, Liu Dequan
School of Medical Imaging, Shandong Second Medical University, Weifang, China.
Department of Ultrasound, Shandong Provincial Maternal and Child Health Care Hospital, Jinan, China.
Front Med (Lausanne). 2024 Oct 9;11:1393115. doi: 10.3389/fmed.2024.1393115. eCollection 2024.
This study aimed to evaluate the growth trajectory of the insula in adequate-for-gestational-age (AGA) and early-onset fetal growth restriction (FGR) fetuses and analyze the difference between the two groups using three-dimensional inversion crytal and realistic vue technique (3D-ICRV).
Singleton pregnant women, with a gestational age ranging from 20 to 32 weeks, who underwent routine examinations at Shandong Maternal and Child Care Hospital between March 2023 and December 2023 were included. The participants were divided into two groups: the FGR and AGA fetuses. Three-dimensional volumes were obtained using transabdominal ultrasound in the transverse section of the fetal hypothalamus based on different gestational ages. 3D-ICRV rendering technology was used for 3D imaging of the fetal insula. Volumes with a clear display of the insula were selected. We observed the morphology of the insula, and measured the area and circumference of the insula. By evaluating the growth trajectory of the insula in AGA and FGR fetuses, differences in insular development between the two groups were compared.
Overall, 203 participants were included in this study, with 164 and 39 in the AGA and FGR groups, respectively. The 3D volumes were successfully acquired, and the area and circumference of the insula were measured using 3D-ICRV imaging technology. We found that as gestational age increased, the area and circumference of the insula gradually increased and showed positive correlations with the gestational age, with no significant changes in morphology. The growth rate of insular area and insular circumference in the FGR group is slower than that in the AGA group (insular area: 0.15 vs 0.19 cm / week, insular circumference: 0.25 vs 0.28 cm / week). The area and circumference of the insula in the FGR group were significantly different from those in the AGA group (insular area: = 0.003, insular circumference: = 0.004).
The measured values of the insula using 3D-ICRV identify the differences in insular development between the FGR and AGA fetuses. The findings of this study have important implications for the prenatal evaluation of cortical development and maturity in FGR fetuses and further clinical consultation and management.
本研究旨在评估适于胎龄（AGA）和早发型胎儿生长受限（FGR）胎儿脑岛的生长轨迹，并使用三维反转晶体和逼真视图技术（3D-ICRV）分析两组之间的差异。
纳入2023年3月至2023年12月期间在山东省妇幼保健院接受常规检查、孕周为20至32周的单胎孕妇。参与者分为两组：FGR胎儿组和AGA胎儿组。基于不同孕周，经腹超声在下丘脑横切面获取三维容积数据。采用3D-ICRV渲染技术对胎儿脑岛进行三维成像。选择脑岛显示清晰的容积数据。观察脑岛形态，测量脑岛面积和周长。通过评估AGA和FGR胎儿脑岛的生长轨迹，比较两组脑岛发育的差异。
本研究共纳入203名参与者，AGA组164例，FGR组39例。成功获取三维容积数据，并使用3D-ICRV成像技术测量脑岛面积和周长。我们发现，随着孕周增加，脑岛面积和周长逐渐增大，且与孕周呈正相关，形态无明显变化。FGR组脑岛面积和脑岛周长的生长速度慢于AGA组（脑岛面积：0.15 vs 0.19 cm²/周，脑岛周长：0.25 vs 0.28 cm/周）。FGR组脑岛面积和周长与AGA组有显著差异（脑岛面积：P = 0.003，脑岛周长：P = 0.004）。
使用3D-ICRV测量的脑岛值可识别FGR和AGA胎儿脑岛发育的差异。本研究结果对FGR胎儿皮质发育和成熟度的产前评估以及进一步的临床咨询和管理具有重要意义。
