J Neuroimaging

. 2023 Feb 22.

 doi: 10.1111/jon.13096. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/36813467/

Brain growth in fetuses with congenital diaphragmatic hernia

Fedel Machado-Rivas ^1 2, Jungwhan J Choi ³, Maria Alejandra Bedoya ^1 2, Lina Acosta Buitrago ¹, Clemente Velasco-Annis ¹, Onur Afacan ^1 2, Carol Barnewolt ^1 2, Judy Estroff ^1 2, Simon K Warfield ^1 2, Ali Gholipour ^1 2, Camilo Jaimes ^1 2

Affiliations expand

• PMID: 36813467
• DOI: 10.1111/jon.13096

Abstract

Background and purpose: To perform a volumetric evaluation of the brain in fetuses with right or left congenital diaphragmatic hernia (CDH), and to compare brain growth trajectories to normal fetuses.

Methods: We identified fetal MRIs performed between 2015 and 2020 in fetuses with a diagnosis of CDH. Gestational age (GA) range was 19-40 weeks. Control subjects consisted of normally developing fetuses between 19 and 40 weeks recruited for a separate prospective study. All images were acquired at 3 Tesla and were processed with retrospective motion correction and slice-to-volume reconstruction to generate super-resolution 3-dimensional volumes. These volumes were registered to a common atlas space and segmented in 29 anatomic parcellations.

Results: A total of 174 fetal MRIs in 149 fetuses were analyzed (99 controls [mean GA: 29.2 ± 5.2 weeks], 34 fetuses left-sided CDH [mean GA: 28.4 ± 5.3 weeks], and 16 fetuses right-sided CDH [mean GA: 27 ± 5.4 weeks]). In fetuses with left-sided CDH, brain parenchymal volume was -8.0% (95% confidence interval [CI] [-13.1, -2.5]; p = .005) lower than normal controls. Differences ranged from -11.4% (95% CI [-18, -4.3]; p < .001) in the corpus callosum to -4.6% (95% CI [-8.9, -0.1]; p = .044) in the hippocampus. In fetuses with right-sided CDH, brain parenchymal volume was -10.1% (95% CI [-16.8, -2.7]; p = .008) lower than controls. Differences ranged from -14.1% (95% CI [-21, -6.5]; p < .001) in the ventricular zone to -5.6% (95% CI [-9.3, -1.8]; p = .025) in the brainstem.

Conclusion: Left and right CDH are associated with lower fetal brain volumes.

Keywords: MRI; motion correction; prenatal; segmentation.

© 2023 American Society of Neuroimaging.