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Multidimensional Analysis of Fetal Posterior Fossa in Health and Disease

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Abstract

Fetal magnetic resonance imaging (MRI) is now routinely used to further investigate cerebellar malformations detected with ultrasound. However, the lack of 2D and 3D biometrics in the current literature hinders the detailed characterisation and classification of cerebellar anomalies. The main objectives of this fetal neuroimaging study were to provide normal posterior fossa growth trajectories during the second and third trimesters of pregnancy via semi-automatic segmentation of reconstructed fetal brain MR images and to assess common cerebellar malformations in comparison with the reference data. Using a 1.5-T MRI scanner, 143 MR images were obtained from 79 normal control and 53 fetuses with posterior fossa abnormalities that were grouped according to the severity of diagnosis on visual MRI inspections. All quantifications were performed on volumetric datasets, and supplemental outcome information was collected from the surviving infants. Normal growth trajectories of total brain, cerebellar, vermis, pons and fourth ventricle volumes showed significant correlations with 2D measurements and increased in second-order polynomial trends across gestation (Pearson r, p < 0.05). Comparison of normal controls to five abnormal cerebellum subgroups depicted significant alterations in volumes that could not be detected exclusively with 2D analysis (MANCOVA, p < 0.05). There were 15 terminations of pregnancy, 8 neonatal deaths, and a spectrum of genetic and neurodevelopmental outcomes in the assessed 24 children with cerebellar abnormalities. The given posterior fossa biometrics enhance the delineation of normal and abnormal cerebellar phenotypes on fetal MRI and confirm the advantages of utilizing advanced neuroimaging tools in clinical fetal research.

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Acknowledgments

This study was funded by Biomedical Research Foundation and Medical Research Council, UK. We would like to thank Dr. Ash Ederies, staff at the Robert Steiner MRI Unit, Hammersmith Hospital, London for their support, and all the mothers for their participation in our research.

Conflict of Interest

None of the authors have any conflict of interest to disclose.

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Authors and Affiliations

  1. Imaging Sciences Department, MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital Campus, London, W12 0NN, UK

    Deniz Vatansever, Vanessa Kyriakopoulou, Joanna M. Allsop, Matthew Fox, Andrew Chew, Joseph V. Hajnal & Mary A. Rutherford

  2. Centre for the Developing Brain, Perinatal Imaging & Health King’s College London, St. Thomas’ Hospital Campus, London, SE1 7EH, UK

    Vanessa Kyriakopoulou, Joanna M. Allsop, Matthew Fox, Joseph V. Hajnal & Mary A. Rutherford

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  1. Deniz Vatansever
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  2. Vanessa Kyriakopoulou
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  7. Mary A. Rutherford
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Correspondence to Deniz Vatansever or Mary A. Rutherford.

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Vatansever, D., Kyriakopoulou, V., Allsop, J.M. et al. Multidimensional Analysis of Fetal Posterior Fossa in Health and Disease. Cerebellum 12, 632–644 (2013). https://doi.org/10.1007/s12311-013-0470-2

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