Comprehensive quantitative analyses of fetal magnetic resonance imaging in isolated cerebral ventriculomegaly

Tomo Tarui, Mother Infant Research Institute, Tufts Medical Center, Boston, USA; Pediatric Neurology, Hasbro Children's Hospital, Providence, USA. Electronic address: tomo_tarui@brown.edu.
Neel Madan, Radiology, Tufts Medical Center, Boston, USA.
George Graham, Obstetrics and Gynecology, South Shore Hospital, South Weymouth, USA.
Rie Kitano, Mother Infant Research Institute, Tufts Medical Center, Boston, USA.
Shizuko Akiyama, Mother Infant Research Institute, Tufts Medical Center, Boston, USA.
Emiko Takeoka, Mother Infant Research Institute, Tufts Medical Center, Boston, USA.
Sophie Reid, Mother Infant Research Institute, Tufts Medical Center, Boston, USA.
Hyuk Jin Yun, Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, USA.
Alexa Craig, Pediatric Neurology, Maine Medical Center, Portland, USA.
Osamu Samura, Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo, Japan.
Ellen Grant, Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, USA.
Kiho Im, Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, USA. Electronic address: Kiho.Im@childrens.harvard.edu.

Abstract

Isolated cerebral ventriculomegaly (IVM) is the most common prenatally diagnosed brain anomaly occurs in 0.2-1 % of pregnancies. However, knowledge of fetal brain development in IVM is limited. There is no prenatal predictor for IVM to estimate individual risk of neurodevelopmental disability occurs in 10 % of children. To characterize brain development in fetuses with IVM and delineate their individual neuroanatomical variances, we performed comprehensive post-acquisition quantitative analysis of fetal magnetic resonance imaging (MRI). In volumetric analysis, brain MRI of fetuses with IVM (n = 20, 27.0 ± 4.6 weeks of gestation, mean ± SD) had revealed significantly increased volume in the whole brain, cortical plate, subcortical parenchyma, and cerebrum compared to the typically developing fetuses (controls, n = 28, 26.3 ± 5.0). In the cerebral sulcal developmental pattern analysis, fetuses with IVM had altered sulcal positional (both hemispheres) development and combined features of sulcal positional, depth, basin area, in both hemispheres compared to the controls. When comparing distribution of similarity index of individual fetuses, IVM group had shifted toward to lower values compared to the control. About 30 % of fetuses with IVM had no overlap with the distribution of control fetuses. This proof-of-concept study shows that quantitative analysis of fetal MRI can detect emerging subtle neuroanatomical abnormalities in fetuses with IVM and their individual variations.