Fetal MRI insular cortical morphometry and its association with neurobehavior in late-onset small-for-gestational-age fetuses

Abstract

Objective To evaluate insular cortical morphometry assessed by magnetic resonance imaging (MRI)

Proton Magnetic Resonance Spectroscopy Assessment of Fetal Brain Metabolism in Late-Onset ‘Small for Gestational Age' versus ‘Intrauterine Growth Restriction' Fetuses

“…The metabolic changes detected in this study are also in line with other brain reorganizational differences reported in SGA fetuses, including microstructural changes in various brain areas, differences in brain sulcation and in cerebellar and brainstem size [12,13,14,39]. …”

“…Thus, small fetuses with abnormal uterine artery Doppler ultrasound [4], birth weight below the 3rd centile [5] or signs of brain redistribution [3] are associated with poorer perinatal outcome. It has been speculated whether those SGA fetuses without signs of poor perinatal outcome showed merely milder forms of the same disease, were constitutionally small fetuses or represented another pathogenic pathway leading to abnormally low fetal growth [8,12,13]. The findings of the present study challenge the notion that SGA fetuses without signs of severity are merely constitutionally small.…”

“…However, it is unclear whether these fetuses are ‘constitutional' SGA or represent other forms of growth restriction. For instance, despite normal perinatal outcomes, small fetuses with normal brain and uterine Doppler sonography still present long-term differences as compared with normally grown fetuses, such as cardiovascular and metabolic programming [7,8], neurological deficits [9,10,11] and neurostructural changes [12,13,14]. Therefore, there is a need to improve the characterization and understanding of the different phenotypes under the common diagnosis of ‘fetal smallness'.…”

Protein S100β in Late-Pregnancy Fetuses with Low Birth Weight and Abnormal Cerebroplacental Ratio

“…Recent research has evaluated the anatomical and functional substrates in this pathology, showing the existence of structural anomalies in fetal brain fissures and cerebral connections as well as functional anomalies that suggest suboptimal neural networking and cortical maturation [17][18][19] . FGR may also lead to direct neuronal damage increasing the leakage of specific markers, especially during early-onset FGR and acute-labor hypoxia [20][21][22] , but there is less evidence of this mechanism in late-onset FGR, possibly because the hypoxia is milder or of a shorter duration prior to birth.…”

Brain Development in Fetuses of Mothers with Diabetes: A Case-Control MR Imaging Study

“…Use of these technologies has revealed alterations in the cerebral NAA:choline ratio and gyrification in fetuses with congenital heart disease, 10 temporal lobe volumes in fetuses with congenital cytomegalovirus infection, 11 and ADC values and parenchymal volume in antenatal ventriculomegaly. 12,13 Historically, most fetal imaging studies have been undertaken at 1.5T. However, although an increasing number of studies have been performed at 3T field strength, 14-20 which has benefits over 1.5T due to improved signal-to-noise and is likely to be advantageous for depicting fetal anatomy, 21 On the basis of disturbances to fetal glucose and fatty acid metabolism associated with maternal diabetes and the neurocognitive profile of offspring, we aimed to investigate the feasibility of comprehensive fetal brain assessment by acquiring measurements of NAA/Cho, NAA/Cr, and Cho/Cr ratios; regional apparent diffusion coefficient measurements; and volume of the cerebrum during the third trimester of pregnancy from women with diabetes and from healthy controls by using 3T MR imaging.…”