Volumetric MRI study of the intrauterine growth restriction fetal brain
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Intrauterine growth restriction (IUGR) is a pathologic fetal condition known to affect the fetal brain regionally and associated with future neurodevelopmental abnormalities. This study employed MRI to assess in utero regional brain volume changes in IUGR fetuses compared to controls.
Retrospectively, using MRI images of fetuses at 30–34 weeks gestational age, a total of 8 brain regions—supratentorial brain and cavity, cerebral hemispheres, temporal lobes and cerebellum—were measured for volume in 13 fetuses with IUGR due to placental insufficiency and in 21 controls. Volumes and their ratios were assessed for difference using regression models. Reliability was assessed by intraclass correlation coefficients (ICC) between two observers.
In both groups, all structures increase in absolute volume during that gestation period, and the rate of cerebellar growth is higher compared to that of supratentorial structures. All structures’ absolute volumes were significantly smaller for the IUGR group. Cerebellar to supratentorial ratios were found to be significantly smaller (P < 0.05) for IUGR compared to controls. No other significant ratio differences were found. ICC showed excellent agreement.
The cerebellar to supratentorial volume ratio is affected in IUGR fetuses. Additional research is needed to assess this as a radiologic marker in relation to long-term outcome.
• IUGR is a pathologic fetal condition affecting the brain
• IUGR is associated with long-term neurodevelopmental abnormalities; fetal characterization is needed
• This study aimed to evaluate regional brain volume differences in IUGR
• Cerebellar to supratentorial volume ratios were smaller in IUGR fetuses
• This finding may play a role in long-term development of IUGR fetuses
KeywordsBrain Cerebellum Embryonic and fetal development IUGR MRI
Left cerebral hemisphere
Left temporal lobe
Right cerebral hemisphere
Right temporal lobe
Total temporal lobes
The scientific guarantor of this publication is Dr. Eldad Katorza, Sheba Medical Center, Israel. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Estela Derazne kindly provided statistical advice for this manuscript. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, case-control study, performed at one institution.
- 1.Romo A, Carceller RTJ (2006) Intrauterine growth retardation (IUGR): epidemiology and etiology. Pediatr Endocrinol Rev 6:332–336Google Scholar
- 27.Bayer SA, Altman J (2003) Atlas of human central nervous system development. Vol 22: the human brain during the third trimester. CRC, Boca RatonGoogle Scholar
- 28.Garel C (2004) MRI of the fetal brain normal development and cerebral pathologies. Springer, Berlin Heidelberg New YorkGoogle Scholar
- 29.Benavides-Serralde A, Scheier M, Cruz-Martinez R et al (2011) Changes in central and peripheral circulation in intrauterine growth-restricted fetuses at different stages of umbilical artery flow deterioration: new fetal cardiac and brain parameters. Gynecol Obstet Investig 71:274–280CrossRefGoogle Scholar