Quantitative MRI measurements of human fetal brain development in utero

Magnetic resonance imaging (MRI) allows for high resolution imaging of the central nervous system. We have tested the feasibility of using MRI in conjunction with quantitative image analysis to perform volumetric measurements of the brain in the developing human fetus in utero. The database comprises MR images of a total of 56 fetuses (gestational age 25-41 weeks) referred because of suspected abnormalities due to ultrasound findings, family history or maternal illness and scanned on a 1.5 T MR system using a single-shot fast spin echo (SSFSE) T2 sequence, slice thickness 3 mm, no gap. Four out of the 56 scans could not be used in the analysis due to poor image quality. Automatic segmentation (using NIH Image routines) was found to be unreliable in these fetal brains, so cerebral, cerebellar and ventricular regions were traced manually. Ventricular volumes did not vary with gestational age in normal fetuses (N=27, R=0.05, p=0.8) while cerebral parenchyma and cerebellum volumes increased significantly during the same period (R=0.67, p=0.0002 and R=0.51, p=0.0066 respectively). Two calculated parameters: percent ventricular asymmetry and volume ratio of ventricles to hemispheric parenchyma were found to be very sensitive to ventricular pathology; such that the mean value of the latter in normal fetuses was 4.4%+/-0.56 (mean+/-SEM, N=27) compared to 34.3%+/-17.6 (N=6, p<0.0001) in fetuses with ventriculomegaly. These results support the use of image analysis and MRI to produce normal growth curves as well as quantitative severity assessments of brain pathologies in the developing human fetus.