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Volumetric Brain MRI Study in Fetuses with Congenital Heart Disease
H Olshaker1,2, R Ber3,2, D Hoffman3,2
1From the Antenatal Diagnostic Unit (H.O., R.B., D.H., R.A., E.K.), Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Israel hagar.olshaker@gmail.com.
Insights
Fetuses with congenital heart disease show smaller cerebellar volumes, indicating potential prenatal neurodevelopmental changes. This finding may serve as a future radiologic marker for long-term outcomes in affected infants.
Area of Science:
- Neuroimaging
- Developmental Biology
- Pediatric Cardiology
Background:
- Congenital heart defects (CHDs) are linked to neurodevelopmental abnormalities in surviving children.
- The underlying causes for these neurodevelopmental issues remain unclear.
- Prenatal brain development may be impacted by congenital heart disease.
Purpose of the Study:
- Investigate prenatal neuroanatomic alterations in fetuses diagnosed with congenital heart disease.
- Understand the pathophysiology connecting congenital heart disease to neurodevelopmental sequelae.
- Identify early indicators of neurodevelopmental abnormalities in fetuses with CHDs.
Main Methods:
- Retrospective analysis of 46 fetal brain MRI scans from a tertiary medical center.
- Semiautomated measurement of supratentorial brain, cerebral hemispheres, and cerebellum volumes.
- Comparison of fetal brain volumes against established normal growth percentiles.
Main Results:
- Significantly reduced cerebellar volume in fetuses with congenital heart disease compared to controls.
- Lower cerebellar-to-supratentorial volume ratio observed in the CHD group.
- No significant differences in supratentorial or hemisphere volumes, or in fetuses with septation defects.
Conclusions:
- Fetuses with congenital heart disease exhibit smaller cerebellar volumes.
- This finding suggests potential prenatal cerebellar underdevelopment associated with CHDs.
- Further research is warranted to validate cerebellar volume as a radiologic marker for neurodevelopmental outcomes.
Background And Purpose:
It is well-established that a high prevalence of infants with congenital heart defects surviving to childhood have neurodevelopmental abnormalities. The etiology is not clear. In this study, we aimed to find prenatal neuroanatomic changes in fetuses with congenital heart disease to better understand the pathophysiology behind these sequelae.
Materials And Methods:
A retrospective study of 46 fetal brain MR imaging scans was performed at a tertiary medical center during a 4-year period. Clinical data were collected from electronic medical charts. Volumes of the supratentorial brain, right hemisphere, left hemisphere, and cerebellum were measured using a semiautomated method and were compared with the normal growth percentiles.
Results:
We found that cerebellar volume and the cerebellar-supratentorial volume ratio were significantly lower among fetuses with congenital heart disease. Supratentorial and hemisphere volumes showed no difference between groups. This difference was not observed in fetuses with septation defects.
Conclusions:
Fetuses with congenital heart disease have smaller cerebellar volumes than healthy fetuses. Additional research is needed to assess this finding as a radiologic marker for long-term outcome.
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