MRI studies of brain size and growth in individuals with congenital heart disease

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Alexandra F Bonthrone1, Christopher J Kelly1, Isabel H X Ng1

  • 1Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.

Translational Pediatrics
|September 29, 2021
PubMed

Insights

Infants with congenital heart disease (CHD) show smaller brain volumes even before birth. This brain growth impairment persists, impacting neurodevelopmental outcomes in children with CHD.

Area of Science:

  • Pediatric Cardiology
  • Neurodevelopmental Pediatrics
  • Medical Imaging

Background:

  • Congenital heart disease (CHD) is the most common birth defect, with increasing survival rates.
  • CHD survivors face a higher risk of neurodevelopmental impairment, potentially linked to altered fetal and neonatal brain development.
  • Magnetic resonance imaging (MRI) offers objective assessment of brain volume and growth patterns.

Purpose of the Study:

  • To review MRI studies examining brain volume and growth in individuals with CHD from fetal development through adolescence.
  • To synthesize current understanding of brain development alterations in CHD patients.
  • To identify risk factors associated with impaired brain growth in CHD.

Main Methods:

  • Systematic review of MRI studies focusing on brain volume and growth in individuals with CHD.
  • Analysis of data from fetal stage to adolescence.
  • Correlation of brain metrics with clinical factors and neurodevelopmental outcomes.

Main Results:

  • Reduced brain volumes are observed in fetuses with CHD around 30 weeks gestation, with increased extracerebral cerebrospinal fluid.
  • Impaired brain growth continues postnatally through childhood and adolescence.
  • Factors like reduced in utero cerebral oxygen delivery, prolonged surgery time, and extended hospital stays are linked to impaired brain growth.

Conclusions:

  • Smaller brain volumes in individuals with CHD are associated with adverse neurodevelopmental outcomes.
  • Early MRI measures of cerebral volume require further investigation regarding their predictive value for later neurodevelopmental issues.
  • Large, prospective, multicenter studies are needed to fully elucidate the relationship between brain volume, growth, clinical factors, and long-term neurodevelopmental impairments in CHD survivors.

Keywords:
Congenital heart disease (CHD)brainbrain volumemagnetic resonance imaging (MRI)

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