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T2 Hyperintensity and ADC Values in Fetal Brain MRI following Prenatal Open Neural Tube Defect Repair
Romain Corroenne1, Magdalena Sanz Cortes1, William E Whitehead2
1From the Department of Obstetrics and Gynecology (R.C., M.S.C., M.A.B.), Division of Maternal-Fetal Medicine, Baylor College of Medicine & Texas Children's Hospital, Houston, Texas.
T2 hyperintensity after open neural tube defect repair is linked to lower ADC values, indicating potential microstructural changes or delayed myelination in fetal brains. This finding aids in understanding brain development post-surgery.
Area of Science:
- Neuroimaging
- Developmental Neuroscience
- Pediatric Surgery
Background:
- T2 hyperintensity is common in fetal brain MRI for open neural tube defects (ONTD).
- It may indicate edema, altered cerebrospinal fluid (CSF) circulation, or impaired brain maturation.
- Diffusion-weighted imaging (DWI) can assess water diffusion to reveal brain microstructure changes.
Purpose of the Study:
- To investigate the association between T2 hyperintensity and apparent diffusion coefficient (ADC) values in fetuses after prenatal ONTD repair.
- To explore DWI as a tool for characterizing brain tissue in this population.
Main Methods:
- Retrospective analysis of fetal MRI scans 6 weeks post-in utero ONTD repair.
- T2 hyperintensity defined as subjective signal intensity increase.
- ADC values measured in cerebral lobes using DWI (b=700 s/mm²).
- Hindbrain herniation reversal evaluated.
Main Results:
- T2 hyperintensity observed in 71.4% of 49 fetuses.
- Lower ADC values found in most brain regions for fetuses with T2 hyperintensity.
- Hindbrain herniation reversal was more frequent in fetuses without T2 hyperintensity (100% vs. 65.7%).
Conclusions:
- T2 hyperintensity post-prenatal ONTD repair correlates with reduced ADC values.
- This suggests altered brain microstructure or delayed myelination.
- Findings highlight DWI's role in assessing brain development after ONTD repair.
