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MR-based morphometry of the posterior fossa in fetuses with neural tube defects of the spine.

Woitek R, Dvorak A, Weber M, Seidl R, Bettelheim D, Schöpf V, Amann G, Brugger PC, Furtner J, Asenbaum U, Prayer D, Kasprian G - PLoS ONE (2014)

Bottom Line: Normal fetuses showed a significant increase in the TDPF (r = .956; p<.001) and CSA (r = .714; p<.001) with gestational age.In both ONTDs and in CNTDs the TDPF was significantly different from controls (p<.001).The skull base morphology in fetuses with ONTDs differs significantly from cases with CNTDs and normal controls.

View Article: PubMed Central - PubMed

Affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.

ABSTRACT

Objectives: In cases of "spina bifida," a detailed prenatal imaging assessment of the exact morphology of neural tube defects (NTD) is often limited. Due to the diverse clinical prognosis and prenatal treatment options, imaging parameters that support the prenatal differentiation between open and closed neural tube defects (ONTDs and CNTDs) are required. This fetal MR study aims to evaluate the clivus-supraocciput angle (CSA) and the maximum transverse diameter of the posterior fossa (TDPF) as morphometric parameters to aid in the reliable diagnosis of either ONTDs or CNTDs.

Methods: The TDPF and the CSA of 238 fetuses (20-37 GW, mean: 28.36 GW) with a normal central nervous system, 44 with ONTDS, and 13 with CNTDs (18-37 GW, mean: 24.3 GW) were retrospectively measured using T2-weighted 1.5 Tesla MR -sequences.

Results: Normal fetuses showed a significant increase in the TDPF (r = .956; p<.001) and CSA (r = .714; p<.001) with gestational age. In ONTDs the CSA was significantly smaller (p<.001) than in normal controls and CNTDs, whereas in CNTDs the CSA was not significantly smaller than in controls (p = .160). In both ONTDs and in CNTDs the TDPF was significantly different from controls (p<.001).

Conclusions: The skull base morphology in fetuses with ONTDs differs significantly from cases with CNTDs and normal controls. This is the first study to show that the CSA changes during gestation and that it is a reliable imaging biomarker to distinguish between ONTDs and CNTDs, independent of the morphology of the spinal defect.

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Related in: MedlinePlus

Line drawings show measurements of the CSA and TDPF performed on MR images of three exemplar fetuses: one fetus with normal CNS development at 27 GW (a–f), one fetus with a CNTD at 28GW (g–l) and one fetus with an ONTD at 27 GW (m–r).The CSA was measured on midsagittal T2-weighted SSFSE MR images (a+b, g+h, m+n). The TDPF was measured on coronal T2-weighted MR images (c+d, i+j, o+p) or on axial T2-weighted MR images (e+f, k+l, q+r).
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pone-0112585-g002: Line drawings show measurements of the CSA and TDPF performed on MR images of three exemplar fetuses: one fetus with normal CNS development at 27 GW (a–f), one fetus with a CNTD at 28GW (g–l) and one fetus with an ONTD at 27 GW (m–r).The CSA was measured on midsagittal T2-weighted SSFSE MR images (a+b, g+h, m+n). The TDPF was measured on coronal T2-weighted MR images (c+d, i+j, o+p) or on axial T2-weighted MR images (e+f, k+l, q+r).

Mentions: Three fetuses at similar gestational ages are shown in Figure 2 in order to illustrate the way the measurements of the CSA and TDPF were performed in fetuses with normal CNS development, with an ONTD or CNTD.


MR-based morphometry of the posterior fossa in fetuses with neural tube defects of the spine.

Woitek R, Dvorak A, Weber M, Seidl R, Bettelheim D, Schöpf V, Amann G, Brugger PC, Furtner J, Asenbaum U, Prayer D, Kasprian G - PLoS ONE (2014)

Line drawings show measurements of the CSA and TDPF performed on MR images of three exemplar fetuses: one fetus with normal CNS development at 27 GW (a–f), one fetus with a CNTD at 28GW (g–l) and one fetus with an ONTD at 27 GW (m–r).The CSA was measured on midsagittal T2-weighted SSFSE MR images (a+b, g+h, m+n). The TDPF was measured on coronal T2-weighted MR images (c+d, i+j, o+p) or on axial T2-weighted MR images (e+f, k+l, q+r).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231033&req=5

pone-0112585-g002: Line drawings show measurements of the CSA and TDPF performed on MR images of three exemplar fetuses: one fetus with normal CNS development at 27 GW (a–f), one fetus with a CNTD at 28GW (g–l) and one fetus with an ONTD at 27 GW (m–r).The CSA was measured on midsagittal T2-weighted SSFSE MR images (a+b, g+h, m+n). The TDPF was measured on coronal T2-weighted MR images (c+d, i+j, o+p) or on axial T2-weighted MR images (e+f, k+l, q+r).
Mentions: Three fetuses at similar gestational ages are shown in Figure 2 in order to illustrate the way the measurements of the CSA and TDPF were performed in fetuses with normal CNS development, with an ONTD or CNTD.

Bottom Line: Normal fetuses showed a significant increase in the TDPF (r = .956; p<.001) and CSA (r = .714; p<.001) with gestational age.In both ONTDs and in CNTDs the TDPF was significantly different from controls (p<.001).The skull base morphology in fetuses with ONTDs differs significantly from cases with CNTDs and normal controls.

View Article: PubMed Central - PubMed

Affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.

ABSTRACT

Objectives: In cases of "spina bifida," a detailed prenatal imaging assessment of the exact morphology of neural tube defects (NTD) is often limited. Due to the diverse clinical prognosis and prenatal treatment options, imaging parameters that support the prenatal differentiation between open and closed neural tube defects (ONTDs and CNTDs) are required. This fetal MR study aims to evaluate the clivus-supraocciput angle (CSA) and the maximum transverse diameter of the posterior fossa (TDPF) as morphometric parameters to aid in the reliable diagnosis of either ONTDs or CNTDs.

Methods: The TDPF and the CSA of 238 fetuses (20-37 GW, mean: 28.36 GW) with a normal central nervous system, 44 with ONTDS, and 13 with CNTDs (18-37 GW, mean: 24.3 GW) were retrospectively measured using T2-weighted 1.5 Tesla MR -sequences.

Results: Normal fetuses showed a significant increase in the TDPF (r = .956; p<.001) and CSA (r = .714; p<.001) with gestational age. In ONTDs the CSA was significantly smaller (p<.001) than in normal controls and CNTDs, whereas in CNTDs the CSA was not significantly smaller than in controls (p = .160). In both ONTDs and in CNTDs the TDPF was significantly different from controls (p<.001).

Conclusions: The skull base morphology in fetuses with ONTDs differs significantly from cases with CNTDs and normal controls. This is the first study to show that the CSA changes during gestation and that it is a reliable imaging biomarker to distinguish between ONTDs and CNTDs, independent of the morphology of the spinal defect.

Show MeSH
Related in: MedlinePlus