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Brain fetal magnetic resonance imaging to evaluate maturation of normal white matter during the third trimester of pregnancy

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Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

Quantitative magnetic resonance imaging (MRI) could improve the estimation of fetal brain maturation and the interpretation of white matter signal intensity in pathological conditions.

Objective

To investigate T2-based and diffusion-weighted imaging (DWI) measurements for the evaluation of fetal brain maturation during the last trimester of pregnancy.

Materials and methods

One hundred sixty-eight fetal brain MRIs were retrospectively analyzed (age range: 28–37 weeks of gestation) after ensuring that none of the children developed psychomotor or cognitive impairment (median follow-up: 4.7 years). Bilateral regions of interest were drawn on the frontal, occipital, parietal and temporal lobes from T2-W imaging and DWI, when available, to evaluate signal intensity and apparent diffusion coefficient (ADC) values. Ratios were calculated with two references (pons or thalamus and cerebrospinal fluid) to standardize signal intensities. Reproducibility was evaluated with intraclass correlation coefficients (ICCs) and Bland-Altman plots. Correlations with gestational age were evaluated with univariate and multivariate linear regressions.

Results

T2 measurements were achieved in all cases, and DWI was available in 37 cases. Measurements and ratios were reproducible in eight localizations (i.e. intra- and interobserver ICCs >0.5): frontal T2/thalamus, parietal T2/thalamus, occipital T2/pons, parietal ADC/thalamus, occipital ADC/pons, temporal ADC/pons, occipital ADC and temporal ADC. The frontal T2/thalamus and parietal T2/thalamus correlated with gestational age (P<0.0001 and P=0.014, respectively). In the multivariate modeling, frontal T2/thalamus remained an independent predictor of the gestational age (P<0.0001).

Conclusion

The frontal T2/thalamus ratio emerged as a potential additional biomarker of fetal brain maturation during the last trimester of pregnancy.

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Acknowledgements

We thank Dr. Catherine Garel for her thorough review and her thoughtful remarks during the writing of this article.

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Authors and Affiliations

  1. Department of Pediatric Radiology, Pellegrin Hospital, CHU Bordeaux, Place Amélie Raba-Léon, Bordeaux, France

    Camille Letissier, Lydie Chérier, Jean Delmas & Jean-François Chateil

  2. Department of Diagnostic and Interventional Oncologic Imaging, Institut Bergonié, Bordeaux, France

    Amandine Crombé

  3. Université de Bordeaux, Bordeaux, France

    Amandine Crombé

  4. Centre de Résonance Magnétique des Systèmes Biologiques, UMR 5536, Centre National de la Recherche Scientifique, Université de Bordeaux, F-33076, Bordeaux, France

    Jean-François Chateil

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  1. Camille Letissier
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Correspondence to Jean-François Chateil.

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Letissier, C., Crombé, A., Chérier, L. et al. Brain fetal magnetic resonance imaging to evaluate maturation of normal white matter during the third trimester of pregnancy. Pediatr Radiol 51, 1826–1838 (2021). https://doi.org/10.1007/s00247-021-05064-1

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  • DOI: https://doi.org/10.1007/s00247-021-05064-1

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