Magnetic resonance imaging of skull and brain parameters in fetuses with intrauterine growth restriction.

Ronaldo Eustáquio De Oliveira Júnior,Fabricio Da Silva Costa,Sara Reis Teixeira,Edward Araujo Júnior,Eduardo Félix Martins Santana,Alessandra Cristina Marcolin,Jorge Elias Junior

doi:10.1590/0100-3984.2020.0025

Abstract

ObjectiveTo compare fetuses with intrauterine growth restriction (IUGR) and those with normal growth, in terms of skull and brain measurements obtained by magnetic resonance imaging (MRI).Materials and MethodsThis was a prospective cohort study including 26 single fetuses (13 with IUGR and 13 with normal growth), evaluated from 26 to 38 weeks of gestation. Using MRI, we measured skull and brain biparietal diameters (BPDs); skull and brain occipitofrontal diameters (OFDs); corpus callosum length and area; transverse cerebellar diameter; extracerebral cerebrospinal fluid (eCSF); and right and left interopercular distances (IODs).ResultsThe following were significantly smaller in IUGR fetuses than in control fetuses: skull BPD (76.9 vs. 78.2 mm; p = 0.0029); brain BPD (67.8 vs. 71.6 mm; p = 0.0064); skull OFD (93.6 vs. 95 mm; p = 0.0010); eCSF (5.5 vs. 8.2 mm; p = 0.0003); right IOD (9.8 vs. 13.9 mm; p = 0.0023); and left IOD (11.8 vs. 16.3 mm; p = 0.0183). The skull BPD/eCSF, brain BPD/eCSF, skull OFD/eCSF, and brain OFD/eCSF ratios were also lower in IUGR fetuses.ConclusionIUGR fetuses had smaller OFD and BPD, both skull and brain, and less eCSF when compared to normal growth fetuses.

Highlights

Intrauterine growth restriction (IUGR), which occurs in 5–10% of pregnancies, is a major cause of perinatal mortality and morbidity, resulting in disorders of psychomotor and neuromotor development, as well as cardiovascular diseases and endocrine disorders in adults[1]
Among the fetuses in the intrauterine growth restriction (IUGR) group, a higher-than-normal umbilical artery (UA) resistance index (RI) was observed in 61.5% and a lower-than-normal cerebroplacental ratio (CPR) was observed in 53.8%, whereas neither was observed in any of the fetuses in the control group
The findings of the present study provide a better understanding of possible cranial changes in IUGR fetuses

Summary

Introduction

Intrauterine growth restriction (IUGR), which occurs in 5–10% of pregnancies, is a major cause of perinatal mortality and morbidity, resulting in disorders of psychomotor and neuromotor development, as well as cardiovascular diseases and endocrine disorders in adults[1]. Kyriakopoulou et al[9] quantified the brain growth of normal fetuses throughout the second half of pregnancy using two-dimensional and three-dimensional biometric parameters on MRI scans. The cranial MRI scans of IUGR fetuses could be compared with those of normal fetuses, which would improve knowledge of the neurodevelopmental patterns associated with fetal malnutrition. MRI may be an auxiliary method for diagnosing neurological lesions associated with chronic fetal hypoxia and for the early identification of fetuses at high risk for future neurological impairment. The few MRI studies of IUGR fetuses have limited clinical applicability, especially because of the long acquisition time and complex image processing, which are often affected by fetal movement. The objective of this study was to compare the MRI measurements of the skull and brain obtained in IUGR fetuses with those obtained in normal fetuses

Methods

Results

Conclusion