Abstract

It is well-established that a high prevalence of infants with congenital heart defects surviving to childhood have neurodevelopmental abnormalities. The etiology is not clear. In this study, we aimed to find prenatal neuroanatomic changes in fetuses with congenital heart disease to better understand the pathophysiology behind these sequelae. A retrospective study of 46 fetal brain MR imaging scans was performed at a tertiary medical center during a 4-year period. Clinical data were collected from electronic medical charts. Volumes of the supratentorial brain, right hemisphere, left hemisphere, and cerebellum were measured using a semiautomated method and were compared with the normal growth percentiles. We found that cerebellar volume and the cerebellar-supratentorial volume ratio were significantly lower among fetuses with congenital heart disease. Supratentorial and hemisphere volumes showed no difference between groups. This difference was not observed in fetuses with septation defects. Fetuses with congenital heart disease have smaller cerebellar volumes than healthy fetuses. Additional research is needed to assess this finding as a radiologic marker for long-term outcome.

Highlights

  • BACKGROUND AND PURPOSEIt is well-established that a high prevalence of infants with congenital heart defects surviving to childhood have neurodevelopmental abnormalities

  • We found that cerebellar volume and the cerebellar-supratentorial volume ratio were significantly lower among fetuses with congenital heart disease

  • One fetus had supratentorial brain volume (STV) below the third percentile, 2 had right hemisphere volume (RHV) below the third percentile, 2 had left hemisphere volume (LHV) below the third percentile, 19 (41%) had cerebellar volume (CV) below the third percentile, and in 21 (46%) fetuses, the cerebellar volume and the supratentorial volume (CV/STV) ratio was below the third percentile

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Summary

Objectives

We aimed to find prenatal neuroanatomic changes in fetuses with congenital heart disease to better understand the pathophysiology behind these sequelae. Our objective was to compare volumetric measurements of different structures in the fetal brain between healthy fetuses and those with CHD using a new 3D MR imaging method

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