MRI super-resolution restoration and atlas-based tissue division. (A, B) Postprocessed MRI super-resolution restorations in axial and sagittal airplanes of a fetus at 26 +6 GW. (C, D) Respective by hand fixed atlas-based tissue division. Color coding: blue– external CSF-spaces, red– cortex, orange– subcortical parenchyma, brown– periventricular zone, dark green– ganglionic eminence, white– ventricular system, dark blue– corpus callosum, yellow– deep gray nuclei (basal ganglia and thalamus), light green– brainstem, light blue– cerebellum, blue-green– left hippocampus, gray– best hippocampus. Credit: RSNA and Marlene Stuempflen, M.D.
In the very first MRI-based research study to examine prenatal alcohol direct exposure, scientists discovered substantial modifications in the brain structure of fetuses exposed to alcohol compared to healthy controls. Results of the research study are existing today at the yearly conference of the Radiological Society of North America (RSNA).
“Fetal alcohol syndrome is a worldwide problem in countries where alcohol is freely available,” stated Gregor Kasprian, M.D., associate teacher of radiology at the Medical University of Vienna inAustria “It’s estimated that 9.8% of all pregnant women are consuming alcohol during pregnancy, and that number is likely underestimated.”
Fetal alcohol syndrome is the most extreme kind of a group of conditions called fetal alcohol spectrum conditions that arise from alcohol direct exposure throughout pregnancy. Babies born with fetal alcohol spectrum conditions might have particular physical functions, finding out specials needs, behavioral issues or speech and language hold-ups. According toDr Kasprian, one in 70 pregnancies with alcohol direct exposure leads to fetal alcohol syndrome.
“There are many postnatal studies on infants exposed to alcohol,”Dr Kasprian stated. “We wanted to see how early it’s possible to find changes in the fetal brain as a result of alcohol exposure.”
Graphical abstract: results of prenatal alcohol direct exposure (PAE). PAE causes a volume decrease in the periventricular zone and a volume boost in the corpus callosum. Credit: RSNA and Marlene Stuempflen, M.D.
For the research study, scientists hired 500 pregnant ladies who were referred for a fetal MRI for scientific factors. On a confidential survey, 51 of the ladies confessed to consuming alcohol throughout their pregnancy. The surveys utilized were the Pregnancy Risk Assessment Monitoring System (PRAMS), a monitoring task of the Centers for Disease Control and Prevention and health departments, and the T-ACE Screening Tool, a measurement tool of 4 concerns that recognize threat drinking.
“We provided a safe environment where women could feel comfortable honestly answering the questions,”Dr Kasprian stated.
After getting rid of a few of the fetal MRIs for factors such as structural brain abnormalities and/or bad image quality, the last study hall included 26 fetal MRI examinations from 24 alcohol-positive fetuses and a control group of 52 gender- and age-matched healthy fetuses. At the time of imaging, fetuses varied in age in between 20 and 37 weeks.
The scientists utilized super-resolution imaging, which enabled them to develop one dataset to re-construct each fetal brain. Next, they finished an analysis of 12 various brain structures, calculating overall brain volume and sector volumes of particular brain compartments.
Longitudinal development trajectories of the periventricular zone (blue) and the corpus callosum (red) in fetuses with (PAE+) and without (PAE-) prenatal alcohol direct exposure. The volumetric relations of consisted of images are not representative: The scaling has actually been become permit a simple contrast of shape and structure of the particular compartments. Credit: RSNA and Marlene Stuempflen, M.D.
“One of the main hallmarks of our study is that we investigated so many smaller sub-compartments of the brain,” stated co-author Marlene Stuempflen, M.D., clinical scientist at the Medical University of Vienna.
The analytical analysis exposed 2 significant distinctions in the alcohol-exposed fetuses compared to healthy controls: an increased volume in the corpus collosum and a reduced volume in the periventricular zone.
“This is the first time that a prenatal imaging study has been able to quantify these early alcohol-associated changes,”Dr Stuempflen stated.
The corpus collosum is the primary connection in between the brain’s 2 hemispheres.Dr Stuempflen kept in mind that it is fitting that this extremely main structure is impacted, since the scientific signs of fetal alcohol spectrum conditions are extremely heterogenous, or varied, and can not be identified to one particular base of the brain.
“The changes found in the periventricular zone, where all neurons are born, also reflect a global effect on brain development and function,” she stated.
The scientists stated discovering a thicker corpus collosum in the alcohol-positive fetuses was unexpected since the corpus collosum is thinner in babies with fetal alcohol spectrum conditions.
“It appears that alcohol exposure during pregnancy puts the brain on a path of development that diverges from a normal trajectory,”Dr Kasprian stated. “Fetal MRI is a very powerful tool to characterize brain development not only in genetic conditions, but also acquired conditions that result from exposure to toxic agents.”
Additional co-authors are Ernst Schwartz, M.Sc, Mariana Diogo, M.D.,Ph D., Sarah Glatter, M.D., M.M.Sc, Birgit Pfeiler, Victor Schmidbauer, M.D., Lisa Bartha-Doering,Ph D., Rainer Seidl, M.D., Elisabeth Krampl-Bettelheim, M.D., and Daniela Prayer, M.D.
Meeting: 107 th Scientific Assembly and Annual Meeting of the Radiological Society of North America
