Additional value of advanced neurosonography and magnetic resonance imaging in fetuses at risk for brain damage

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dc.contributor.authorVan der Knoop, B. J.en_ZA
dc.contributor.authorZonnenberg, I. A.en_ZA
dc.contributor.authorVerbeke, J. I. M. L.en_ZA
dc.contributor.authorDe Vries, S.en_ZA
dc.contributor.authorPistorius, L. R.en_ZA
dc.contributor.authorVan Weissenbruch, M. M.en_ZA
dc.contributor.authorVermeulen, R. J.en_ZA
dc.contributor.authorDe Vries, J. I. P.en_ZA
dc.date.accessioned2022-02-15T09:14:10Z
dc.date.available2022-02-15T09:14:10Z
dc.date.issued2020
dc.descriptionCITATION: Van der Knoop, B. J. et al. 2020. Additional value of advanced neurosonography and magnetic resonance imaging in fetuses at risk for brain damage. Ultrasound in Obstetrics and Gynecology, 56:348-358, doi:10.1002/uog.21943.
dc.descriptionThe original publication is available at https://obgyn.onlinelibrary.wiley.com
dc.description.abstractObjective: To assess the additional value of fetal multiplanar (axial, coronal and sagittal) neurosonography and magnetic resonance imaging (MRI) to that of the standard axial ultrasound planes in diagnosing brain damage in fetuses at high risk. Methods: This was a prospective, multicenter, observational study. Women were eligible for participation if their fetus was at risk for acquired brain anomalies. Risk factors were congenital infection, alloimmune thrombocytopenia, fetal growth restriction, trauma during pregnancy, fetal hydrops, monochorionic twins and prior ultrasound finding suggestive of an acquired brain anomaly. Examinations of the fetal brain before birth comprised axial ultrasound and advanced neurosonography biweekly and MRI once. After birth, neonatal cranial ultrasound was performed at < 24 h and at term-equivalent age. Neonatal brain MRI was performed once at term-equivalent age. An expert panel blinded to medical information, including imaging findings by the other methods, evaluated the presence of periventricular echogenicity (PVE) changes, peri- and intraventricular hemorrhage (IVH) and changes in basal ganglia and/or thalami echogenicity (BGTE) on ultrasound, and the equivalent signal intensity (SI) changes on MRI. Conclusions on imaging findings were generated by consensus. The children were followed up with examinations for psychomotor development at 1 year of age, using the Touwen examination and Alberta Infant Motor Scale, and at 2 years of age using Bayley Scale of Infant Development-III (BSID-III) and behavioral, sensory profile and linguistic questionnaires; scores > 1 SD below the mean were considered suspicious for neurodevelopmental sequelae. Results: Fifty-six fetuses were examined, and in 39/56 fetuses, all fetal-imaging modalities were available. PVE/SI changes were observed in 6/39, 21/39 and 2/39 fetuses on axial ultrasound planes, multiplanar neurosonography and MRI, respectively. IVH was found in 3/39, 11/39 and 1/39 fetuses, and BGTE/SI changes in 0/39, 12/39 and 0/39 fetuses, respectively. Outcome was suspicious for neurodevelopmental sequelae in 13/46 infants at 1 year, and at 2 years, 41/41 children had scores within 1 SD of the mean on BSID-III and 20 had scores > 1 SD below the mean on the behavioral (5/38), sensory profile (17/37) and/or linguistic (6/39) questionnaires. Conclusions: In this cohort of fetuses at risk for brain damage, the severity of acquired brain anomalies was limited. Nevertheless, multiplanar neurosonography detected more fetal PVE changes, IVH and/or BGTE changes compared to the standard axial ultrasound planes and MRI. Fetal MRI did not demonstrate any anomalies that were not seen on neurosonography. Neurodevelopmental outcome at 2 years of age showed no or mild impairment in most cases. © 2019 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.en_ZA
dc.description.urihttps://obgyn.onlinelibrary.wiley.com/doi/10.1002/uog.21943
dc.description.versionPublisher's version
dc.format.extent11 pagesen_ZA
dc.identifier.citationVan der Knoop, B. J. et al. 2020. Additional value of advanced neurosonography and magnetic resonance imaging in fetuses at risk for brain damage. Ultrasound in Obstetrics and Gynecology, 56:348-358, doi:10.1002/uog.21943.
dc.identifier.issn1469-0705 (online)
dc.identifier.otherdoi:10.1002/uog.21943
dc.identifier.urihttp://hdl.handle.net/10019.1/124161
dc.language.isoen_ZAen_ZA
dc.publisherJohn Wiley & Sonsen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectNeurosonographyen_ZA
dc.subjectMagnetic resonance imagingen_ZA
dc.subjectFetuses -- NMR imagingen_ZA
dc.subjectBrain damage -- Diagnosisen_ZA
dc.subjectNeurodevelopmental treatment for infantsen_ZA
dc.subjectResonant ultrasound spectroscopyen_ZA
dc.titleAdditional value of advanced neurosonography and magnetic resonance imaging in fetuses at risk for brain damageen_ZA
dc.typeArticleen_ZA
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