基于MR图像的三维容积测量评价胎儿颅脑发育

Evaluation of fetal brain development by three-dimensional volume on MRI image

目的探讨基于正常胎儿和脑室增宽胎儿MRI三维脑容积测量来评估孕期胎儿脑发育情况的价值。方法回顾性分析我院2015~2019年临床超声检查怀疑侧脑室增宽的胎儿及因各种原因脑部显示不清的胎儿脑MR图像共165例,根据侧脑室宽度分为正常组83例和侧脑室增宽组82例,人工分割图像后,对胎儿颅内组织包括大脑实质、脑室、小脑、脑干及脑脊液进行三维重建,计算不同孕周胎儿脑各解剖结构的容积变化,建立胎儿脑容积孕期正常值范围。结果两组中,妊娠期间所有脑容积均随孕周增加。与正常组相比,脑室增宽组所有结构的脑容积均没有显著性差异。正常组大脑实质、小脑、脑干、脑室及脑脊液容积同孕周的Pearson相关系数分别为ρ=0.931,0.942,0.859,0.625,0.855。除脑室外,其余脑结构的容积与孕周和双顶径均高度相关。结论正常胎儿脑容积的MR评价可以为产科医生评估胎儿脑部发育情况提供更多的参考数据,避免误诊及漏诊情况发生,可在临床进行推广应用。未来需要更多的研究来评估与长期预后相关的放射学指标。

Objective:To investigate the value of three-dimensional(3D)MRI brain volume measurements based on normal fetus and ventricular widening fetus in evaluating fetal brain development during pregnancy.Methods:A total of 165 population who were suspected of a ventricular widening or brain images blurring foe various causes on ultrasound results underwent fetal brain MRI examination between 2015-1 and 2019-9 in our hospital.They were divided into normal group and lateral ventricle widening group according to lateral ventricle width.After the artificial image segmentation,we performed a 3D reconstruction for the brain tissue of fetus including cerebral parenchyma,ventricles,cerebellum,brain stem and brain crest fluid.We further calculated the brain volume changes of each tissue in different gestational weeks and to establish the normal range fetal brain volume.Results:Within both groups,all the brain volumes increased with gestational weeks increasing.Compared with the normal group,there was no significant difference in the brain volume of all structures in the lateral ventricle widening group.The pearson correlation coefficient between gestational week and cerebral parenchyma,ventricles,cerebellum,brain stem an,brain crest fluid in normal group wereρ=0.931,0.625,0.942,0.859,0.855,respectively.The volume of all brain structures was highly correlated with gestational week and BPD except ventricles.Conclusion:The measurement of normal fetal brain volume by MRI may provide more information for obstetricians to evaluate the development of fetal brain,which can avoid misdiagnosis or missed diagnosis and promote the application in clinical practice.Future research is warranted to evaluate the association between radiologic parameters and long-term prognosis.