PMID- 31828836 OWN - NLM STAT- MEDLINE DCOM- 20210907 LR - 20210907 IS - 1469-0705 (Electronic) IS - 0960-7692 (Print) IS - 0960-7692 (Linking) VI - 56 IP - 3 DP - 2020 Sep TI - Additional value of advanced neurosonography and magnetic resonance imaging in fetuses at risk for brain damage. PG - 348-358 LID - 10.1002/uog.21943 [doi] AB - OBJECTIVE: 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. (c) 2019 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. CI - (c) 2019 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. FAU - van der Knoop, B J AU - van der Knoop BJ AD - Department of Obstetrics and Gynaecology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. AD - Amsterdam UMC, Research Institute Amsterdam Movement Sciences, Amsterdam, The Netherlands. AD - Amsterdam UMC, Research Institute Neuroscience Campus Amsterdam, Amsterdam, The Netherlands. FAU - Zonnenberg, I A AU - Zonnenberg IA AD - Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. FAU - Verbeke, J I M L AU - Verbeke JIML AD - Department of Radiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. FAU - de Vries, L S AU - de Vries LS AD - Department of Neonatology, University Medical Centre Utrecht, Utrecht, The Netherlands. FAU - Pistorius, L R AU - Pistorius LR AD - Department of Obstetrics and Gynaecology, University of Stellenbosch/Tygerberg Hospital, Tygerberg, South Africa. FAU - van Weissenbruch, M M AU - van Weissenbruch MM AD - Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. FAU - Vermeulen, R J AU - Vermeulen RJ AD - Amsterdam UMC, Research Institute Neuroscience Campus Amsterdam, Amsterdam, The Netherlands. AD - Department of Child Neurology, MUMC+, Maastricht, The Netherlands. FAU - de Vries, J I P AU - de Vries JIP AD - Department of Obstetrics and Gynaecology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. AD - Amsterdam UMC, Research Institute Amsterdam Movement Sciences, Amsterdam, The Netherlands. AD - Amsterdam UMC, Research Institute Neuroscience Campus Amsterdam, Amsterdam, The Netherlands. LA - eng GR - ABIP-2011-23/Amsterdam Brain Imaging Platform (ABIP), ONWAR grant for MRI costs/ PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't PL - England TA - Ultrasound Obstet Gynecol JT - Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology JID - 9108340 SB - IM CIN - Ultrasound Obstet Gynecol. 2021 Jan;57(1):175-176. PMID: 33387403 CIN - Ultrasound Obstet Gynecol. 2021 Jan;57(1):176-177. PMID: 33387416 CIN - Ultrasound Obstet Gynecol. 2021 Mar;57(3):507-509. PMID: 33646636 CIN - Ultrasound Obstet Gynecol. 2021 Mar;57(3):507. PMID: 33646638 MH - Brain Injuries/*diagnostic imaging MH - Female MH - Humans MH - *Magnetic Resonance Imaging MH - Nervous System Malformations/*diagnostic imaging MH - Netherlands MH - Predictive Value of Tests MH - Pregnancy MH - Prospective Studies MH - *Ultrasonography, Prenatal PMC - PMC7496149 OTO - NOTNLM OT - MRI OT - acquired brain damage OT - fetus OT - neonate OT - neurodevelopment OT - ultrasound EDAT- 2019/12/13 06:00 MHDA- 2021/09/08 06:00 PMCR- 2020/09/17 CRDT- 2019/12/13 06:00 PHST- 2019/05/31 00:00 [received] PHST- 2019/11/28 00:00 [revised] PHST- 2019/12/02 00:00 [accepted] PHST- 2019/12/13 06:00 [pubmed] PHST- 2021/09/08 06:00 [medline] PHST- 2019/12/13 06:00 [entrez] PHST- 2020/09/17 00:00 [pmc-release] AID - UOG21943 [pii] AID - 10.1002/uog.21943 [doi] PST - ppublish SO - Ultrasound Obstet Gynecol. 2020 Sep;56(3):348-358. doi: 10.1002/uog.21943.