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. 2023 Jul;43(8):1002-1007.
doi: 10.1002/pd.6368. Epub 2023 May 22.

Brain cortical assessment by MRI in fetuses with left congenital diaphragmatic hernia

Isabella Fabietti  1 , Giulia Grassini  1   2 , Sara Savelli  3 , Roberta Vicario  1 , Anita Romiti  1 , Milena Viggiano  1 , Chiara Vassallo  1 , Laura Valfrè  4 , Paola Giliberti  5 , Irma Capolupo  5 , Marco Bonito  6 , Pietro Bagolan  4   7 , Francesco Morini  8 , Leonardo Caforio  1
Affiliations

Brain cortical assessment by MRI in fetuses with left congenital diaphragmatic hernia

Isabella Fabietti et al. Prenat Diagn. 2023 Jul.

Abstract

Objective: To evaluate fetal brain development using MRI (magnetic resonance imaging) in CDH (congenital diaphragmatic hernia).

Methods: 52 isolated left CDH and 104 control fetuses were imaged using MRI. Brain morphometry (Biparietal diameter-BPD, brain fronto-occipital diameter-BFOD, third ventricle, posterior ventricles, transcerebellar diameter-TCD, anteroposterior and craniocaudal cerebellar vermis diameter-AP and CC) and cortical structures (bilateral cingulate fissure-CF, insular fissure-IF, insular depth - ID) were compared with controls using Mann-Whitney test.

Results: Median gestational age at MRI (p = 0.95)and the median biparietal diameter (p = 0.737) were comparable. Among morphometric parameters, only the brain fronto-occipital diameter was significantly smaller in CDH (p = 0.001) and the third ventricle was significantly greater in CDH (<0.0001). Among cortical structures, the cingulate and insular fissures were significantly deeper in CDH fetuses (p < 0.0001) as the insular depth ID was smaller in CDH (p < 0.03).

Conclusions: CDH fetuses have a smaller fronto-occipital diameter, reduced insular depth, deeper cingulate and insular fissure, and greater third ventricle width as compared to controls. These findings suggest that left CDH may have an impact on fetal brain development with an overall reduction in brain volume.

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References

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