This paper describes a novel approach to forming high-resolution MR images of the human fetal brain. It addresses the key problem of fetal motion by proposing a registration-refined compounding of ...multiple sets of orthogonal fast two-dimensional MRI slices, which are currently acquired for clinical studies, into a single high-resolution MRI volume.
A robust multiresolution slice alignment is applied iteratively to the data to correct motion of the fetus that occurs between two-dimensional acquisitions. This is combined with an intensity correction step and a super-resolution reconstruction step, to form a single high isotropic resolution volume of the fetal brain.
Experimental validation on synthetic image data with known motion types and underlying anatomy, together with retrospective application to sets of clinical acquisitions, are included.
Results indicate that this method promises a unique route to acquiring high-resolution MRI of the fetal brain in vivo allowing comparable quality to that of neonatal MRI. Such data provide a highly valuable window into the process of normal and abnormal brain development, which is directly applicable in a clinical setting.
Summary
Leukodystrophy is a common central nervous system manifestation of inborn errors of metabolism. Until magnetic resonance imaging (MRI) emerged as a clinical tool, the diagnosis of ...leukodystrophy was difficult and imprecise; MRI has allowed new understandings and classifications of leukodystrophies that have greatly enhanced both our diagnostic ability and our understanding of these complex disorders. However, optimal use of MRI in this setting requires a fundamental understanding of myelin structure, myelin development, and the changes seen on MRI with myelination and demyelination. The purpose of this review is to provide the reader with the necessary tools for the use of MRI to diagnose and follow patients with leukodystrophies.
Evaluation is presented of whether or not a detailed neuromotor examination at 3 months of age could predict later neurologic abnormalities among term infants with perinatal depression. In a ...prospective cohort, infants were neurologically evaluated at 3 and 12 months. Infants were scored from 0 to 5 according to a new neuromotor scoring system. The neuromotor score at 3 months (NMS-3) was compared with the NMS at 12 months (NMS-12). Seventy-four infants were enrolled in the study; nine were lost to follow-up, and five died before reaching 1 year. Sixty infants were examined (neurologic abnormalities = 52%, normal = 48% at 1 year). The NMS-3 correlated strongly with the NMS-12 and the results of the 12-month neurologic examination. All infants with a NMS-3 of 5 had neurologic abnormalities at 1 year. Infants with neonatal seizures had a significantly increased risk of developmental abnormalities at 1 year. Eighteen infants exhibited transient abnormalities. Using a simple scoring system, the results of the early neurologic examinations correlated strongly with outcome among term infants with perinatal depression. A subgroup of infants had transient abnormalities. These findings suggest that in term high-risk infants, the 1-year neurologic outcome can be predicted at 3 months of age using these parameters.