OC02.05: MR‐based brain volumetry in fetuses with congenital diaphragmatic hernia

Recent research has shown that fetuses with congenital diaphragmatic hernia (CDH) and fetuses with congenital heart disease (CHD) share cardiac pathologies, specifically ventricular hypoplasia, which results in impaired cerebral perfusion. While in CHD fetuses reduced brain growth has been demonstrated, in CDH fetuses, evidence concerning fetal brain volumetry has failed to show reduced brain volume. The aim of this pilot study was to perform brain volumetry of CDH fetuses based on fetal MRI data and to compare brain volumes of CDH and normal fetuses. Brain volumetry based on fetal MRI data of 24 CDH and 24 age-matched normal control cases was performed and brain volumes of CDH and normal fetuses were compared using paired t-test. Brain volumetry was done using ITK-Snap. Furthermore, Pearson's correlation of brain and lung volumes of CDH fetuses was performed. Brain volumes of CDH fetuses were significantly smaller than brain volumes of normal fetuses (−8709.70 mm3 +−7904.66 mm3, p=0.032). Brain volumes and lung volumes of CDH fetuses correlated significantly (r=0,615, p=0,003). Brain volumes of CDH fetuses are significantly smaller than those of normal controls. Future prospective studies are needed to confirm these results and to evaluate a potential association of reduced brain growth with left ventricular hypoplasia and reduced cerebral perfusion. Furthermore, registries of fetal MRI data are needed to advance fetal MRI as an imaging modality in both research and routine clinical use.