RESUMEN
Structural fetal body MRI provides true 3D information required for volumetry of fetal organs. However, current clinical and research practice primarily relies on manual slice-wise segmentation of raw T2-weighted stacks, which is time consuming, subject to inter- and intra-observer bias and affected by motion-corruption. Furthermore, there are no existing standard guidelines defining a universal approach to parcellation of fetal organs. This work produces the first parcellation protocol of the fetal body organs for motion-corrected 3D fetal body MRI. It includes 10 organ ROIs relevant to fetal quantitative volumetry studies. We also introduce the first population-averaged T2w MRI atlas of the fetal body. The protocol was used as a basis for training of a neural network for automated organ segmentation. It showed robust performance for different gestational ages. This solution minimises the need for manual editing and significantly reduces time. The general feasibility of the proposed pipeline was also assessed by analysis of organ growth charts created from automated parcellations of 91 normal control 3T MRI datasets that showed expected increase in volumetry during 22-38 weeks gestational age range.
Asunto(s)
Feto , Procesamiento de Imagen Asistido por Computador , Embarazo , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Feto/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Edad Gestacional , Atención PrenatalRESUMEN
Foetal MRI is a complementary imaging method to antenatal ultrasound. It provides advanced information for detection and characterisation of foetal brain and body anomalies. Even though modern single shot sequences allow fast acquisition of 2D slices with high in-plane image quality, foetal MRI is intrinsically corrupted by motion. Foetal motion leads to loss of structural continuity and corrupted 3D volumetric information in stacks of slices. Furthermore, the arbitrary and constantly changing position of the foetus requires dynamic readjustment of acquisition planes during scanning.
Asunto(s)
Feto , Imagen por Resonancia Magnética , Humanos , Femenino , Embarazo , Estudios Retrospectivos , Imagen por Resonancia Magnética/métodos , Feto/diagnóstico por imagen , Movimiento (Física) , Algoritmos , Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional/métodos , Encéfalo , ArtefactosRESUMEN
BACKGROUND: Image-domain motion correction of black-blood contrast T2-weighted fetal cardiovascular magnetic resonance imaging (CMR) using slice-to-volume registration (SVR) provides high-resolution three-dimensional (3D) images of the fetal heart providing excellent 3D visualisation of vascular anomalies [1]. However, 3D segmentation of these datasets, important for both clinical reporting and the application of advanced analysis techniques is currently a time-consuming process requiring manual input with potential for inter-user variability. METHODS: In this work, we present novel 3D fetal CMR population-averaged atlases of normal and abnormal fetal cardiovascular anatomy. The atlases are created using motion-corrected 3D reconstructed volumes of 86 third trimester fetuses (gestational age range 29-34 weeks) including: 28 healthy controls, 20 cases with postnatally confirmed neonatal coarctation of the aorta (CoA) and 38 vascular rings (21 right aortic arch (RAA), 17 double aortic arch (DAA)). We used only high image quality datasets with isolated anomalies and without any other deviations in the cardiovascular anatomy.In addition, we implemented and evaluated atlas-guided registration and deep learning (UNETR) methods for automated 3D multi-label segmentation of fetal cardiac vessels. We used images from CoA, RAA and DAA cohorts including: 42 cases for training (14 from each cohort), 3 for validation and 6 for testing. In addition, the potential limitations of the network were investigated on unseen datasets including 3 early gestational age (22 weeks) and 3 low SNR cases. RESULTS: We created four atlases representing the average anatomy of the normal fetal heart, postnatally confirmed neonatal CoA, RAA and DAA. Visual inspection was undertaken to verify expected anatomy per subgroup. The results of the multi-label cardiac vessel UNETR segmentation showed 100[Formula: see text] per-vessel detection rate for both normal and abnormal aortic arch anatomy. CONCLUSIONS: This work introduces the first set of 3D black-blood T2-weighted CMR atlases of normal and abnormal fetal cardiovascular anatomy including detailed segmentation of the major cardiovascular structures. Additionally, we demonstrated the general feasibility of using deep learning for multi-label vessel segmentation of 3D fetal CMR images.
Asunto(s)
Coartación Aórtica , Cardiopatías Congénitas , Humanos , Lactante , Recién Nacido , Aorta Torácica/diagnóstico por imagen , Corazón Fetal/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Espectroscopía de Resonancia Magnética , Valor Predictivo de las PruebasRESUMEN
Los huesos antiguos son una buena fuente de ADN, útil en muchos casos para el análisis forense, Los huesos antiguos son una buena fuente de ADN, útil en muchos casos para el análisis forense,El consumo de cocaína en Costa Rica es un problema creciente y muchas de las muertes pueden ser causadas por situaciones en las cuales la droga está involucrada. En este estudio todas las autopsias médico legales hechas en 1996 en este país fueron analizadas con el objeto de determinar la mortalidad y por lo tanto el impacto que ella genera en la sociedad costarricense. Palabras clave: cocaína, drogadicción, muerte súbita