Xinyi Xu¹, Jiwei Sun¹, Wen Shi^1,2, Yao Shen¹, Ruoke Zhao¹, Wanrong Luo¹, Cong Sun³, Ruike Chen¹, Mingyang Li¹, Yi-Cheng Hsu⁴, Yi Sun⁴, Yi Zhang¹, Guangbin Wang^3,5, and Dan Wu^1
1Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biodical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, HangZhou, China, ²Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ³Department of Radiology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong University, Jinan, China, ⁴MR Collaboration, Siemens Healthineers Ltd, Shanghai, China, ⁵Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China

We constructed a 4D spatiotemporal atlas of the normal fetal brain development from 23 to 38 gestational weeks in a Chinese population. We depicted the developmental trajectories of morphological indices of the cerebral cortex, which showed a characteristic regional variations and indicated the developmental order and rates in the different cortical parcels. The fetal brain atlas and fetal cerebral cortex trajectory offer a better understanding of fetal brain development and can be used as an analytic reference for clinicians in diagnostic or research settings.

Shuang He¹, Qiang Lei¹, Xiaoli Zhao¹, Ya Yang¹, Zhigang Wang¹, Hua Lai¹, Xiaoyong Zhang², and Xilin Wen^1
1Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, ²Philips Healthcare, Chengdu, China

Magnetic resonance image (MRI) has been increasingly used to evaluate fetal malformations. Currently, the commonly used fetal spine scanning sequences include conventional 2D Single-Shot TSE (2D SSH TSE) and 2D balanced fast field echo sequence (2D BTFE), However, 2D MR sequences have disadvantages such as unclear display of tiny structures especially the fetal cervical vertebra, furthermore the image quality is strongly affected by fetal postures. In this study we compared 3D T2-star-weighted FFE sequence with conventional 2D SSH TSE sequence and 2D BTFE sequence. The 3D T2-star FFE sequence has high prenatal diagnosis value for fetal spine malformation, and can be used as an important supplementary sequence for fetal spine diagnosis in clinical practice. 

Wenqi Wang¹, Jia Xuan², Jiawei Liang², Xiaohui Ma², Weibo Chen³, Dan Wu¹, Hongxi Zhang², Can Lai², and Yi Zhang^1
1Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China, ²Department of Radiology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China, ³Philips Healthcare, Shanghai, China

Neuroblastoma (NB) is most often diagnosed in young children, and high-risk NB indicates a poor prognosis and requires aggressive treatment. Here, we assessed the utility of radiomics for amide proton transfer (APT) imaging in the preoperative classification of high-risk and low-risk abdominal NBs. Thirty-three pediatric patients underwent APT scans, with 16 confirmed high-risk NBs and 17 confirmed low-risk NBs. Radiomic models were constructed from four APT-related metric maps using 7 classifiers, with their prediction performances evaluated by associated AUCs. The optimal model achieved an AUC of 0.86, demonstrating the potential of APT MRI-based radiomics for risk stratification of NB.

Yupeng Zhu¹, Yun Peng¹, Xiaorong Liu², Jianxiu Lian³, Zhiwei Shen³, and Jiazheng Wang^3
1Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China, ²Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China, ³Philips Healthcare, Beijing, China

It is difficult to identify IgA nephropathy (IgAN) and Henoch Schonlein purpura nephritis (HSPN) due to their similar image features on conversional MR anatomic images. Arterial spin labeling (ASL) and mDIXON-Quant MR imaging can provide more data about perfusion and relaxation time to evaluate the functional state of kidney. In this study, we explore to different IgAN from HSPN in pediatric patients with nephropathy using ASL and mDIXON-Quant MR sequences, and hope to improve accuracy in differential diagnosis of IgAN and HSPN.

Xue Chen¹, Zhou Huang², Yonggang Li^2,3,4, Jibin Zhang¹, Xiaowen Gu¹, and Zhisen Li^1
1Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou city, Jiangsu province, 215002, China, ²Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou city, Jiangsu province, 215000, China, ³Institute of Medical Imaging, Soochow University, Suzhou city, Jiangsu province, 215000, China, ⁴National Clinical Research Center for Hematologic Diseases, the First Affiliated Hospital of Soochow University, Suzhou city, Jiangsu province, 215000, China

Fetal ventriculomegaly (FV) is one of the central nervous system (CNS) major malformations. Prenatal clinical research has seen only a few applications of machine learning. To our knowledge, radiomic machine learning for predicting the change of cerebral ventricular in fetuses with ventriculomegaly has not been reported. We discovered that a combination of clinical characteristics and fetal MRI features could accurately predict postnatal ventricular changes in fetuses with ventriculomegaly. The occipital lobe white matter on the dilated lateral ventricle side may play an important role in the pathophysiological process in FV. 

Jing Wang¹, Zhuo Wang¹, Yi Zhu², and Ke Jiang^2
1Radiology, the First Hospital of Jilin University, Changchun, China, ²Philips Healthcare, Beijing, China

The quality of commonly used fetal T1-weighed inversion recovery(IR) images is relatively poor. Compressed SENSE(CS) technique allows shortening of scan time, but the overall image quality has not been significantly improved. In this study, Compressed-SENSE Artificial intelligence(CS-AI) framework was applied to reduce the scan time and increase the spatial resolution. This study aims at acquiring high-resolution fetal brain T1-weighted image with reduced scan time and compare the image quality among images reconstructed with CS-AI, CS and conventional SENSE.

Claire Kelly^1,2,3, Deanne K Thompson^2,3,4, Chris Adamson³, Gareth Ball^3,4, Thijs Dhollander³, Richard Beare³, Bonnie Alexander^3,5, Jeanie LY Cheong^2,6,7, Marc L Seal^3,4, Terrie E Inder⁸, Lex W Doyle^2,4,6,7, and Peter J Anderson^1,2
1Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia, ²Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia, ³Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia, ⁴Department of Paediatrics, The University of Melbourne, Melbourne, Australia, ⁵Department of Neurosurgery, The Royal Children's Hospital, Melbourne, Australia, ⁶The Royal Women's Hospital, Melbourne, Australia, ⁷Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia, ⁸Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States

Longitudinal cortical development following very preterm (VP) birth has been infrequently studied. We undertook a unique longitudinal MRI study of 202 VP infants and 66 term-born infants from shortly after birth to age 13 years. Longitudinal changes in surface-based volume, area and thickness measurements for 62 cortical regions were modelled using generalised additive models. We reveal cortical alterations in the neonatal period and altered cortical development in the early years of life following VP birth. Cortical alterations persisted to age 13, with several regions of reduced volume and area, thickness reductions in temporal regions, and thickness increases in frontal regions.

AnDong Ma¹, YaoMing Qu¹, MingJun Lu¹, Xia Zou¹, XinZi Liu¹, Chen Zhao², and ZhiBo Wen^1
1Radiology, ZhuJiang Hospital of Southern Medical University, GuangZhou, China, ²Philips Healthcare, GuangZhou, China

Preoperative prediction of molecular subgroup based on magnetic resonance imaging (MRI) remains a challenge. The objective of this study was to assess amide proton transfer-weighted (APTw) method in medulloblastoma (MB). Preliminary results showed that the mean value of APT value in sonic hedgehog (SHH) -activated MB tended to be higher than that of Group 4 MB.

jie LI¹, xiao Ling¹, songhong Yue¹, haoyuan Li¹, tao Wen¹, jing Zhang¹, and kai Ai^2
1Lanzhou University Second Hospital, Lanzhou, China, ²Philips Healthcare, Xi'an, China

We use midsagittal T2WI-based structural MRI images to investigate the relationship between fetal brainstem growth and corresponding gestational weeks. The changes of fetal brainstem substructure in of 153 pregnant women in the middle and late stages were quantitatively evaluated. We found that all measurement indices (height, anteroposterior diameter and cross-sectional area) of normal fetal brainstem were significantly correlated with gestational age. Our study demonstrates that MRI can clearly show the fetal brainstem structure, and the changes of brainstem substructure follow certain rules in fetus.

Yupeng Zhu¹, Yun Peng¹, Xiaorong Liu², Jianxiu Lian³, Zhiwei Shen³, and Geli Hu^3
1Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China, ²Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China, ³Philips Healthcare, Beijing, China

It is difficult to identify IgA nephropathy (IgAN) and Henoch Schonlein purpura nephritis (HSPN) due to their similar clinical features. Functional magnetic resonance imaging (fMRI) can simultaneously obtain tissue structure and function imaging, and evaluate the functional state of kidney. In this study, intravoxel incoherent motion (IVIM) and mDIXON-Quant were performed in pediatric patients with nephropathy, and it was found that IgAN and HSPN were remarkably different in renal function. The values of medulla’s D and cortex’s R2* obtained by IVIM and mDIXON-Quant had the ability in differential diagnosis of IgAN and HSPN.

Penghua Zhang¹, Xiaoan Zhang¹, Xin Zhao¹, Lin Lu¹, Jinxia Guo², Qingna Xing¹, Meiying Cheng¹, and Lingsong Meng^1
1The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²MR Research，GE Healthcare，Beijing，China, Beijing, China

Study explored the brain development of children with sensorineural hearing loss (SNHL),which may cause children's language discrimination ability and voice localization ability worse.The auditory pathway was regarded impaired and the related brain structure may change in SNHL,especially in early development stage for children age less  than 3 months.Studies with Diffusion tensor imaging,diffusion kurtosis imaging and fMRImainly investigate the patient age over 2 years old,when it’s a timechildren's brain is myelinated[1] .  

Synthetic MRI was used in this study to quantitatively evaluate the differences among normal and SNHL with varying degree of hearing loss. The quantitative value of T1 in inferior colliculus,lateral lemniscus and middle cerebellar peduncle were found help early diagnosis of hearing loss of SNHL infants.

Xianyun Cai^1,2, Jinxia Zhu³, and Guangbin Wang^1
1Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China., Jinan, China, China, ²Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China., Jinan, China, China, ³MR Collaboration, Siemens Healthineers Ltd, Beijing, China. Email: jinxia.zhu@siemens-healthineers.com, beijing, China

This study explored the feasibility and clinical value of susceptibility weighted imaging (SWI) in depicting fetal vertebral growth and related anomalies. The results showed that vertebral development in fetuses on SWI was remarkably linearly correlated with gestational ages. In addition, SWI demonstrated superior image quality and higher diagnostic accuracy compared to conventional Half-Fourier acquisition single-shot turbo spin-echo (HASTE) or true fast imaging with steady-state precession (TrueFISP) sequences. In conclusion, SWI is a reliable choice when imaging fetal vertebrae and vertebral anomalies.

Ruike Chen¹, Cong Sun², Yuhao Liao¹, Tingting Liu¹, Junyan Wang³, Yi-Cheng Hsu⁴, Yi Sun⁴, Yi Zhang¹, Guangbin Wang², and Dan Wu^1
1Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China, ²Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China, ³Zhejiang Lab, Hangzhou, China, ⁴MR Collaboration, Siemens Healthineers Ltd., Shanghai, China

 Diffusion MRI (dMRI) is a powerful tool to characterize the developing brain, e.g., to map the spatiotemporal development of early white matter (WM) in the fetal brain and to quantify microstructural changes for diagnosis of prenatal disorders. We proposed a pipeline for dMRI atlas generation with fiber orientation distribution-based registration and shape update, and constructed the first spatiotemporal dMRI atlas of the fetal brain in a Chinese population of 90 normal fetuses from 24 to 38 gestational weeks. The atlas provided information for deciphering the morphological and microstructural development of WM tracts during the second to third trimester.

Hyun Gi Kim¹, Sumin Kim², JeeYoung Kim¹, Na Young Shin¹, and Yoonho Nam^2
1The Catholic University of Korea, Seoul, Korea, Republic of, ²Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Korea, Republic of

Perivascular spaces (PVS) are fluid-filled cavities around the blood vessels in the brain. In adults, dilated PVS (dPVS) is known to increase with age but dPVS in neonates is poorly understood. In this study, we performed both visual and volumetric evaluation of dPVS in neonates using T2-weighted images from the Developing Human Connectome project. We found that gender did not affect dPVS extent in neonates, preterm neonates had lower dPVS extent than term neonates, and dPVS fraction decreased with gestational age (GA) at MRI scan. 

Pei-Hsin Wu¹, Felix W Wehrli², and Seyed A Nabavizadeh^2
1Department of Electrical Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan, ²Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States

SvO₂ and CMRO₂ in patients with sickle cell anemia (SCA) were evaluated by MR susceptibility-based oximetry and compared with that derived from T₂-based methods. The results show that (1) SvO₂ trends lower and OEF tends to be higher in T₂-based methods, (2) there is high correlation of CMRO₂ between SBO and HbS model, (3) CMRO₂ derived from SBO indicates tCBF was elevated to maintain oxygen delivery and oxygen metabolism in the brain given that CMRO₂ is comparable with the healthy subjects reported previously. The preliminary results demonstrate the feasibility of OEF and CMRO₂ estimation via SBO in subjects with SCA.

Cong Sun¹, Xinyi Xu², Jiaguang Song³, Yufan Chen¹, Chao Zhang¹, Yuhao Liao², Wanrong Luo², Jinxia Zhu⁴, Dan Wu², and Guangbin Wang^1,3
1Radiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China, ²Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China, ³Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China, ⁴Siemens Healthineers Ltd, Beijing, China

Fetuses with complex congenital heart disease (CHD, n=23) and healthy gestational age-matched controls (n=25) were investigated. Hemodynamics were assessed by Doppler examinations. Fetal brain MR images were segmented to get global and regional morphological measurements. Results showed that fetuses with CHD have abnormally higher umbilical artery pulsation index and smaller global and regional brain volumes as early as 20-30 weeks; however, thickness, mean curvature, and sulcal depth of different brain lobes showed no statistical difference from the healthy controls. These results add to growing evidence of antenatal brain abnormalities of the CHD fetuses during the second and early third trimesters.

Cong Sun¹, Jiaguang Song², Yufan Chen¹, Jinxia Zhu³, and Guangbin Wang^1,4
1Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China, ²Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China, ³Siemens Healthineers Ltd, Beijing, China, ⁴Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China, Jinan, China

We measured apparent diffusion coefficient (ADC) values in the brains of 64 normal fetuses at 20-40 gestational weeks and 23 fetuses with complex CHD during second and early third trimesters. We also compared  ADC values between the fetuses with CHD and the 27 gestational age-matched normal controls using covariance analyses. Our results showed normal variations in ADC values for fetal brains during maturation in utero. Moreover, the ADC values in the CHD group were not significantly different than the GA-matched normal fetuses, indicating that myelin development was not delayed in the CHD fetuses during the second and early third trimesters.