Multiparametric prenatal imaging characterization of fetal brain edema in Chiari II malformation might help to select candidates for fetal surgery

ConclusionsBrain edema in fetuses with Chiari II is common and radiologically detectable on T2-weighted fetal MRI sequences, and DTI-based FA values and radiomics features provide further evidence of microstructure differences between subgroups with and without edema.Clinical relevance statementA more severe phenotype of fetuses with Chiari II malformation is characterized by prenatal brain edema and more postnatal clinical morbidity and disability. Fetal brain edema is a promising prenatal MR imaging biomarker candidate for optimizing the risk-benefit evaluation of selection for fetal surgery.Key PointsBrain edema of fetuses prenatally diagnosed with Chiari II malformation is a common, so far unknown, association.DTI metrics and radiomics confirm microstructural differences between the brains of Chiari II fetuses with and without edema.Fetal brain edema may explain worse motor outcomes in this Chiari II subgroup, who may substantially benefit from fetal surgery.Graphical Abstract
Source: European Radiology - Category: Radiology Source Type: research