{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:56:40Z","timestamp":1786978600088,"version":"build-2736575974"},"reference-count":66,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","award":["[NS\/A000049\/1; NS\/A000050\/1; NS\/A000027\/1; EP\/L016"],"award-info":[{"award-number":["[NS\/A000049\/1; NS\/A000050\/1; NS\/A000027\/1; EP\/L016"]}],"id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["[203148\/Z\/16\/Z; 203145Z\/16\/Z; WT101957]"],"award-info":[{"award-number":["[203148\/Z\/16\/Z; 203145Z\/16\/Z; WT101957]"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2023,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n Prenatal surgery is offered for selected fetuses with open spina bifida (OSB) to improve long\u2010term outcome. We studied the effect of fetal OSB surgery on brain development using advanced magnetic resonance imaging (MRI) techniques to quantify the volume, surface area and shape of cerebral structures and to analyze surface curvature by means of parameters that correspond to gyrification.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We compared MRI data from 29 fetuses with OSB before fetal surgery (mean gestational age (GA), 23\u2009+\u20093\u2009weeks) and at 1 and 6\u2009weeks after surgery, with that of 36 GA\u2010matched control fetuses (GA range, 21\u2009+\u20092 to 36\u2009+\u20092\u2009weeks). Automated super\u2010resolution reconstruction provided three\u2010dimensional isotropic volumetric brain images. Unmyelinated white matter, cerebellum and ventricles were segmented automatically and refined manually, after which volume, surface area and shape parameter (volume\/surface area) were quantified. Mathematical markers (shape index (SI) and curvedness) were used to measure gyrification. Parameters were assessed according to lesion type (myelomeningocele\n vs<\/jats:italic>\n myeloschisis (MS)), postoperative persistence of hindbrain herniation (HH) and the presence of supratentorial anomalies, namely partial agenesis of the corpus callosum (pACC) and heterotopia (HT).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Growth in ventricular volume per week and change in shape parameter per week were higher at 6\u2009weeks after surgery in fetuses with OSB compared with controls (median, 2500.94 (interquartile range (IQR), 1689.70\u20133580.80)\u2009mm\n 3<\/jats:sup>\n \/week\n vs<\/jats:italic>\n 708.21 (IQR, 474.50\u2013925.00)\u2009mm\n 3<\/jats:sup>\n \/week;\n P<\/jats:italic>\n \u2009<\u20090.001 and 0.075 (IQR, 0.047\u20130.112)\u2009mm\/week\n vs<\/jats:italic>\n 0.022 (IQR, 0.009\u20130.042)\u2009mm\/week;\n P<\/jats:italic>\n \u2009=\u20090.046, respectively). Ventricular volume growth increased 6\u2009weeks after surgery in cases with pACC (\n P<\/jats:italic>\n \u2009<\u20090.001) and those with persistent HH (\n P<\/jats:italic>\n \u2009=\u20090.002). During that time period, the change in unmyelinated white\u2010matter shape parameter per week was decreased in OSB fetuses compared with controls (0.056 (IQR, 0.044\u20130.092)\u2009mm\/week\n vs<\/jats:italic>\n 0.159 (IQR, 0.100\u20130.247)\u2009mm\/week;\n P<\/jats:italic>\n \u2009=\u20090.002), particularly in cases with persistent HH (\n P<\/jats:italic>\n \u2009=\u20090.011), MS (\n P<\/jats:italic>\n \u2009=\u20090.015), HT (\n P<\/jats:italic>\n \u2009=\u20090.022), HT with corpus callosum anomaly (\n P<\/jats:italic>\n \u2009=\u20090.017) and persistent HH with corpus callosum anomaly (\n P<\/jats:italic>\n \u2009=\u20090.007). At 6\u2009weeks postoperatively, despite OSB fetuses having a lower rate of change in curvedness compared with controls (0.061 (IQR, 0.040\u20130.093)\u2009mm\n \u20131<\/jats:sup>\n \/week vs 0.094 (IQR, 0.070\u20130.146)\u2009mm\n \u20131<\/jats:sup>\n \/week;\n P<\/jats:italic>\n \u2009<\u20090.001), reversing the trend seen at 1 week after surgery (0.144 (IQR, 0.099\u20130.236)\u2009mm\n \u20131<\/jats:sup>\n \/week\n vs<\/jats:italic>\n 0.072 (IQR, 0.059\u20130.081)\u2009mm\n \u20131<\/jats:sup>\n \/week;\n P<\/jats:italic>\n \u2009<\u20090.001), gyrification, as determined using SI, appeared to be increased in OSB fetuses overall compared with controls. This observation was more prominent in fetuses with pACC and those with severe ventriculomegaly (\n P<\/jats:italic>\n \u2010value range, <\u20090.001 to 0.006).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Following fetal OSB repair, volume, shape and curvedness of ventricles and unmyelinated white matter differed significantly compared with those of normal fetuses. Morphological brain changes after fetal surgery were not limited to effects on the circulation of cerebrospinal fluid. These observations may have implications for postnatal neurocognitive outcome. \u00a9 2023 The Authors.\n Ultrasound in Obstetrics & Gynecology<\/jats:italic>\n published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.26244","type":"journal-article","created":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T22:06:24Z","timestamp":1683756384000},"page":"707-720","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Assessment of longitudinal brain development using super\u2010resolution magnetic resonance imaging following fetal surgery for open spina bifida"],"prefix":"10.1002","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9839-8085","authenticated-orcid":false,"given":"N.","family":"Mufti","sequence":"first","affiliation":[{"name":"Elizabeth Garrett Anderson Institute for Women's Health University College London London UK"},{"name":"School of Biomedical Engineering and Imaging Sciences (BMEIS) King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Chappell","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences (BMEIS) King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1994-5365","authenticated-orcid":false,"given":"M.","family":"Aertsen","sequence":"additional","affiliation":[{"name":"Department of Radiology University Hospitals Katholieke Universiteit (KU) Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Ebner","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences (BMEIS) King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Fidon","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences (BMEIS) King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4920-945X","authenticated-orcid":false,"given":"J.","family":"Deprest","sequence":"additional","affiliation":[{"name":"Elizabeth Garrett Anderson Institute for Women's Health University College London London UK"},{"name":"Department of Obstetrics and Gynaecology University Hospitals Katholieke Universiteit (KU) Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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