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3D Reconstructions of the Cerebral Ventricles and Volume Quantification in Children with Brain Malformations

Posted Apr 30, 2009 Updated Apr 7, 2023
By Frederik L. Giesel MD MBA , Anthony R. Hart MBChB , Horst K. Hahn PhD , Emma Wignall PhD , Fabian Rengier BSc , Rol Talanow MD PhD , Iain D. Wilkinson PhD , Christian M. Zechmann MD , Marc-Andrè Weber MD MSc , H.U. Kauczor MD PhD , Marco Essig MD , Paul D. Griffiths MBChB PhD
6 min read

Rationale and Objectives

The aim of this study was to assess the ability of a semiautomated process to produce three-dimensional reconstructions of the ventricles and calculate ventricular volumes from magnetic resonance (MR) imaging data in children with structural brain abnormalities.

Materials and Methods

Fourteen children referred for MR imaging of the brain for neurologic symptoms were selected. Seven participants had structural brain abnormalities on MR imaging; seven further participants were age-matched controls with normal brain morphology. MR imaging included T1-weighted volumetric images in all cases. Semiautomated postprocessing techniques were performed on the MR imaging data to generate three-dimensional reconstructions of the ventricles. These were analyzed for morphologic changes, and volumes were calculated. Inter- and intrarater agreement of ventricular volumes were calculated.

Results

This technique produced detailed three-dimensional reconstructions of the ventricles, even in children with grossly abnormal ventricular morphology. All MR imaging data were successfully postprocessed in <5 minutes. Inter- and intrarater reliability was excellent, with correlation coefficients of 0.99 and 0.92, respectively.

Conclusion

This methodology can create detailed three-dimensional visualizations and volumetric measurements of morphologically abnormal ventricles. This technique could help physicians and parents comprehend abnormal ventricular anatomy better and may have future clinical uses in monitoring disease progression or neurosurgical planning.

There are many congenital abnormalities affecting the structure of children’s brains. Acquired brain injuries are also seen in childhood, including those associated with premature birth, hypoxic ischemic encephalopathy, or neurodegenerative disorders. Many of these conditions are associated with abnormal ventricular anatomy.

Outside the neonatal period, magnetic resonance (MR) imaging has become the first-line method of investigating developmental brain abnormalities . One valuable sequence in that assessment is the T1-weighted volume acquisition of the whole brain. This can be acquired relatively quickly, with high morphologic and contrast resolution. These data can be manipulated in many different ways. Reformations can be made in orthogonal, nonorthogonal, or nonlinear planes at its simplest. At its most complex, cortical surface reconstructions and segmentation can be produced, generating gray-matter and white-matter maps for volumetric assessments of both structures .

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Material and methods

Subjects

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MR Imaging

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Postprocessing and Three-dimensional Ventricular Visualization

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Results

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Table 1

Measured Ventricular Volumes of the 14 Children Studied (seven with ventricular abnormalities and seven age-matched controls)

Brain Malformation Type Ventricular Volume of Abnormal Brain (mm 3 ) Ventricular Volume of Age-Matched Patient (mm 3 ) Age (y) Lissencephaly 54.3 6.5 2 Semilobar holoprocephaly 224.5 10.4 5 Unilateral polymicrogyria 25.1 11.2 5 Closed-lip schizencephaly 74.7 12.5 9 Agenesis of corpus callosum 66.3 13.7 9 Hemimegalencephaly 45.5 13.8 10 Subependymal heterotopia 50.3 19.4 14

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Figure 1, Images from a child with polymicrogyria and a normal ventricular system. T1 volume data reconstructed in the axial plane (a) shows the abnormal cleft of gray matter in the right hemisphere on routine imaging. Lateral (b) , anterior (c) , and inferior (d) views of the ventricular “cast” confirm a normal configuration of the ventricles.

Figure 2, A child with multifocal subependymal heterotopia and a persistent cavum septum pellucidum shown on the coronal in turkey color reconstruction of the T1 volume data (a) . Lateral (b) , anterior (c) , and inferior (d) projections of the ventricular “casts” show indentations in the ventricular contour produced by the heterotopia (arrows) . Note that the cavum septum pellucidum has been recognized as a separate structure by the software algorithm.

Figure 3, A child with closed-lip schizencephaly of the left hemisphere shown on an axial reconstruction of the T1 volume data (a) . Posterior (b) , superior (c) , and inferior (d) views of the ventricular “cast” show the nipplelike deformity of the body of the left lateral ventricle (arrows) , indicating where the cleft joins the ventricular system.

Figure 4, A child with agenesis of the corpus callosum shown on a sagittal reconstruction of the T1 volume data (a) . Lateral (b) , anterior (c) , and superior (d) projections of the ventricular “casts” shows colpocephaly, high-riding third ventricle, and lateral ventricles separated by the Probst bundles, characteristic of agenesis of the corpus callosum. Note the large massa intermedia on the T1 image and lateral projection of the ventricles (arrow) .

Figure 5, A child with Dandy-Walker malformation shown on a sagittal reconstruction of the T1 volume data (a) . This child also had extensive bilateral frontal polymicrogyria (not shown). Lateral (b) , anterior (e) , and inferior (d) views of the ventricular “casts” show gross hydrocephalus and a patulous fourth ventricle. Additionally, a three-dimensional print of the three-dimensional ventricular system was created and visually compared to the three-dimensional visualization and the two-dimensional source images (c,f) .

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Discussion

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Academic Radiology, Volume 16, Issue 5
Journals General Radiology
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