New MRI scans of babies in the womb
This research was completed on 3 June 2009
Published on 31 January 2007
In theory, MRI scans during pregnancy have the potential to provide extremely detailed images of an unborn baby’s brain. But currently, movement of the baby during the scanning procedure seriously reduces image quality. Researchers are developing ways to overcome the babies’ movement, to provide superior quality images. This could improve both the ability to diagnose a problem and to reassure parents whose babies seem healthy.
What's the problem and who does it affect?
Ultrasound scans provide valuable information on the state of health of unborn babies in their mother’s womb. We have relied on this technique, which was developed with help from Action Medical Research, for over 30 years.
More recently, doctors have started to take MRI scans of some unborn babies, particularly if ultrasound scans raise suspicions that the baby has a brain injury or its brain is developing abnormally. MRI has the potential to provide additional information that’s even more detailed than ultrasound. It is already well established as a powerful tool for diagnosing abnormalities in the brains of adults.
The success of the scanning procedure relies on the patient staying totally still – a typical high-resolution, 3D scan of an adult’s brain takes up to 10 minutes. But it’s obviously impossible to tell an unborn baby to stay still. The babies’ unpredictable movements in the womb mean that only poorer quality, 2D snapshots can generally be obtained, and even this is very time consuming.
Without full information from MRI scans, subtle but important abnormalities may therefore be missed. These include genetic malformations, bleeds in the brain, and early signs that brain tissue has been starved of oxygen, which can occur if the mother is ill or injured, or following the death of one twin.
What is the project trying to achieve?
Better quality MRI images
In pilot studies, the research team has developed a radical new way of producing higher resolution, 3D MRI images of babies’ brains while they’re in the womb, all without needing to spend overly lengthy times in the scanner. The new MRI scans also provide hitherto unobtainable measures of the size of different parts of the brain.
The technique involves taking high-resolution scans of a series of thin ‘slices’ through the brain, and then building up a 3D image by automatically realigning the slices to correct for the baby’s movements.
In this project, researchers aim to develop the new technique for routine clinical use. They are performing about 400 brain scans of babies in the womb, with full parental consent, and then following the babies’ progress by taking further scans after birth. They are also comparing the images of unborn babies with MRI scans of premature babies, to provide invaluable insight into how premature birth affects the brain’s development.
What are the researchers' credentials?
|Project Leader||Professor M A Rutherford MD FRCPCH FRCR|
|Location||Imaging Sciences Department, Imperial College London, London and the Centre for Fetal Care, Queen Charlotte's & Chelsea Hospital, London|
|Grant awarded||31 October 2006|
|Start date||1 May 2007|
|End date||3 June 2009|
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The project team has a superb track record in developing new techniques for taking MRI scans of the most premature and vulnerable newborn babies. The project leader, Professor Mary Rutherford, edited a prize-winning textbook on MR imaging of newborns in 2002 – the first book of its kind.
The team’s more recent successes in developing new ways of taking MRI scans of unborn babies within the womb has been helped by the multidisciplinary environment in which they work, and the large number of pregnant women who are referred to the excellent fetal care unit at Queen Charlotte’s Hospital. The state-of-the-art facilities at the team’s disposal, which include three research scanners, are unique worldwide.
Who stands to benefit from this research and how?
Tremendous benefits of improved image quality
Each year in the UK, nearly 30,000 babies are born with a birth defect.1 The researchers working on this project envisage that the ability to take better MRI scans during pregnancy has the potential to help these babies, particularly if the baby’s brain is affected.
Both the babies, and their parents, stand to benefit. The new MRI scans could provide vital extra information during pregnancy, which may help doctors diagnose the baby’s problem, predict how it may affect them in the future, and decide what sort of specialist care the baby may need, both during pregnancy and after birth. For example, for certain abnormalities within the brain, doctors may recommend delivering the baby by caesarean section, as this may stop the process of labour from causing further damage to the brain. They may also consider delivering the baby early. With more detailed information from MRI scans, expectant parents could be spared the stress of going through a pregnancy with uncertainties over their baby’s health.
The new MRI scans will also boost understanding of how babies’ brains normally develop during pregnancy, and how illnesses can affect this development, both during pregnancy or after premature birth.
- March of Dimes. Global Report on Birth Defects. The Hidden Toll of Dying and Disabled Children. 2006. See the report’s Wallchart, by Christianson A, Howson CP and Modell B at http://mod.hoffmanpr.com/MOD-WallChart.pdf