Surface reconstructions of foetal brain abnormalities using ultrafast steady state 3D acquisitions

MRI of the foetal brain in utero is performed in routine clinical practice using sequences that produce two-dimensional (2D) images. Recent developments in image post-processing have allowed the construction of three-dimensional (3D) volume data sets from 2D images acquired in different anatomical planes, but these have limitations due to the unpredictable nature of foetal movement. These limitations have been overcome by development of several different advanced computer techniques, which require specialist knowledge, software, and processing methods, which are rarely available in routine clinical settings. Our aim was to develop a technique that can be used in routine clinical situations without the need for custom-developed or expensive software by utilizing MRI sequences that can produce a 3D data set in “ultrafast” timescales. The 3D dataset, combined with versatile image post-processing and visualization techniques, has resulted in the production of high-resolution images of foetal brain surfaces in utero. The aim of this paper is to demonstrate our methods and early results by way of a pictorial review illustrating a range of developmental brain disease in utero.