Fetal MRI is an exciting, rapidly evolving field due to the use of advanced motion correction protocols and the advent of functional imaging. These have enabled assessment of not only fetal anatomy but also tissue function.
Necrotising Enterocolitis (NEC) is a devastating condition which can affect premature and low birthweight infants. Gut tissue becomes inflamed and can die, causing significant morbidity and even mortality for neonates. Currently it is difficult to predict which fetuses may subsequently develop NEC. The ability to do this may enable different feeding protocols to be initiated after birth thereby reducing the incidence of NEC.
We propose that advanced MRI and post processing protocols applied to the fetal bowel such as:
– T2* imaging, which harness the fact oxygenated and deoxygenated haemoglobin have different paramagnetic properties thereby providing an indirect assessment of perfusion
– diffusion imaging which can assess tissue microstructure
– combined T2*diffusion protocols which may give insight into tissue inflammation
– motion correction and alignment of diffusion and T2* data to anatomical images allowing quantification of functional data from selected regions of the bowel
may prove to be a more effective way to predict subsequent NEC in fetuses known to have growth restriction or are at high risk of preterm delivery.
We have experience of using these techniques for assessment of the placenta, fetal lungs, thymus and brain. Using>300 existing datasets as well as prospective data from uncomplicated pregnancies, and those at high risk of NEC, this project will assess the fetal bowel using advanced MRI techniques and correlate findings with neonatal outcomes.
Year 1-2: analysis of existing datasets, optimisation of data acquisition and post processing
Year 3: data analysis and correlation with neonatal outcomes
Dr Story is a Clinical Academic and Prof Hajnal an Engineer and will provide supervision in the above areas.