Early joint cranial and brain development from fetal and pediatric imaging

项目摘要 儿童早期颅骨和头骨畸形的破坏性影响影响到近25%的婴儿， 单胎妊娠和50%的多胎妊娠。如果没有早期诊断和有效治疗， 这些异常会影响大脑发育，导致认知障碍，颅内压升高， 压力和运动障碍。临床医生有效诊断和治疗这些疾病的能力是 受到两件事的阻碍：首先，对颅骨和大脑如何正常生长和共同生长的理解有限， 第二，缺乏足够灵敏的成像技术来分析关节颅骨和 在健康和异常情况下的大脑发育。为了克服这些局限性， 来自国家儿童医院、洛杉矶儿童医院、布朗的跨学科协作团队 科罗拉多大学和亚利桑那州立大学提出了当前的R 01，旨在开发 第一个出生前后大脑和颅骨发育的规范性联合模型。这项工作是由 该团队之前的强大努力，他们独立收集了大量的，规范的计算数据集， 婴儿和胎儿的断层扫描（CT）和磁共振（MR）图像，并初步实施 工具来分析它们，作为开发新方法的起点，作为该项目的一部分。球队的 这一假设是，区域皮质和颅骨形态的发育将密切相关。它 将使用以下目标进行测试：（1）开发定量成像工具，以模拟健康颅骨 （2）确定婴儿颅骨和皮质形状和厚度的联合发育， 婴儿;（3）建立整个妊娠期胎儿大脑和颅骨生长的初步模型;（4）建立和 为临床医生和研究人员传播方便用户的工具箱。 该项目将是第一个系统的联合健康的颅骨和大脑发育的体内研究之前， 和出生后。因此，它将确定颅骨形状的典型变化及其与大脑的相关性， 参数，根据年龄和性别进行调整。这里生成的规范模型将作为临床资源 用于对患有涉及颅骨形状异常的可疑疾病的个别儿童进行匹配比较。 此外，精确的体内定量成像方法用于评估婴儿的关节颅骨和大脑形状， 将在本项目中开发，并将作为医生更好地评估，诊断， 并计划未来对婴儿颅骨畸形的治疗。

PROJECT SUMMARY The devastating impacts of early-childhood cranial and skull deformities affect nearly 25% of infants from single pregnancies and 50% of those from multiple pregnancies. If not diagnosed early and treated effectively, these abnormalities can impact brain development, leading to cognitive impairment, elevated intracranial pressure, and motor disabilities. Clinicians’ capacity to effectively diagnose and treat these disorders is hindered by two things: first, a limited understanding of how the cranium and brain normally grow and co- develop; and, second, a dearth of imaging techniques that are sensitive enough to analyze joint cranial and brain development in both healthy and abnormal instances. To address these limitations, a strong, interdisciplinary, collaborative team from Children’s National Hospital, Children’s Hospital Los Angeles, Brown University, University of Colorado and Arizona State University proposes the current R01 aimed at developing the first normative joint model of brain and cranium development before and after birth. This work is f ueled by the team’s robust prior efforts, in which they independently collected large, normative datasets of computed tomography (CT) and magnetic resonance (MR) images of infants and fetuses, and implemented preliminary tools to analyze them as a starting point for new methods to be developed as part of this project . The team’s hypothesis is that the development of regional cortical and cranial morphologies will be strongly associated. It will be tested using the following aims: (1) Develop quantitative imaging tools to model healthy cranial development in infants; (2) Determine the joint development of cranial and cortical shape and thickness in infants; (3) Develop a preliminary model of fetal brain and cranial growth across gestation; and (4) Build and disseminate a user-friendly toolbox for clinicians and researchers. This project will be the first systematic in-vivo study of joint healthy cranial and brain development before and after birth. As such, it will determine typical variations of the cranial shape and their correlations with brain parameters, adjusted for age and sex. The normative models generated here will serve as clinical resources for matched comparisons in individual children with suspected disorders that involve abnormal cranial shapes. Additionally, precise in-vivo quantitative imaging methods for assessing joint cranial and brain shape in inf ants will be developed in this project and will serve as invaluable tools for physicians to better assess, diagnose, and plan treatment for infant cranial deformities in the future.