Research

Quantifying Volumetric Differences in Infants with Hydrocephalus

Abstract

Hydrocephalus is the abnormal accumulation of cerebrospinal fluid which results in the dilation of the cerebral ventricles and is often associated with intraventricular pressure. Hydrocephalus occurs in ~1 in 1136 live births. Infants often present with symptoms such as irritability, lethargy, vomiting, a bulging of fontanelle, and above percentile head circumference. If left untreated, hydrocephalus can potentially lead to death. Currently, pediatric hydrocephalus diagnosis is more dependent on interpretation of anatomical changes rather than clinical exams. Three pediatric patients with enlarged ventricles were recruited from M Health and underwent structural MRIs. An additional participant with an enlarged ventricle was identified from an incidental finding in the Baby Connectome Project (BCP). For these four cases, MRI scans from age-matched healthy controls were also pulled from the BCP. An open-source deep-learning  model (BIBSNet) was utilized to create full brain segmentations. These segmentations were manually corrected with ITK-SNAP for the participants with enlarged ventricles, as current segmentation models do not perform well on patients with enlarged ventricles. Then volumetric data for cortical and select subcortical structures and regions (Lateral Ventricle, Inferior Lateral Ventricle, Cerebral White Matter, Cerebral Cortex, Thalamus, Caudate Nucleus, Hippocampus, Amygdala) were pulled and compared between clinical patients and age-matched healthy controls. Comparisons found that there are differences in cortical and subcortical volume metrics between typically developing infants and the infants with either the enlarged ventricle, ventriculomegaly, and hydrocephalus infants above and beyond the expected differences in ventricle volume. By further quantifying and understanding differences between these clinical infants and the healthy control infants, we can work to better understand the full effects of hydrocephalus on brain development which can be influential in research and eventually clinical settings.