Apparent diffusion coefficient of different areas of brain in foetuses with intrauterine growth restriction

Abstract

Purpose: This study aimed to compare the apparent diffusion coefficient (ADC) values of different brain areas between two groups of intrauterine growth restricted (IUGR) foetuses and control cases. Material and methods: A total of 38 foetuses with IUGR and 18 normal control foetuses with similar gestational age were compared using a 3T magnetic resonance scanner. IUGR cases included 23 foetuses with clinical severity signs (group A) and 15 foetuses without clinical severity signs (group B). ADC values were measured in different brain regions and compared among groups. Foetuses with structural brain abnormalities were excluded from the study. Results: All foetuses had normal foetal structural brain anatomy. Head circumference (HC) < 5% was more common in IUGR group A compared to IUGR group B (56.5% vs. 13.3%, p < 0.0001). In comparison to the normal group, the ADC values in IUGR foetuses were significantly lower in cerebellar hemispheres (CH) (1.239 vs. 1.280.5 × 10-3 mm 2 /s, p = 0.045), thalami (1.205 vs. 1.285 × 10-3 mm 2 /s, p = 0.031) and caudate nucleus (CN) (1.319 vs. 1.394 × 10-3 mm 2 /s, p = 0.04). However, there were no significant differences in ADC values between IUGR subtypes. Among all brain regions, pons had the lowest ADC values. Conclusions: ADC values of thalami, CN, and CH were significantly lower in IUGR than control foetuses, while there was no significant difference among IUGR groups. Further studies are needed to evaluate the prognostic value of ADC changes in IUGR foetuses.

Early detection of ischemic brain injuries by diffusion‐weighted imaging after radiofrequency ablation for fetal reduction in monochorionic pregnancies

“…According to the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) guidelines, fetal brain evaluation of the surviving twin is necessary 4–6 weeks after reduction due to a higher prevalence of hypoxic‐ischemic brain injuries in MC pregnancies complicated with IUFD of one twin. Performing intrauterine brain MRI is also recommended between 30 and 32 weeks of gestation to check for chronic hypoxic‐ischemic brain injuries 26,34–36 . It should also be considered that although ultrasound and conventional MRI enable us to detect cerebral ischemic changes after two weeks, DWI could detect intracranial abnormalities such as ischemic and hemorrhagic changes earlier compared to conventional T2‐weighted imaging 22,33,37 …”

“…Performing intrauterine brain MRI is also recommended between 30 and 32 weeks of gestation to check for chronic hypoxic-ischemic brain injuries. 26,[34][35][36] It should also be considered that although ultrasound and conventional MRI enable us to detect cerebral ischemic changes after two weeks, DWI could detect intracranial abnormalities such as ischemic and hemorrhagic changes earlier compared to conventional T2-weighted imaging. 22,33,37 There are several studies regarding the detection of intracranial ischemic lesions of the surviving twin on ultrasound and MRI in multiple pregnancies with IUFD of a single twin.…”

Postmortem Magnetic Resonance Imaging of In Utero Fetuses and Its Relationship With Postmortem Interval: A Multi‐Organ Observational Study on Reduced Fetuses of Complicated Multiple Pregnancies

“…17 However, previous studies have suggested that FGR might affect the brain ADC values independently. 11,18 Shelmerdine et al performed MRI on 14 neonatal deaths and 66 stillbirths. 19 They evaluated ADC values of several organs and found that they were associated with the degree of maceration, but not with the PM interval.…”

Differences in the Brain Cortical Thickness and Area of Different Lobes Between Fetuses with Intrauterine Growth Restriction and Controls Based on 3-Tesla Magnetic Resonance Imaging (MRI)

“…The use of magnetic resonance imaging (MRI) has recently increased the possibility of determining structural and morphometric differences in the brain structure of IUGR and appropriate for gestational age (AGA) fetuses (1,2). According to previous research, the patterns of brain abnormalities associated with IUGR remain unknown (11,12).…”