Contribution of Diffusion-Weighted Imaging in the Evaluation of Diffuse White Matter Ischemic Lesions in Fetuses: Correlations with Fetopathologic Findings

Guimiot, Fabien; Garel, Catherine; Fallet-Bianco, C; Ménez, F.; Khung‐Savatovsky, Suonavy; Oury, Jean‐François; Sebag, G.; Delezoïde, Anne Lise

doi:10.3174/ajnr.a0754

Cited by 56 publications

(53 citation statements)

References 17 publications

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“…DWI patterns have been characterised in the normal fetal brain,32 but unlike in neonates, a chronic rather than acute pattern of ischaemic change is seen, with a likely increase in the ADC. As yet, the prognosis of white matter abnormalities with a raised ADC is unknown, although they correlate strongly with fetopathologic findings of cerebral oedema with astrogliosis 33. If earlier lesions are found to have improved outcomes, the technique could play an important role in the prevention of disorders such as cerebral palsy.…”

Section: Alternative Fetal Mri Techniquesmentioning

confidence: 99%

The role of fetal magnetic resonance imaging

Wright

Sibley

Baker

2009

Archives of Disease in Childhood - Fetal and Neonatal Edition

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The role of magnetic resonance imaging (MRI) in fetal imaging is expanding. The depth of structural information provided by MRI means it is more than just a useful adjunct to ultrasound, as several structures are more clearly visualised and many of the limitations of ultrasound are avoided. Currently, MRI is most frequently utilised with reference to the fetal central nervous system and is valuable in ventriculomegaly, agenesis of the corpus callosum and posterior fossa abnormalities. Outside this, MRI remains primarily a research tool; there is increasing interest in applying it to thoracic abnormalities and also scope for development in other niche areas. MRI is able to accurately determine fetal organ volumes and weight, although whether such measurements could play a role in conditions such as fetal growth restriction, has yet to be fully established. Techniques such as diffusion weighted imaging, magnetic resonance spectroscopy and functional imaging are also being remodelled for use in the fetus, improving our knowledge of in utero metabolism and development.

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Section: Alternative Fetal Mri Techniquesmentioning

confidence: 99%

The role of fetal magnetic resonance imaging

Wright

Sibley

Baker

2009

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…This imaging modality has been widely used to assess central nervous system diseases in children and adults [1,2,3,4]. Currently, fetal brain DWI has focused on quantitative studies about normal fetal brain development and is becoming a useful method to assess fetal brain structure in pathological conditions [5,6,7,8,9,10,11]. However, it is still not clear whether the ADC value could be useful to quantitatively assess changes in brain development due to pathological conditions.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Apparent Diffusion Coefficient of Normal Fetal Brain Development from Gestational Age Week 24 Up to Term Age: A Preliminary Study

Han

Huang²,

Sun

et al. 2014

Fetal Diagn Ther

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Objectives: This study was designed to investigate the feasibility of apparent diffusion coefficient (ADC) values in evaluating normal fetal brain development from gestational week 24 up to term age. Methods: Diffusion-weighted imaging (DWI) was performed on 40 normal fetuses (with normal results on sonography and normal fetal MRI results), with two b-values of 0 and 600 s/mm² in the three (x, y, z) orthogonal axes. Ten regions of interest (ROIs) were manually placed symmetrically in the bilateral frontal white matter (FWM), occipital white matter (OWM), thalamus (THAL), basal ganglia (BG), and cerebellar hemispheres (CH). ADC values of the ten ROIs in all subjects were measured by two radiologists independently. One-way ANOVA was used to calculate the differences among the five regions in the fetal brain and linear regression analysis was used to evaluate the correlation between ADC values and gestational age (GA). p < 0.05 was considered significantly different. Results: Mean GA was 31.3 ± 3.9 (range 24-41) weeks. The overall mean ADC values (×10^-6 mm²/s) of the fetuses were 1,800 ± 214 (FWM), 1,400 ± 100 (BG), 1,300 ± 126 (THAL), 1,700 ± 133 (OWM) and 1,400 ± 155 (CH), respectively. The ADC value of BG was not significantly different from those of THAL and CH, while the other four ROIs had significant differences with each other. The ADC values of BG, THAL, OWM and CH had strong negative correlations with increasing GA (R were -0.568, -0.716, -0.830 and -0.700, respectively, all p < 0.01), OWM declined fastest with GA, followed by CH and THAL, the slowest being BG. The ADC value of FWM had no significant change with GA (p = 0.366). Conclusions: The measurement of ADC values is feasible to evaluate fetal brain development with high reliability and reproducibility.

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“…6,7 Diffusion-weighted imaging (DWI) technique is commonly used for fetal imaging. 8,9 It also seems to be a promising technique for assessing placental function because no contrast agent is needed. The apparent diffusion coefficient (ADC) is the most commonly used parameter and reflects cellular structure of the tissue.…”

mentioning

confidence: 99%