DWI in Brains of Fetuses with Congenital Heart Disease: A Case-Control MR Imaging Study

Ren, Jing-Ya; Ji, Hui; Zhu, Ming; Dong, Shumei

doi:10.3174/ajnr.a7267

Cited by 7 publications

(5 citation statements)

References 24 publications

(30 reference statements)

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“…In contrast to earlier findings ( 20 , 30 ), no difference was detected in the mean ADCs of the FWM, TWM, PWM, OWM, CH, centrum semiovale, BGR, TH, and pons between the CHD and GA-matched controls. Although this finding is inconsistent with our hypothesis, it can be explained in several ways.…”

Section: Discussioncontrasting

confidence: 99%

Regional changes in brain apparent diffusion coefficient in fetuses with complex congenital heart disease and normal pregnancy assessed using diffusion-weighted imaging

Song

Zhu

et al. 2023

Front. Neurol.

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ObjectivesTo explore changes in brain apparent diffusion coefficient (ADC) in normal fetuses and fetuses with complex congenital heart disease (CHD) during the second and early third trimesters.MethodsThis single-center prospective study was conducted from May 2019 through October 2021. We measured and compared the mean ADC values between 23 fetuses with CHD and 27 gestational age (GA)-matched controls using covariance analyses. ADC density plots and histograms were used to compare brain characteristics. False-discovery rates (FDR, α = 0.05) correction was used for multiple testing.ResultsThe mean ADC in the frontal white matter, temporal white matter, parietal white matter, occipital white matter, cerebellar hemisphere, central area of the centrum semiovale, basal ganglia region, thalamus, and pons were not significantly different (all p > 0.05). Based on histogram analysis, there were no significant differences between the controls and fetuses with CHD after FDR correction. However, the ADC density plots showed significant heterogeneity between the controls and fetuses with CHD.ConclusionThe mean ADC values and ADC histogram analysis did not differ between the CHD and normal groups. The ADC density plots may provide supplementary information and improve the sensitivity for detecting early brain changes in fetuses with CHD.

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Section: Discussioncontrasting

confidence: 99%

Regional changes in brain apparent diffusion coefficient in fetuses with complex congenital heart disease and normal pregnancy assessed using diffusion-weighted imaging

Song

Zhu

et al. 2023

Front. Neurol.

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“…All ADC measurements were performed manually by the same pediatric neuroradiologist with 5 years of experience in fetal brain MRI. Previous studies have demonstrated good intra- and interobserver reproducibility of this technique ( 6 ). Importantly, the pediatric neuroradiologist was blinded to the fetal sex during ADC measurements to mitigate any potential bias.…”

Section: Methodsmentioning

confidence: 84%

“…Fetal age was determined based on the first day of the last normal menstrual period and confirmed by a first-trimester ultrasound scan. Previously, some findings of ADC analyses on this cohort were published to delineate normative data by gestational age (GA) ( 6 ). However, those analyses did not explore the potential influence of the fetal sex.…”

Section: Methodsmentioning

confidence: 99%

“…The diagnostic value of diffusion-weighted imaging (DWI) in fetal brain imaging has been established for acute conditions, such as hypoxic–ischemic insults, chronic fetal pathologies, and congenital heart diseases, that impact the normal brain development and maturation ( 5 , 6 ). Apparent diffusion coefficient (ADC) values can be used as a quantitative measure of water diffusion in fetal brain tissues ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

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Sex differences in normal fetal regional brain apparent diffusion coefficient changes assessed by in utero DWI

Ren,

Zhu,

Dong

2024

Front. Pediatr.

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ObjectiveThere are differences in the vulnerability of male and female fetal brains to adverse intrauterine exposure, preterm birth, and associated perinatal brain injury. The main objective of this study was to identify any statistically significant difference in the change of apparent diffusion coefficient (ADC) in the intracranial regions of male and female fetuses in the second and third trimesters.MethodsDiffusion-weighted imaging (DWI) was performed in 200 fetuses between 20 and 37 gestational ages (GA) with normal results or suspicious results on sonography followed by structural MRI. Pairwise ADC values of the regions of interest (ROIs) were manually delineated on either side of the cerebral white matter: frontal white matter (FWM), parietal white matter (PWM), occipital white matter (OWM), temporal white matter (TWM), basal ganglia (BG), thalamus (THA), cerebellar hemisphere (CBM), and a single measurement in the pons. The changes in these values were studied over the gestational range, along with potential sex differences and asymmetries of the cerebral hemispheres.ResultsDuring the third trimester, ADC values in OWM, TWM, and CBM were significantly higher in male fetuses than those in female fetuses (p < 0.05). After the correction of false-discovery rates (FDR), the difference in CBM was the only statistically significant (p = 0.0032). However, the decreased rate of ADC values in male fetuses in CWM (except for FWM), BG, THA, CBM, and pons was higher than that in female fetuses during the second and third trimesters.ConclusionsWe have shown some differences in the intracranial regional ADC changes between male and female fetuses using in utero DWI during the second and third trimesters.

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“…membrane oxygenation (ECMO), possible cardiac arrest, prolonged mechanical ventilation and hospitalization, congenital central nervous system abnormalities, and chromosomal or genetic abnormalities [7][8][9][10][11][12][13][14][15][16] . Prolonged perioperative hypoxemia is specifically associated with attentional and executive deficits and may be responsible for damage in the oxygen sensitive regions of the prefrontal cortex 8,17,18 .…”

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confidence: 99%

Altered white matter connectivity in children with congenital heart disease with single ventricle physiology

Williamson

Barnes‐Davis

Vannest

et al. 2023

Sci Rep

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Children born with congenital heart disease (CHD) have seen a dramatic decrease in mortality thanks to surgical innovations. However, there are numerous risk factors associated with CHD that can disrupt neurodevelopment. Recent studies have found that psychological deficits and structural brain abnormalities persist into adulthood. The goal of the current study was to investigate white matter connectivity in early school-age children (6–11 years), born with complex cyanotic CHD (single ventricle physiology), who have undergone Fontan palliation, compared to a group of heart-healthy, typically developing controls (TPC). Additionally, we investigated associations between white matter tract connectivity and measures on a comprehensive neuropsychological battery within each group. Our results suggest CHD patients exhibit widespread decreases in white matter connectivity, and the extent of these decreases is related to performance in several cognitive domains. Analysis of network topology showed that hub distribution was more extensive and bilateral in the TPC group. Our results are consistent with previous studies suggesting perinatal ischemia leads to white matter lesions and delayed maturation.

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DWI in Brains of Fetuses with Congenital Heart Disease: A Case-Control MR Imaging Study

Cited by 7 publications

References 24 publications

Regional changes in brain apparent diffusion coefficient in fetuses with complex congenital heart disease and normal pregnancy assessed using diffusion-weighted imaging

Regional changes in brain apparent diffusion coefficient in fetuses with complex congenital heart disease and normal pregnancy assessed using diffusion-weighted imaging

Sex differences in normal fetal regional brain apparent diffusion coefficient changes assessed by in utero DWI

Altered white matter connectivity in children with congenital heart disease with single ventricle physiology

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