Department of Radiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, PR China.
Fetal Medicine Unit & Prenatal Diagnosis Centre, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, PR China.
Placenta. 2018 Sep;69:26-31. doi: 10.1016/j.placenta.2018.07.001. Epub 2018 Jul 5.
The apparent diffusion coefficient (ADC) was associated with the onset of intrauterine growth restriction in singleton pregnancies. However, the correlation of ADC with selective intrauterine growth restriction (sIUGR) of monochorionic (MC) twin pregnancies remained unknown. In this study, we aimed to evaluate the association of ADC with sIUGR in MC twin pregnancies by exploring diffusion weighted MR imaging (DWI).
Fifty-one MC twin pregnancies, consisting 19 cases of sIUGR and 32 cases without sIUGR, were re-analyzed by DWI. ADCs were quantitated from two regions of interest, surrounding the insertion of the umbilical cord of placenta for each twin. A rADC (ADC/ADC) in each placenta was also evaluated. Then ADCs and rADCs were compared between cases with and without sIUGR.
The ADC in cases with sIUGR was significantly decreased compared with cases without sIUGR (1.846 × 10 vs 2.471 × 10 mm/s, p < 0.001). The rADC in cases with sIUGR was significantly increased (1.346 vs 1.053, p < 0.001).
The ADC decreases and the rADC increases in the placentas of MC twins with sIUGR, suggesting that diffusion in the placenta is restricted in pregnancies with sIUGR.
单胎妊娠中，表观扩散系数（ADC）与宫内生长受限（IUGR）的发生有关。然而，对于单绒毛膜（MC）双胎妊娠中，ADC 与选择性 IUGR（sIUGR）的相关性尚不清楚。本研究旨在通过磁共振弥散加权成像（DWI）评估 ADC 与 MC 双胎妊娠中 sIUGR 的相关性。
对 51 例 MC 双胎妊娠（19 例 sIUGR，32 例非 sIUGR）进行 DWI 再分析。在胎盘脐带插入处周围的两个感兴趣区（ROI）定量 ADC 值。还评估了每个胎盘的相对 ADC（rADC，ADC/ADC）。然后比较 sIUGR 组和非 sIUGR 组之间的 ADC 值和 rADC 值。
与非 sIUGR 组相比，sIUGR 组的 ADC 值明显降低（1.846×10-3mm2/s 比 2.471×10-3mm2/s，p<0.001）。sIUGR 组的 rADC 值明显升高（1.346 比 1.053，p<0.001）。
sIUGR 的 MC 双胎妊娠胎盘 ADC 值降低，rADC 值升高，提示 sIUGR 妊娠胎盘弥散受限。
