25-39 孕周胎儿脑发育的初步研究：应用体素内不相干运动扩散加权成像。
Fetal brain development at 25-39 weeks gestational age: A preliminary study using intravoxel incoherent motion diffusion-weighted imaging.
机构信息
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Shaanxi, China.
Student Brigade, Fourth Military Medical University (Air Force Medical University), Shaanxi, China.
出版信息
J Magn Reson Imaging. 2019 Sep;50(3):899-909. doi: 10.1002/jmri.26667. Epub 2019 Jan 24.
BACKGROUND
The fetal brain developmental changes of water diffusivity and perfusion has not been extensively explored.
PURPOSE/HYPOTHESIS: To evaluate the fetal brain developmental changes of water diffusivity and perfusion using intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI).
STUDY TYPE
Prospective.
POPULATION
Seventy-nine normal singleton fetuses were scanned without sedation of healthy pregnant women.
FIELD STRENGTH/SEQUENCE: 5 T MRI/T / -weighted image and IVIM-DWI.
ASSESSMENT
Pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) values were calculated in the frontal (FWM), temporal (TWM), parietal (PWM), and occipital white matter (OWM) as well as cerebellar hemisphere (CH), basal ganglia region (BGR), thalamus (TH), and pons using an IVIM model.
STATISTICAL TESTS
One-way analysis of variable (ANOVA) followed by Bonferroni post-hoc multiple comparison was employed to reveal the difference of IVIM parameters among the investigated brain regions. The linear and the nonlinear polynomial regression analyses were utilized to reveal the correlation between gestational age (GA) and IVIM parameters.
RESULTS
There were significant differences in both D (F(7,623) = 96.64, P = 0.000) and f values (F(7,623) = 2.361, P = 0.0219), but not D* values among the varied brain regions. D values from TWM (r = 0.1402, P = 0.0002), PWM (r = 0.2245, P = 0.0002), OWM (r = 0.2519, P = 0.0002), CH (r = 0.2245, P = 0.0002), BGR (r = 0.3393, P = 0.0001), TH (r = 0.1259, P = 0.0001), and D* value from pons (r = 0.2206, P = 0.0002) were significantly correlated with GA using linear regression analysis. Quadratic regression analysis led to results similar to those using the linear regression model.
DATA CONCLUSION
IVIM-DWI parameters may indicate fetal brain developmental alterations but the conclusion is far from reached due to the not as high-powered correlation between IVIM parameters and GA.
LEVEL OF EVIDENCE
2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:899-909.
背景
胎儿脑水弥散和灌注的发育变化尚未得到广泛研究。
目的/假设：使用体素内不相干运动扩散加权成像（IVIM-DWI）评估胎儿脑发育的水弥散和灌注变化。
研究类型
前瞻性。
人群
79 名正常单胎胎儿在健康孕妇未镇静的情况下进行扫描。
磁场强度/序列：5T MRI/T2-加权图像和 IVIM-DWI。
评估
在额（FWM）、颞（TWM）、顶（PWM）和枕叶白质（OWM）以及小脑半球（CH）、基底节区（BGR）、丘脑（TH）和脑桥中计算纯扩散系数（D）、假性扩散系数（D*）和灌注分数（f）值，使用 IVIM 模型。
统计学检验
采用单因素方差分析（ANOVA），然后进行 Bonferroni 事后多重比较，以显示各研究脑区 IVIM 参数的差异。线性和非线性多项式回归分析用于揭示 GA 与 IVIM 参数之间的相关性。
结果
不同脑区的 D（F（7,623）=96.64，P=0.000）和 f 值（F（7,623）=2.361，P=0.0219）差异有统计学意义，但 D值差异无统计学意义。TWM（r=0.1402，P=0.0002）、PWM（r=0.2245，P=0.0002）、OWM（r=0.2519，P=0.0002）、CH（r=0.2245，P=0.0002）、BGR（r=0.3393，P=0.0001）、TH（r=0.1259，P=0.0001）和 D值来自脑桥（r=0.2206，P=0.0002）的 D 值与 GA 之间存在显著的线性相关性。二次回归分析得出的结果与线性回归模型相似。
数据结论
IVIM-DWI 参数可能提示胎儿脑发育改变，但由于 IVIM 参数与 GA 之间的相关性不高，结论还远远不够。
证据水平
2 技术功效阶段：2 J. Magn. Reson. Imaging 2019;50:899-909.
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