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宫内生长受限胎儿大脑不同区域的表观扩散系数

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

作者信息

Moradi Behnaz, Nezhad Zohreh Alibeigi, Saadat Nazanin Seyed, Shirazi Mahboobeh, Borhani Ali, Kazemi Mohammad Ali

机构信息

Department of Radiology, Women's Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Department of Radiology, Medical Imaging Centre, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Pol J Radiol. 2020 Jun 15;85:e301-e308. doi: 10.5114/pjr.2020.96950. eCollection 2020.

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%, < 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 mm/s, = 0.045), thalami (1.205 vs. 1.285 × 10 mm/s, = 0.031) and caudate nucleus (CN) (1.319 vs. 1.394 × 10 mm/s, = 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.

摘要

目的

本研究旨在比较两组宫内生长受限(IUGR)胎儿与对照组不同脑区的表观扩散系数(ADC)值。

材料与方法

使用3T磁共振扫描仪对38例IUGR胎儿和18例孕周相似的正常对照胎儿进行比较。IUGR病例包括23例有临床严重程度体征的胎儿(A组)和15例无临床严重程度体征的胎儿(B组)。在不同脑区测量ADC值并进行组间比较。有脑结构异常的胎儿被排除在研究之外。

结果

所有胎儿的脑结构解剖均正常。与IUGR B组相比,IUGR A组头围(HC)<5%更为常见(56.5%对13.3%,<0.0001)。与正常组相比,IUGR胎儿小脑半球(CH)的ADC值显著降低(1.239对1.280×10⁻³mm²/s,=0.045),丘脑(1.205对1.285×10⁻³mm²/s,=0.031)和尾状核(CN)(1.319对1.394×10⁻³mm²/s,=0.04)。然而,IUGR各亚型之间的ADC值无显著差异。在所有脑区中,脑桥的ADC值最低。

结论

IUGR胎儿丘脑、CN和CH的ADC值显著低于对照胎儿,而IUGR组之间无显著差异。需要进一步研究评估IUGR胎儿ADC变化的预后价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f31/7361370/3c9bffd2145c/PJR-85-41182-g001.jpg

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