Wang Aonan, Huo Ran, Wei Yuan, Guo Xiaoyue, Wang Zheng, Zhao Qiang, Liu Ying, Yuan Huishu
Department of Radiology, Peking University Third Hospital, Beijing, 100191, China.
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China.
BMC Med Imaging. 2025 Mar 3;25(1):70. doi: 10.1186/s12880-025-01609-0.
Single intrauterine fetal death (sIUFD) will lead to an increased risk of adverse events such as fetal brain abnormalities in the survivor. However, how to detect these anomalies in the early stages remains to be explored.
To compare apparent diffusion coefficient (ADC) values of fetal brain in cases of single intrauterine fetal death (sIUFD) with twins control and singleton control using diffusion weighted imaging (DWI), and to perform follow-up study to reveal the underlying cerebral microstructure changes.
In this prospective MRI-based cohort study, we compared 43 surviving fetuses of sIUFD (18 following selective fetal reduction, 2 following laser ablation treatment for twin-to-twin transfusion syndrome, and 23 spontaneous) with 2 control cohorts ( 43 healthy twin fetuses, 43 singletons). All fetuses underwent fetal brain MRI. DWI was performed and ADC map was reconstructed. ADC values of certain regions were compared among the three groups.
ADC values were lower in bilateral white matter of frontal, parietal, temporal lobes and cerebellum in surviving fetuses compared with twins control and singleton control, respectively. ADC values of bilateral basal ganglia, thalamus and cerebellum in surviving fetuses, that of bilateral frontal lobes, cerebellum in twins control and that of right temporal lobe, left basal ganglia, and bilateral cerebellum in singleton control, were negatively correlated with gestational age. ADC values of left cerebellum in surviving fetuses were positively correlated with interval time.
DWI is a very useful sequence for detecting underlying changes. ADC value might be a effective indicator of subtle anomalies in surviving fetuses.
单胎宫内胎儿死亡（sIUFD）会增加存活胎儿出现诸如脑异常等不良事件的风险。然而，如何在早期阶段检测这些异常仍有待探索。
使用扩散加权成像（DWI）比较单胎宫内胎儿死亡（sIUFD）病例中胎儿脑的表观扩散系数（ADC）值与双胎对照和单胎对照，并进行随访研究以揭示潜在的脑微观结构变化。
在这项基于MRI的前瞻性队列研究中，我们将43例sIUFD存活胎儿（18例为选择性减胎后，2例为双胎输血综合征激光消融治疗后，23例为自然发生）与2个对照队列（43例健康双胎胎儿、43名单胎胎儿）进行比较。所有胎儿均接受胎儿脑MRI检查。进行DWI并重建ADC图。比较三组中特定区域的ADC值。
与双胎对照和单胎对照相比，存活胎儿额叶、顶叶、颞叶和小脑的双侧白质ADC值较低。存活胎儿双侧基底节、丘脑和小脑的ADC值，双胎对照双侧额叶、小脑的ADC值，以及单胎对照右侧颞叶、左侧基底节和双侧小脑的ADC值与胎龄呈负相关。存活胎儿左侧小脑的ADC值与间隔时间呈正相关。
DWI是检测潜在变化的非常有用的序列。ADC值可能是存活胎儿细微异常的有效指标。
