Nagaraj Usha D, Dudley Jonathan A, Lam Kristin, Kline-Fath Beth M, Merhar Stephanie L, Mangano Francesco T, Yuan Weihong
Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Prenat Diagn. 2025 Jul;45(8):1045-1052. doi: 10.1002/pd.6835. Epub 2025 Jun 11.
To evaluate differences in diffusion tensor imaging (DTI) parameters in the brain between fetuses with congenital diaphragmatic hernia (CDH) and age-matched controls.
This retrospective IRB-approved study included fetal MRIs for CDH and gestational age (GA) matched controls with lung pathology other than CDH with normal fetal brains. Fetal DTI data were acquired in 15 noncollinear diffusion-weighting directions with the b-value at 600 s/mm (1 b0). Slice-to-volume registration (SVR) was employed to correct for motion artifact.
Twenty-eight controls (27.3 ± 4.1 weeks GA) and 26 CDH (28.1 ± 4.2 weeks GA) fetuses were included. Fractional anisotropy (FA) values were significantly higher (p < 0.05) in CDH fetuses relative to controls in 12 of 50 white matter (WM) regions examined based on ANCOVA controlling for GA. After controlling for GA, sex, and CDH side, FA values in the CDH fetuses had a significant positive correlation with observed-to-expected lung volumes in 20 of 50 WM regions and with percent predicted lung volumes in 29 of 50 WM regions.
Our data demonstrate evidence of microstructural differences based on DTI indices in the brain between CDH fetuses and age-matched controls along with correlation with the degree of pulmonary hypoplasia.
评估先天性膈疝（CDH）胎儿与年龄匹配的对照组胎儿大脑中扩散张量成像（DTI）参数的差异。
这项经机构审查委员会（IRB）批准的回顾性研究纳入了患有CDH的胎儿磁共振成像（MRI）以及与胎龄（GA）匹配、具有除CDH外的肺部病变且胎儿大脑正常的对照组。在15个非共线扩散加权方向上采集胎儿DTI数据，b值为600 s/mm²（1个b0）。采用层到容积配准（SVR）来校正运动伪影。
纳入了28例对照组胎儿（GA为27.3±4.1周）和26例CDH胎儿（GA为28.1±4.2周）。基于协方差分析（ANCOVA）控制胎龄，在检查的50个白质（WM）区域中的12个区域，CDH胎儿的各向异性分数（FA）值相对于对照组显著更高（p<0.05）。在控制胎龄、性别和CDH侧别后，CDH胎儿的FA值在50个WM区域中的20个区域与观察到的与预期肺容积显著正相关，在50个WM区域中的29个区域与预测肺容积百分比显著正相关。
我们的数据表明，基于DTI指标，CDH胎儿与年龄匹配的对照组胎儿大脑存在微观结构差异，且与肺发育不全程度相关。
