Xia Bingqing, Jiang Ling, Qian Zhaoxia, Qu Feifei, Wu Jiangjie, Wei Hongjiang, Sun Taotao
The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China.
Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China.
Pediatr Radiol. 2025 Nov;55(12):2539-2549. doi: 10.1007/s00247-025-06373-5. Epub 2025 Aug 26.
Small-for-gestational-age (SGA) pregnancy is often associated with impaired placental function, which would lead to neurodevelopmental deficits.
To utilize the geometric properties of cortical development for quantitative analysis of the relationship between impaired placental function and fetal brain development in pregnancies with SGA fetuses.
This retrospective study included 41 pregnant women with appropriate gestational age (GA) (range, 23-38.6 weeks) and 26 pregnant women with SGA pregnancies (range, 23.3-36.3 weeks). After the exclusion of 25 participants with normal fetal brain data but noticeable motor artifacts, 29 fetal brains from the normal group and 16 fetal brains from the SGA group were included in this analysis. Examinations were conducted using a 1.5-T magnetic resonance imaging (MRI) system. Fetal brain cortical thickness and regional volume were calculated for each participant according to a standardized anatomical atlas. Placental intravoxel incoherent motion (IVIM) imaging and T2* mapping were performed. IVIM parameters (perfusion fraction (f), perfusion diffusivity coefficient (D*), and tissue diffusivity (D)) and T2* parameters were subsequently analyzed.
T2* and f values were significantly lower in SGA pregnancies than in the control group (P < 0.05), indicating impaired placental growth. Nine regions of cortical thickness exhibited significant differences (P<0.05) between the normal and the SGA groups. In the control group, 30 of 86 brain regions (34.88%) exhibited moderate or strong correlations between cortical thickness and T2* values. Among these regions, 19 were in the right hemisphere, whereas 11 were in the left hemisphere.
Quantitative assessment of changes in placental function and fetal brain cortical thickness is feasible and may provide valuable pathophysiological insights. Cortical thickness variations may act as potential biomarkers, assisting clinicians in early identification of SGA fetuses at risk of neurodevelopmental challenges.
小于胎龄（SGA）妊娠常与胎盘功能受损相关，这会导致神经发育缺陷。
利用皮质发育的几何特性，对SGA胎儿妊娠中胎盘功能受损与胎儿脑发育之间的关系进行定量分析。
这项回顾性研究纳入了41例孕龄适宜（GA）的孕妇（范围为23 - 38.6周）和26例SGA妊娠孕妇（范围为23.3 - 36.3周）。在排除25例胎儿脑数据正常但有明显运动伪影的参与者后，本分析纳入了正常组的29例胎儿脑和SGA组的16例胎儿脑。使用1.5-T磁共振成像（MRI）系统进行检查。根据标准化解剖图谱为每位参与者计算胎儿脑皮质厚度和区域体积。进行胎盘体素内不相干运动（IVIM）成像和T2映射。随后分析IVIM参数（灌注分数（f）、灌注扩散系数（D）和组织扩散系数（D））以及T2*参数。
SGA妊娠中的T2和f值显著低于对照组（P < 0.05），表明胎盘生长受损。正常组和SGA组之间有9个皮质厚度区域存在显著差异（P < 0.05）。在对照组中，86个脑区中的30个（34.88%）在皮质厚度和T2值之间表现出中度或强相关性。在这些区域中，19个位于右半球，而11个位于左半球。
对胎盘功能和胎儿脑皮质厚度变化进行定量评估是可行的，并且可能提供有价值的病理生理学见解。皮质厚度变化可能作为潜在的生物标志物，帮助临床医生早期识别有神经发育挑战风险的SGA胎儿。
