A diffusion‐weighted template for gestational age‐related apparent diffusion coefficient values in the developing fetal brain

Cannie, Mieke; Keyzer, Frederik De; Meersschaert, Joke; Jani, Jacques; Lewi, Liesbeth; Deprest, Jan; Dymarkowski, Steven; Demaerel, Philippe

doi:10.1002/uog.4078

Cited by 40 publications

(53 citation statements)

References 24 publications

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“…4,5 Our observation of a decline in ADC values in the thalamus, pons, and cerebellum with increasing gestational age is similar to the largest study of fetal DWI in 78 sedated fetuses by Schneider et al 4 However, it is interesting to note that they observed an increase in ADC values in the periatrial and frontal WM and basal ganglia from 23 to 29 weeks’ gestation, with a decrease in ADC values from 30 to 36 weeks’ gestation. These differences in observation could be the result of the size and shape of ROIs because our ROIs were adjusted depending on the size of the fetal brain.…”

Section: Discussionsupporting

confidence: 86%

Normative Apparent Diffusion Coefficient Values in the Developing Fetal Brain

Schneider¹,

Berman²,

Bäumer³

et al. 2009

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE Previous studies of diffusion-weighted imaging (DWI) in fetuses are limited. Because of the need for normative data for comparison with young fetuses and preterm neonates with suspected brain abnormalities, we studied apparent diffusion coefficient (ADC) values in a population of singleton, nonsedated, healthy fetuses. MATERIALS AND METHODS DWI was performed in 28 singleton nonsedated fetuses with normal or questionably abnormal results on sonography and normal fetal MR imaging results; 10 fetuses also had a second fetal MR imaging, which included DWI. ADC values in the periatrial white matter (WM), frontal WM, thalamus, basal ganglia, cerebellum, and pons were plotted against gestational age and analyzed with linear regression. We compared mean ADC in different regions using the Tukey Honestly Significant Difference test. We also compared rates of decline in ADC with increasing gestational age across different areas by using the t test with multiple comparisons correction. Neurodevelopmental outcome was assessed. RESULTS Median gestational age was 24.28 weeks (range, 21–33.43 weeks). Results of all fetal MR imaging examinations were normal, including 1 fetus with a normal variant of a cavum velum interpositum. ADC values were highest in the frontal and periatrial WM and lowest in the thalamus and pons. ADC declined with increasing gestational age in periatrial WM (P = .0003), thalamus (P < .0001), basal ganglia (P = .0035), cerebellum (P < .0001), and pons (P = .024). Frontal WM ADC did not significantly change with gestational age. ADC declined fastest in the cerebellum, followed by the thalamus. CONCLUSIONS Regional differences in nonsedated fetal ADC values and their evolution with gestational age likely reflect differences in brain maturation and are similar to published data in premature neonates.

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Section: Discussionsupporting

confidence: 86%

Normative Apparent Diffusion Coefficient Values in the Developing Fetal Brain

Schneider¹,

Berman²,

Bäumer³

et al. 2009

AJNR Am J Neuroradiol

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“…It provides a measure of tissue complexity and rises during late fetal life with a steady decline during infancy [17-22]. A high ADC value is seen in chronic damaged white matter; however, a low ADC value indicates acute ischemia.…”

Section: Introductionmentioning

confidence: 99%

Multi-Tiered Analysis of Brain Injury in Neonates With Congenital Heart Disease

et al. 2013

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Early brain injury occurs in newborns with congenital heart disease (CHD) placing them at risk for impaired neurodevelopmental outcomes. Predictors for preoperative brain injury have not been well described in CHD newborns. This study aimed to analyze, retrospectively, brain magnetic resonance imaging (MRI) in a heterogeneous group of newborns who had CHD surgery during the first month of life using a detailed qualitative CHD MRI Injury Score, quantitative imaging assessments (regional apparent diffusion coefficient [ADC] values and brain volumes), and clinical characteristics. Seventy-three newborns that had CHD surgery at 8 ± 5 (mean ± standard deviation) days of life and preoperative brain MRI were included; 38 also had postoperative MRI. Thirty-four (34/73, 47%) had at least 1 type of preoperative brain injury, and 28/38 (74%) had postoperative brain injury. The 5-minute APGAR score was negatively associated with preoperative injury, but there was no difference between CHD types. Infants with intraparenchymal hemorrhage, deep gray matter injury, and/or watershed infarcts had the highest CHD MRI Injury Scores. ADC values and brain volumes were not different in infants with different CHD types, or in those with and without brain injury. In a mixed group of CHD newborns, brain injury was found preoperatively on MRI in almost 50%, and there were no significant baseline characteristic differences to predict this early brain injury, except 5-minute APGAR score. We conclude that all infants, regardless of CHD type, who require early surgery, should be evaluated with MRI as they are all at high risk for brain injury.

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“…3). Studies have also shown that there is a decline in mean diffusivity values of the white matter during gestation, 26,29,30 which is less marked than that observed in the deep gray nuclei 28,30 (Fig. 3).…”

Section: Glennmentioning

confidence: 87%