VP39.03: Spontaneous resolution of transient right heart circular shunt in Twin–twin transfusion syndrome: a case of recipient before and another case of donor after laser surgery

Abstract

Virtual poster abstractsin RFA setting. Two large regions of interests (ROI) were manually placed on bilateral hemispheres of both dead and living fetuses on ADC map while avoiding adjacent structures (as CSF space) and average of ADCs were calculated. The fetuses were classified based on the post mortem interval (PMI) between MRI and RFA into two groups: A) Early (≤3 weeks) and B) late. Results: We included 46 fetuses (37 in group A and 9 in group B). All dead fetuses in group A showed brain restriction with mean ADC values of 744±310×10 -6 mm 2 /s (ADC values of living fetuses in this group was 1640±202×10 -6 mm 2 /s). Mean ADC values in group B was 951±394.1 ×10 -6 mm 2 /s (ADC values of living fetuses in this group was 1578.6±189.2×10 -6 mm 2 /s). The mean of PMI in group A was 5.9±1.3 days (range: 1-17 days) and in group B was 34± 9.2 days (range: 20-46 days). Only two (22.2%) fetuses in group B showed no brain restriction and PMI in these fetuses was about 6-7 weeks. Conclusions: These data indicate that in post mortem brain as in post stroke setting, parenchymal restriction and low ADC values can persist long time after brain death. Although the ADC values were higher in group B, we did not find significant difference between ADC values of two groups.