Apparent diffusion coefficient of different areas of brain in foetuses with intrauterine growth restriction

Behnaz Moradi; Zohreh Alibeigi Nezhad; Nazanin Seyed Saadat; Mahboobeh Shirazi; Ali Borhani; Mohammad Ali Kazemi

doi:10.5114/pjr.2020.96950

Apparent diffusion coefficient of different areas of brain in foetuses with intrauterine growth restriction

Pol J Radiol. 2020 Jun 15:85:e301-e308. doi: 10.5114/pjr.2020.96950. eCollection 2020.

Authors

Behnaz Moradi^{1

2}, Zohreh Alibeigi Nezhad², Nazanin Seyed Saadat², Mahboobeh Shirazi³, Ali Borhani², Mohammad Ali Kazemi^{2

4}

Affiliations

¹ Department of Radiology, Women's Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran.
² Department of Radiology, Medical Imaging Centre, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran.
³ Maternal, Foetal and Neonatal Research Centre, Women's Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Purpose: This study aimed to compare the apparent diffusion coefficient (ADC) values of different brain areas between two groups of intrauterine growth restricted (IUGR) foetuses and control cases.

Material and methods: A total of 38 foetuses with IUGR and 18 normal control foetuses with similar gestational age were compared using a 3T magnetic resonance scanner. IUGR cases included 23 foetuses with clinical severity signs (group A) and 15 foetuses without clinical severity signs (group B). ADC values were measured in different brain regions and compared among groups. Foetuses with structural brain abnormalities were excluded from the study.

Results: All foetuses had normal foetal structural brain anatomy. Head circumference (HC) < 5% was more common in IUGR group A compared to IUGR group B (56.5% vs. 13.3%, p < 0.0001). In comparison to the normal group, the ADC values in IUGR foetuses were significantly lower in cerebellar hemispheres (CH) (1.239 vs. 1.280.5 × 10^-3 mm²/s, p = 0.045), thalami (1.205 vs. 1.285 × 10^-3 mm²/s, p = 0.031) and caudate nucleus (CN) (1.319 vs. 1.394 × 10^-3 mm²/s, p = 0.04). However, there were no significant differences in ADC values between IUGR subtypes. Among all brain regions, pons had the lowest ADC values.

Conclusions: ADC values of thalami, CN, and CH were significantly lower in IUGR than control foetuses, while there was no significant difference among IUGR groups. Further studies are needed to evaluate the prognostic value of ADC changes in IUGR foetuses.

Keywords: apparent diffusion coefficient; diffusion-weighted imaging; foetus; growth restriction; hypoxia.