DWI在脐动脉多普勒正常的迟发型宫内生长受限胎儿脑中的研究

Diffusion Weighted Imaging Research in Late-Onset Intrauterine Growth-Restricted Fetal Brain with Normal Umbilical Artery Doppler

目的探讨扩散加权成像对脐动脉多普勒正常的迟发型宫内生长受限胎儿脑的诊断价值。方法回顾性分析58例经产前超声诊断脐动脉多普勒血流参数正常的迟发型宫内生长受限胎儿,同时选取与其胎龄相匹配的33例正常胎儿作为对照组。所有胎儿均接受产前常规MRI和DWI检查。分析胎儿脑表现特征,测量额叶白质、顶叶白质、枕叶白质、基底节、桥脑和小脑半球的ADC值,计算额叶/枕叶ADC比值和额叶/小脑半球ADC比值。比较上述参数在两组间的差异。结果所有胎脑常规MRI检查形态和信号均未见异常。与对照组相比,宫内生长受限组胎儿脑枕叶白质ADC值下降,额枕比显著增加,差异具有统计学意义(P<0.05)。结论ADC值对检测潜在脑损伤较敏感,有助于诊断脐动脉多普勒正常的迟发型宫内生长受限,但ADC值改变的意义和远期预后需要进一步的研究。

Objective To explore the diagnostic value of ADC values in late-onset intrauterine growth-restricted fetal brain with normal umbilical artery Doppler.Methods 58 fetuses with late-onset intrauterine growth restriction diagnosed with prenatal ultrasound and 33 gestational age matched healthy controls were enrolled in the study.All the cases with normal umbilical artery Doppler,subsequently underwent routine fetal brain magnetic resonance imaging(MRI)and diffusionweighted magnetic resonance imaging(DWI).The fetal brain morphology of the two groups were analyzed.The ADC values of basal ganglia,pons,cerebellum,white matter of the frontal lobes,parietal lobes and occipital lobes were measured.Frontooccipital and fronto-cerebellar ADC ratio were calculated.The above parameters were compared between the two groups.Results No signal and morphological abnormalities were observed in the fetal brain on routine MRI.Compared to the control group,intrauterine growth-restricted fetuses showed a significantly lower ADC of the white matter of the occipital lobes while that of a higher ADC ratiooffronto-occipital,and there were significant differences between the two groups(allP<0.05).Conclusion The ADC value may be more sensitive for detecting potential damage of brain,which is helpful for the diagnosis of the late-onset intrauterine growth-restricted fetal brain with normal umbilical artery Doppler.The prognostic value of these ADC changes is still unknown.