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DWI in Brains of Fetuses with Congenital Heart Disease: A Case-Control MR Imaging Study
1From the Department of Radiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, P.R. China.
Insights
In utero diffusion-weighted imaging (DWI) revealed abnormal apparent diffusion coefficient (ADC) values in the developing brains of fetuses with congenital heart disease, suggesting early structural changes.
Area of Science:
- Neuroimaging
- Fetal Development
- Cardiology
Background:
- Abnormal apparent diffusion coefficient (ADC) values are indicative of ischemic brain lesions.
- In utero diffusion-weighted imaging (DWI) allows for the assessment of brain development in fetuses.
Purpose of the Study:
- To evaluate differences in ADC values in the developing fetal brain between fetuses with congenital heart disease and healthy controls.
- To investigate the potential of in utero DWI as an early indicator of brain changes in fetuses with congenital heart disease.
Main Methods:
- In utero DWI was conducted on 50 fetuses with congenital heart disease and 100 healthy controls.
- Regions of interest (ROIs) including frontal and periatrial white matter, basal ganglia, thalamus, cerebellar hemisphere, and pons were manually delineated.
- Pair-wise ADC values were measured for each ROI.
Main Results:
- Fetuses with congenital heart disease exhibited significantly lower ADC values in the frontal and periatrial white matter and pons compared to controls (P < .05).
- Elevated ADC values were observed in the thalamus of fetuses with congenital heart disease from 26 weeks gestation onwards.
- No significant differences in ADC values were found in the basal ganglia or cerebellar hemisphere between the groups.
Conclusions:
- In utero DWI can detect abnormal brain diffusivity in fetuses with congenital heart disease.
- Abnormal ADC values identified by mean gestational age of 26 weeks suggest structural brain alterations.
- These findings indicate that in utero DWI may serve as an early diagnostic tool for assessing the impact of congenital heart disease on fetal brain development.
Background And Purpose:
Abnormal ADC values are seen in ischemic brain lesions such as acute or chronic hypoxia. We aimed to assess whether ADC values in the developing brain measured by in utero DWI were different in fetuses with congenital heart disease compared with healthy controls.
Materials And Methods:
In utero DWI was performed in 50 fetuses with congenital heart disease and 100 healthy controls at a similar gestational age. Pair-wise ADC values of the ROIs were manually delineated on each side of the frontal and periatrial WM and in the basal ganglia, thalamus, and cerebellar hemisphere, as well as a single measurement in the pons.
Results:
Fetuses with congenital heart disease had significantly lower ADC values in frontal and periatrial WM and the pons than controls (all P < .05) in the early stages of pregnancy. However, ADC values in the thalamus were higher for fetuses with congenital heart disease than for controls (gestational age, ≥26 weeks). For ADC values in the cerebellar hemisphere, there was no obvious significance between cases and controls (P = .07) in the late stages of pregnancy. Basal ganglia ADC values were consistently not significantly different between the 2 groups during the early and late stages of pregnancy (P = .47; .21).
Conclusions:
Abnormal brain diffusivity can be detected using in utero DWI in fetuses with congenital heart disease. Abnormal ADC values found at a mean gestational age of 26 weeks suggest structural changes, which may provide an early indicator of the impact of congenital heart disease on the developing brain.
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