Contribution of diffusion-weighted imaging in the evaluation of diffuse white matter ischemic lesions in fetuses: Correlations with fetopathologic findings
Contribution of diffusion-weighted imaging in the evaluation of diffuse white matter ischemic lesions in fetuses: Correlations with fetopathologic findings
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DOI：
10.3174/ajnr.a0754
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发表时间：
2008-01-01
影响因子：
3.5
通讯作者：
Delezoide, A. -L.
中科院分区：
文献类型：
--
作者：
Guilmiot, F.;Garel, C.;Delezoide, A. -L.
背景和目的：胎儿磁共振成像评价弥漫性缺血性白色物质（WM）异常的敏感性较差。我们的目的是评估的贡献扩散加权成像（DWI）在WM的微观结构变化的分析和相关的神经影像学与neurofetopathologicfindings.MATERIALS和METHODS：我们包括胎儿与MR成像，DWI，和胎儿病理学检查。在MR成像确定的感兴趣区域，T1和T2信号异常，测量表观扩散系数（ADC），并进行免疫组化分析。在WM信号强度无异常的胎儿中，随机定义感兴趣区域。组织学阅读是在对MR成像结果和ADC值完全设盲的情况下进行的。根据血管源性水肿、星形胶质细胞增生、小胶质细胞增生、神经元和少突胶质细胞异常以及血管增生或充血定义了三种程度的组织学表现，并在A组（ADC正常）和B组（ADC增加）胎儿中进行了卡方检验。所有B组胎儿和I组A胎儿均显示WM信号强度异常。脑水肿和星形胶质细胞增生在B组比A组更常见（分别为7/9和2/12，8/9和4/12）。两组之间没有显着差异，观察到其他parameters.CONCLUSION：这项研究表明，增加ADC和1）WM异常信号强度的MR成像，和2）血管源性水肿与星形胶质细胞增生的脑实质之间的强相关性。
BACKGROUND AND PURPOSE: The sensitivity of fetal MR imaging is poor with regard to the evaluation of diffuse ischemic white matter (WM) abnormalities. Our purpose was to evaluate the contribution of diffusion-weighted imaging (DWI) in the analysis of microstructural changes in WM and to correlate neuroimaging with neurofetopathologic findings.MATERIALS AND METHODS: We included fetuses with MR imaging, DWI, and a fetopathologic examination. In a region of interest defined by MR imaging, where T1 and T2 intensities were abnormal, the apparent diffusion coefficient (ADC) was measured and immunolhistochemical analysis was performed. In fetuses with no WM abnormality in signal intensity, region of interest was defined at random. Histologic reading was performed with a complete blinding of the MR imaging results and ADC values. Three degrees of histologic appearance were defined with regard to vasogenic edema, astrogliosis, microgliosis, neuronal and oligodendrocytic abnormalities, and proliferation or congestion of vessels and were compared with a chi(2) test in groups A (normal ADC) and B (increased ADC) fetuses.RESULTS: We included 12 fetuses in group A and 9 in group B, ranging from 29 to 38 weeks of gestation. All group B fetuses and I group A fetus demonstrated WM abnormalities in signal intensity. WM edema and astrogliosis were more common in group B than in group A (7/9 vs 2/12 and 8/9 vs 4/12, respectively). No significant difference was observed between both groups with regard to the other parameters.CONCLUSION: This study showed a strong correlation between increased ADCs and 1) WM abnormalities in signal intensity on MR imaging, and 2) vasogenic edema with astrogliosis of the cerebral parenchyma.