Utility of placental diffusion-weighted magnetic resonance imaging in prenatal diagnosis of small for gestational age infants and pregnancy outcome prediction

作者：He, Junshen; Chen, Zhao; Wen, Ting; Xu, Liqun; Chen, Chunlin^*; Liu, Ping^*

来源：Placenta, 2022, 121: 91-98.

DOI：10.1016/j.placenta.2022.03.010

• MRI
• Placenta
• Diffusion
• IVIM
• SGA

Introduction: Ultrasound-diagnosed small for gestational age (SGA) has a particular rate of misdiagnosis. We hypothesized that diffusion-weighted magnetic resonance imaging (MRI), specifically intravoxel incoherent motion (IVIM) imaging, could identify false-positive SGA (fpSGA). @@@ Methods: A prospective study. Placentas were scanned at gestational weeks 28-41 on a 3.0 T MRI using 9 b-values (0-800 s/mm(2)). Pregnancies were suspected as complicated by SGA when fortnightly ultrasound biometries confirmed that estimated fetal weights (EFW) were <10th percentile, while final birth weight >10th percentile was considered fpSGA. A total of 28 control, 20 fpSGA and 27 SGA patients were included. The mean values of the diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) were calculated and compared between groups. @@@ Results: In the control and fpSGA groups, D (control, 1866.61 +/- 213.74 mu m(2)/s; fpSGA, 1807.37 +/- 199.89 mu m(2)/s), D* (control, 54833.29 +/- s 8174.20 mu m(2)/s; fpSGA, 52689.20 +/- 9420.63 mu m(2)/s) and f (control, 33.31% +/- 3.49%; fpSGA, 33.17% +/- 2.96%) were similar. However, all three were significantly lower in the SGA group (D, 1664.32 +/- 288.53 mu m(2)/s; D*, 48279.82 +/- 7497.36 mu m(2)/s; f, 27.53% +/- 3.52%) than in the other two groups (p < 0.05). The f was the best parameter in distinguishing the control and SGA groups, and the fpSGA and SGA groups. @@@ Discussion: IVIM analysis might be suitable for the noninvasive identification of fpSGA pregnancies and SGA patients as an important supplement to ultrasound biometry.

• 单位
  南方医科大学