扩散加权成像评估双胎妊娠一胎宫内死亡的存活胎儿脑部改变  

Evaluating the cerebral changes in surviving fetus of twin pregnancies with demise of one twin by using diffusion weighted imaging

作　　者：刘颖[1] 霍然 王筝[1] 袁慧书[1] LIU Ying;HUO Ran;WANG Zheng;YUAN Huishu(Department of Radiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院放射科,北京100191

出　　处：《实用放射学杂志》2021年第6期993-996,共4页Journal of Practical Radiology

基　　金：北京大学第三医院临床重点项目(BYSY2017021)。

摘　　要：目的探讨扩散加权成像(DWI)及表观扩散系数(ADC)在双胎妊娠一胎宫内死亡的存活胎儿脑部潜在微观结构改变中的应用价值.方法14例存活胎儿和14例对照进行DWI扫描及ADC值测量,选择双侧额顶颞枕叶白质、丘脑、基底节区和小脑为感兴趣区(ROI).比较2组间各个脑区ADC值差异,比较存活胎儿组左右脑区ADC值差异,将各脑区ADC值与一胎死亡时间、孕周及孕龄进行相关分析.结果存活胎儿组双额叶、右顶叶、左颞叶ADC值下降,左右各个脑区ADC值差异无统计学意义;各脑区ADC值与一胎死亡时间、孕龄无明显相关.存活胎儿组各脑区ADC值与孕周无明显相关;对照组左侧丘脑及双侧小脑ADC值与孕周呈负相关.结论在其他序列未见明显异常的情况下,ADC值对于检测潜在脑部改变更为敏感,存活胎儿脑部ADC值下降可能提示其潜在损伤.Objective To investigate the application value of diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)in detecting the underlying cerebral microstructure changes in surviving fetus with demise of one twin.Methods Fourteen twin pregnant women with demise of one twin and fourteen healthy controls were recruited.DWI was performed and ADC values were measured.White matter of bilateral frontal lobes,parietal lobes,temporal lobes and occipital lobes,thalamus,basal ganglia and cerebella was selected as region of interest(ROI)for analysis.The differences of ADC values in selected regions of brain were compared between the surviving fetuses and the controls.The ADC values in left hemisphere were compared with those in the right hemisphere of surviving fetuses.Correlatior^between ADC values and time of one fetus demise,gestational age and maternal age were amlyzed by correlation coefficie^^ADC values were lower in bilateral frontal lobes,right parietal lobe and left temporal lobe in surviving fetuses than those in the controls.No significantJP differences were found between left-and right-hemisphere.There were no correlations between ADC values with time of one fetus demise and maternal age.No significant correlations were found between ADC values and gestational age in surviving fetuses.ADC values in left thalamus and bilateral cerebella were negatively correlated with gestational age in controls.Conclusion In surviving fetus with demise of one twin,ADC value is more sensitive in detecting the cerebral microstructure change.The decrease of ADC value in the brain of the surviving fetus may indicate the underlying damage,although no significant abnormality is found in other sequences.

关 键 词：扩散加权成像 表观扩散系数 双胎妊娠 一胎宫内死亡 

分 类 号：R445.2[医药卫生—影像医学与核医学] R714.23[医药卫生—诊断学]