Apparent diffusion coefficient measurements of the fetal brain during the third trimester of pregnancy: how reliable are they in clinical practice?. (12th February 2014)

• Record Type: Journal Article
• Authors: Sartor, Agnès; Arthurs, Owen; Alberti, Corinne; Belarbi, Nadia; Tilea, Bogdana; Boizeau, Priscilla; Oury, Jean‐Francois; Elmaleh‐Berges, Monique; Gressens, Pierre; Sebag, Guy; Alison, Marianne
• Is Part Of: Prenatal diagnosis. Volume 34:Number 4(2014:Apr.)
• Page Start: 357
• Page End: 366
• Publication Date: 2014-02-12
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.4309
• Languages: English
• ISSNs: 0197-3851

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="pd4309-sec-0001" sec-type="section"> <title>Objective</title> <p>The objective of this study was to determine the reproducibility, the inter‐hemispheric difference and the reference apparent diffusion coefficient (ADC) values of the fetal brain according to gestational age.</p> </sec> <sec id="pd4309-sec-0002" sec-type="section"> <title>Method</title> <p>One hundred and one normal fetal brain (29.4–38.4 weeks) were analysed with diffusion‐weighted MR imaging. ADC was measured in frontal white matter (FWM), occipital white matter (OWM), centrum semi‐ovale (CSO), basal ganglia (BG), cerebellar hemisphere (CBM) and pons. ADC ratios (fronto‐occipital, fronto‐cerebellar and occipito‐cerebellar) were calculated. Inter‐observer reproducibility was assessed on 27 studies, using intra‐class correlation coefficient and Bland–Altman plot. Inter‐hemispheric difference was evaluated with Bland–Altman plot. Gestation‐specific reference intervals were estimated for each brain region.</p> </sec> <sec id="pd4309-sec-0003" sec-type="section"> <title>Results</title> <p>Inter‐observer bias was near zero. Limits of agreement (LOA) were clinically acceptable (−0.17; 0.20 to −0.38; 0.31 × 10<sup>−3</sup> mm<sup>2</sup>/s) for all brain regions except for CSO and pons. Inter‐hemispheric bias was near zero. Smallest LOA were for FWM (±0.09 mm<sup>2</sup>/s) and BG (±0.019 mm<sup>2</sup>/s). ADC values decreased, whereas ADC ratio increased with gestational age, reflecting normal maturation. Fronto‐occipital, fronto‐cerebellar and occipito‐cerebellar ratios were consistently above 0.8, 1 and 1, respectively.</p> </sec> <sec id="pd4309-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The fetal brain regions with the highest reproducibility and smallest inter‐hemispheric differences are the frontal, occipital, cerebellar white matter and BG. ADC ratio could be useful to assess differential temporo‐spatial maturation. © 2013 John Wiley & Sons, Ltd.</p> </sec> </abstract>