Diffusion-weighted post-mortem magnetic resonance imaging of the human fetal brain in situ

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• 作者：Ioanna Papadopoulou^a ; ^{ioapapadopou@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Dean Langan^a ; ^{d.langan@ucl.ac.uk" class="auth_mail" title="E-mail the corresponding author} ; Neil J. Sebire^a ; ^b ; ^{Neil.sebire@gosh.nhs.uk" class="auth_mail" title="E-mail the corresponding author} ; Thomas S. Jacques^a ; ^b ; ^{t.jacques@ucl.ac.uk" class="auth_mail" title="E-mail the corresponding author} ; Owen J. Arthurs^a ; ^b ; ^{owen.arthurs@gosh.nhs.uk" class="auth_mail" title="E-mail the corresponding author}
• 关键词：ADC ; apparent diffusion coefficient ; DWI ; diffusion weighted (magnetic resonance) imaging ; (PM)MR ; (post mortem) magnetic resonance imaging ; ROI ; region of interest
• 刊名：European Journal of Radiology
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：85
• 期：6
• 页码：1167-1173
• 全文大小：913 K

文摘

To evaluate perinatal brain apparent diffusion coefficient (ADC) values at postmortem MRI (PMMR) in order to evaluate post mortem changes.

Materials and methods

Postmortem brain MRI was performed with diffusion gradient values b = 0, 500, and 1000 s/mm² on 43 fetal cases. Mean ADC values were calculated from 7 regions of interest (ROIs) throughout the brain.

Results

43 fetuses were evaluated with median gestational age 36 weeks (range 21–41). Overall, fetal brain ADC varied with maceration score, but not with gestational age or post mortem interval. The best single predictor of brain ADC was maceration score, which accounted for 52% of data variation for frontal cortex (p < 0.001) and 44% in basal ganglia (p < 0.001), and between 24% and 32% in all five of the other included brain areas. Gestation was only significantly associated with occipital ADC changes and post mortem interval only significantly associated with basal ganglia ADC changes. Median intra-observer and inter-observer variability was 6.0% (95% range 1.0%–18.1%) and 8.0% (95% range 0.2%–33.9%) respectively.

Conclusion

DWI characteristics in different fetal brain areas following death are multifactorial, with maceration the strongest predictor in most anatomical areas. Deep grey matter areas are also affected by gestation and post mortem interval. With better models, brain ADC may be useful to estimate the degree of maceration where gestation and post mortem interval is unknown.