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Prognostic value of diffusion‐weighted magnetic resonance imaging of brain in fetal growth restriction: Results of prospective multicenter study

Ultrasound in Obstetrics & Gynecology Dec 22, 2020

Jouannic JM, Blondiaux E, Senat MV, et al. - Researchers here determined prospectively apparent diffusion coefficient (ADC) values between 28 and 32 weeks of gestation in different cerebral territories of fetuses with estimated fetal weight (EFW) ≤ 5th centile. In addition, they examined their correlation with adverse perinatal outcomes. In this prospective study involving six tertiary‐level perinatal centers, they included singleton, small‐for‐gestational‐age (SGA) fetuses with EFW ≤ 5th percentile, between 28 and 32 weeks of gestation, regardless of the umbilical artery Doppler and maternal uterine artery Doppler findings. Within 14 days following inclusion and before 32 weeks, they performed a fetal magnetic resonance imaging (MRI) examination with diffusion‐weighted sequences (DWI). Within 1 week prior to the MRI examination, an ultrasound examination was done. This is identified to be the first prospective, multicenter, cohort study using DWI in the setting of SGA revealing that ADC values in the frontal white‐matter territory were lower in fetuses with, vs those without, adverse perinatal outcome. A cut‐off value of 1.70 × 10–3 mm2/s was linked with a sensitivity of 57%, a specificity of 78%, a positive predictive value of 27% and a negative predictive value of 93% for the prediction of adverse perinatal outcome.

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