Jouannic JM, Blondiaux E, Senat MV, et al. - Researchers sought to determine the possible diffusion coefficient (ADC) values between 28 and 32 weeks of gestation in various cerebral territories of fetuses with estimated fetal weight (EFW) ≤ 5th centile to investigate their relationship with an adverse perinatal outcome. They conducted a prospective multi-center study involving 6 tertiary perinatal centers with the following inclusion criteria: singleton small-for-gestational-age (SGA) fetuses with EFW ≤ 5th percentile between 28 and 32 weeks of gestation whatever the results of the umbilical Doppler and maternal uterine Doppler examinations. Following the inclusion, they performed a fetal MRI examination in 64 patients with diffusion-weighted sequences (DWI) within 14 days. Measurement of ADC values was done in frontal and occipital white matter, centrum semi-ovale, basal ganglia, cerebellar hemispheres, and pons. They excluded five patients owing to fetal movement artifacts on DWI (7.8%) and two patients for termination of pregnancies with no link to fetal growth restriction. Secondary to severe IUGR, one intrauterine death occurred. At a mean GA of 33.6 (3.0) weeks, 56 live-born neonates were delivered with a mean birth weight of 1,441 (566) g; of these, four neonatal deaths occurred. Further, prolonged mechanical ventilation was required in two neonates, one of whom also developed necrotizing enterocolitis. Finally, adverse perinatal outcomes were reported in 7 cases out of 57. The analysis suggests that lower ADC values in the frontal WM territory in fetuses are associated with adverse perinatal outcomes.