DWI in Brains of Fetuses with Congenital Heart Disease: A Case-Control MR Imaging Study

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FIG 1.
ADC map in a fetus at 26 weeks’ GA showing ROIs in the different regions. A and B, T2WI. C and D, The same GA, DWI. Pair-wise ADC values of the ROIs are manually delineated on each side of the frontal WM, periatrial WM, basal ganglia, thalamus, and cerebellar hemisphere, as well as a single measurement in the pons.
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FIG 2.
ADC values versus GA for all ROIs. Fetuses with CHD are referenced with red triangles, and blue circles indicate healthy controls. Periatrial WM (A), basal ganglia (B), thalamus (C), cerebellar hemisphere (D), pons (E).
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FIG 3.
Box-and-whisker plots representing the distribution of ADC measurements across the fetal brain anatomic structures and pregnancy trimesters. Asterisks indicate significant differences between the CHD (red) and control (blue) groups for the same structure. BG indicates basal ganglia; TH, thalamus; CH, cerebellar hemisphere; FWM, frontal WM; PWM, periatrial WM.

Table 1:

Clinical characteristics of our cohort^{^a}

	Control (n = 100)	CHD (n = 50)	P Value^{^b}
GA at MR imaging (mean) (wk)	26.6 (SD, 3.9)	26.1 (SD, 3.5)	.45
Maternal age (mean) (yr)	31.6 (SD, 5.0)	33.1 (SD, 4.0)	.65
Sex (No.) (%)
Male	46 (46.0%)	26 (52.0%)
Female	54 (54.0%)	24 (48.0%)
Cardiac lesion
TOF	NA	20 (40.0%)
Double-outlet right ventricle	NA	10 (20.0%)
TGA	NA	15 (30.0%)
HLHS	NA	5 (10.0%)

Table 2:

ADC values in the CHD and control groups in different brain areas^{^a}

	Unit	Control (n = 100) (mean)	CHD (n = 50) (mean)	P Value
GA <26 wk (No.)		50	25
Frontal WM	(10⁻³ mm²/s)	1.87 (SD, 0.15)	1.77 (SD, 0.14)	.01^{^b}
Periatrial WM	(10⁻³ mm²/s)	1.88 (SD, 0.10)	1.83 (SD, 0.08)	.04^{^b}
Basal ganglia	(10⁻³ mm²/s)	1.65 (SD, 0.15)	1.62 (SD, 0.11)	.47
Thalamus	(10⁻³ mm²/s)	1.61 (SD, 0.16)	1.55 (SD, 0.15)	.22
CH	(10⁻³ mm²/s)	1.79 (SD, 0.15)	1.77 (SD, 0.12)	.40
Pons	(10⁻³ mm²/s)	1.53 (SD, 0.13)	1.44 (SD, 0.13)	.03^{^b}
GA ≥26 wk (No.)		50	25
Frontal WM	(10⁻³ mm²/s)	1.94 (SD, 0.18)	1.82 (SD, 0.15)	.006^{^b}
Periatrial WM	(10⁻³ mm²/s)	1.80 (SD, 0.16)	1.78 (SD, 0.13)	.41
Basal ganglia	(10⁻³ mm²/s)	1.53 (SD, 0.13)	1.50 (SD, 0.10)	.21
Thalamus	(10⁻³ mm²/s)	1.39 (SD, 0.11)	1.44 (SD, 0.08)	.04^{^b}
CH	(10⁻³ mm²/s)	1.58 (SD, 0.13)	1.65 (SD, 0.13)	.07
Pons	(10⁻³ mm²/s)	1.37 (SD, 0.13)	1.34 (SD, 0.15)	.38