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Feasibility and reproducibility of diffusion‐weighted magnetic resonance imaging of the fetal brain in twin–twin transfusion syndrome
Author(s) -
Gomes Neto Orlando,
Marins Marcos,
Botelho Rafael D.,
Nivoloni Rafaela C.,
Saura Glauco E.,
Vessoni Arias Amábile,
Barini Ricardo,
Peralta Cleisson F. A.
Publication year - 2014
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4449
Subject(s) - reproducibility , medicine , effective diffusion coefficient , magnetic resonance imaging , kappa , diffusion mri , nuclear medicine , limits of agreement , radiology , mathematics , statistics , geometry
Objective The aim of this study is to test the feasibility and reproducibility of diffusion‐weighted magnetic resonance imaging (DW‐MRI) evaluations of the fetal brains in cases of twin–twin transfusion syndrome (TTTS). Method From May 2011 to June 2012, 24 patients with severe TTTS underwent MRI scans for evaluation of the fetal brains. Datasets were analyzed offline on axial DW images and apparent diffusion coefficient (ADC) maps by two radiologists. The subjective evaluation was described as the absence or presence of water diffusion restriction. The objective evaluation was performed by the placement of 20‐mm 2 circular regions of interest on the DW image and ADC maps. Subjective interobserver agreement was assessed by the kappa correlation coefficient. Objective intraobserver and interobserver agreements were assessed by proportionate Bland–Altman tests. Results Seventy‐four DW‐MRI scans were performed. Sixty of them (81.1%) were considered to be of good quality. Agreement between the radiologists was 100% for the absence or presence of diffusion restriction of water. For both intraobserver and interobserver agreement of ADC measurements, proportionate Bland–Altman tests showed average percentage differences of less than 1.5% and 95% CI of less than 18% for all sites evaluated. Conclusion Our data demonstrate that DW‐MRI evaluation of the fetal brain in TTTS is feasible and reproducible. © 2014 John Wiley & Sons, Ltd.