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P18.04: The evolution of FA values in the fetal corticospinal tract, the corpus callosum and germinal matrix on fetal postmortem DTI
Author(s) -
Thonissen Y.,
Demaerel P.,
De Keyzer F.,
Verly M.,
Dymarkowski S.,
Deprest J.,
De Catte L.,
Aertsen M.
Publication year - 2019
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.21054
Subject(s) - medicine , corpus callosum , germinal matrix , fetus , fractional anisotropy , corticospinal tract , anatomy , diffusion mri , arthrogryposis , magnetic resonance imaging , gestational age , radiology , pregnancy , intraventricular hemorrhage , genetics , biology
Objectives: To explore the feasibility of diffusion tensor imaging (DTI) to track the germinal matrix (GM), corticospinal tract (TCS) and corpus callosum (CC) in fetal post mortem MRI (PM MR). The influence of the maceration score (MaS) and the timing between feticide, expulsion and MR scan on the fractional anisotropy (FA) was also evaluated. Methods: All PMMRs between June 2017 and December 2018 performed on a 3 Tesla MRI were included. All fetuses were delivered after termination of pregnancy for severe fetal abnormalities, approved by a multidisciplinary team. For fetus older than 20 weeks (w) of gestation, feticide was performed. No PM fixation was carried out prior to MR. At MRI, a brain DTI sequence (60 directions, max b-value 1300 s/mmˆ2) was acquired, with additional visual image evaluation using a whole-body maceration score (MaS 0-1-2). Philips IntelliSpace Portal software (Best, Netherlands) was used for evaluation. Results: fetuses were included, mean gestational age of 25 w 6 days (d) (range: 16w 4d 33w 5d). 18 fetuses scored MaS 0 (45%), 15 MaS 1 (37.5%) and 7 MaS 2 (17.5). The CC, TCS (right (R) and left (L)) and GM (R and L) could be tracked in 26 fetuses (65%). In 10 fetuses (25%) DTI-tracking of 1 or more tracks was impossible due to interfering pathology. Only in 4 fetuses (10%), the tracking of 1 or 2 tracks was impossible without an apparent reason; these had a MaS of 1 or 2. No significant effect of MaS, time between feticide and expulsion (Tfe), between expulsion and scan (Tes) or between feticide and scan (Tfs) on the FA of the tracks was found. Conclusions: When tracks are spared from pathology, it is feasible to calculate the CC, TCS and GM FA using DTI in 87% of cases. Furthermore, based on our data the FA values were independent from the maceration score and the time between feticide, expulsion and the scan.