E-ISSN 1305-3612
Fetal Imaging - Original Article
Diffusion-weighted imaging of placenta in intrauterine growth restriction with worsening Doppler US findings
1 Division of Pediatric Radiology, Department of Radiology, Erciyes University School of Medicine, Kayseri, Turkey  
2 Department of Obstetrics and Gynaecology, Erciyes University School of Medicine, Kayseri, Turkey  
3 Department of Biostatistics, Erciyes University School of Medicine, Kayseri, Turkey  
Diagn Interv Radiol 2019; 25: 280-284
DOI: 10.5152/dir.2019.18358
Abstract

 

PURPOSE

We aimed to compare the placental diffusion difference between intrauterine growth restriction (IUGR) patients with worsening Doppler ultrasonography (US) findings and control group with normal Doppler US findings by using diffusion-weighted imaging (DWI).

 

METHODS

We performed a prospective study to compare the placental diffusion difference in 63 patients (gestational week, 28–34 weeks), including 50 IUGR patients (mean gestational week, 30 weeks 3 days ±16.2 days) with worsening Doppler US findings and 13 patients with normal Doppler US findings (mean gestational week, 29 weeks 4 days ±12.3 days) by using DWI (b value, 0–1000 s/mm2). We classified IUGR patients into three groups according to the reference values of the umbilical artery pulsatility index (PI) chart. Placenta apparent diffusion coefficient (ADC) calculations were performed by freehand drawn regions-of-interest (ROIs) (min, 8.04 cm2; max, 200 cm2).

 

RESULTS

Placental ADC values in IUGR patients (mean, 1.624±0.181 ×10–³ mm²/s; range, 1.35–1.96 ×10−3 mm2/s) were significantly reduced compared with the control group (mean, 1.827±0.191 ×10–³ mm²/s; range, 1.35–2.84 ×10−3 mm2/s) (P = 0.001). For adjusted ROI area calculation, ADC values were significantly lower in groups 3, 2 and 1, respectively, compared with the control group (P < 0.05); and there was no significant difference between groups 1 and 2 (P > 0.05). Preeclampsia significantly reduced the placental diffusion compared with patients without preeclampsia (P = 0.003). Gestational aging did not significantly affect ADC values in control patients (r=0.08, P = 0.561). The sensitivity, specificity, negative and positive predictive values of ADC to detect IUGR were 72%, 84.6%, 44%, and 94.7% with a cutoff value of 1.727 ×10−3 mm2/s, respectively.

 

CONCLUSION

The diagnostic estimation of placental ADC values to predict the severity of IUGR is comparable to that of umbilical artery PI. Considering that at the very early onset of IUGR, placental diffusion diminishes, ADC as a marker for IUGR in lieu of umbilical artery PI has the potential to determine the threshold for decreased placental diffusion. Therefore, DWI should be added to routine fetal MRI to show diffusion changes in placenta.

 

 

You may cite this article as: Görkem SB, Coşkun A, Eşlik M, Kütük MS, Öztürk A. Diffusion-weighted imaging of placenta in intrauterine growth restriction with worsening Doppler US findings. Diagn Interv Radiol 2019; 25:280–284.

Key Words
Authors
All
Author's Corner
Reviewer's Corner
Survey
Copyright © 2019 Turkish Society of Radiology | Latest Update: 03.09.2019