Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Apparent Diffusion Coefficient of the Placenta and Fetal Organs in Intrauterine Growth Restriction

Abdel Razek, Ahmed Abdel Khalek, MD; Thabet, Mahmoud, MD; Salam, Eman Abdel, MD

Journal of Computer Assisted Tomography: May/June 2019 - Volume 43 - Issue 3 - p 507–512
doi: 10.1097/RCT.0000000000000844
Abdominal Imaging
Buy
SDC

Purpose This study aimed to assess apparent diffusion coefficient (ADC) of the placenta and fetal organs in intrauterine growth restriction (IUGR).

Materials and methods A prospective study of 30 consecutive pregnant women (aged 21–38 years with mean age of 31.5 years and a mean gestational week of 35 ± 2.3) with IUGR and 15 age-matched pregnant women was conducted. All patients and controls underwent diffusion-weighted magnetic resonance imaging. The ADCs of the placenta and fetal brain, kidney, and lung were calculated and correlated with neonates needing intensive care unit (ICU) admission.

Results There was a significant difference in ADC of the placenta and fetal brain, lung, and kidney (P = 0.001, 0.001, 0.04, and 0.04, respectively) between the patients and the controls. The cutoff ADCs of the placenta and fetal brain, lung, and kidney used to detect IUGR were 1.45, 1.15, 1.80, and 1.40 × 10−3 mm2/s, respectively, with areas under the curve (AUCs) of 0.865, 0.858, 0.812, and 0.650, respectively, and accuracy values of 75%, 72.5%, 72.5%, and 70%, respectively. Combined ADC of the placenta and fetal organs used to detect IUGR revealed an AUC of 1.00 and an accuracy of 100%. There was a significant difference in ADC of the placenta and fetal brain, lung, and kidney between neonates needing admission and those not needing ICU admission (P = 0.001, 0.001, 0.002, and 0.002, respectively). The cutoff ADCs of the placenta and fetal brain, lung, and kidney used to define neonates needing ICU were 1.35, 1.25, 1.95, and 1.15 × 10−3 mm2/s with AUCs of 0.955, 0.880, 0.884, and 0.793, respectively, and accuracy values of 86.7%, 46.7%, 76.7%, and 70%, respectively. Combined placental and fetal brain ADC used to define neonates needing ICU revealed an AUC of 0.968 and an accuracy of 93.3%.

Conclusion Combined ADC of the placenta and fetal organs can detect IUGR, and combined ADC of the placenta and fetal brain can define fetuses needing ICU.

From the Departments of Diagnostic Radiology and Obstetrics and Gynecology, Mansoura Faculty of Medicine, Mansoura. Egypt.

Received for publication October 3, 2018; accepted December 14, 2018.

Correspondence to: Ahmed Abdel Khalek Abdel Razek, MD, Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura 13551, Egypt (e-mail: arazek@mans.edu.eg).

The authors declare no conflict of interest.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.