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

Abstract

Abnormal ADC values are seen in ischemic brain lesions such as acute or chronic hypoxia. We aimed to assess whether ADC values in the developing brain measured by in utero DWI were different in fetuses with congenital heart disease compared with healthy controls. In utero DWI was performed in 50 fetuses with congenital heart disease and 100 healthy controls at a similar gestational age. Pair-wise ADC values of the ROIs were manually delineated on each side of the frontal and periatrial WM and in the basal ganglia, thalamus, and cerebellar hemisphere, as well as a single measurement in the pons. Fetuses with congenital heart disease had significantly lower ADC values in frontal and periatrial WM and the pons than controls (all P < .05) in the early stages of pregnancy. However, ADC values in the thalamus were higher for fetuses with congenital heart disease than for controls (gestational age, ≥26 weeks). For ADC values in the cerebellar hemisphere, there was no obvious significance between cases and controls (P = .07) in the late stages of pregnancy. Basal ganglia ADC values were consistently not significantly different between the 2 groups during the early and late stages of pregnancy (P = .47; .21). Abnormal brain diffusivity can be detected using in utero DWI in fetuses with congenital heart disease. Abnormal ADC values found at a mean gestational age of 26 weeks suggest structural changes, which may provide an early indicator of the impact of congenital heart disease on the developing brain.