Diffusion-weighted imaging evaluation of subtle cerebral micro structural changes in intrauterine fetal hydrocephalus

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dc.authoridErdem, Gülnur/0000-0003-2200-8620
dc.authoridKarakas, Hakki/0000-0002-1328-8520
dc.authorwosidErdem, Gülnur/GPS-7725-2022
dc.contributor.authorErdem, Gulnur
dc.contributor.authorCelik, Onder
dc.contributor.authorHascalik, Seyma
dc.contributor.authorKarakas, Hakki Muammer
dc.contributor.authorAlkan, Alpay
dc.contributor.authorFirat, Ahmet Kemal
dc.date.accessioned2024-08-04T20:30:38Z
dc.date.available2024-08-04T20:30:38Z
dc.date.issued2007
dc.departmentİnönü Üniversitesien_US
dc.description.abstractObjective: Hydrocephalus is an important etiological factor in neurological decline. With the advent of fetal ultrasound, fetal hydrocephalus is now more frequently detected than in the past. Ultrasonography (USG) provides information on general morphology, but microstructural changes that may play a prognostic role are beyond the resolution of that technique. These changes may theoretically be revealed by diffusion-weighted magnetic resonance imaging (DW-MRI). In this study, our preliminary findings of DW-MRI on the hydrocephalic fetuses are presented. Materials and Methods: Twelve fetuses with fetal USG diagnosis of hydrocephalus were investigated using a 1.5-T MR scanner. In addition to conventional techniques, DWI was performed. It was obtained using a single-shot echo-planar imaging sequence (TR/TE: 4393/81 ms; slice thickness: 5 mm; interslice gap: 1 mm; FOV: 230 mm; matrix size: 128x256; b values: 0 and 1000 s/mm(2)). Apparent diffusion coefficient (ADC) values were measured in the white matter of the periventricular frontal and occipital lobes, basal ganglia, thalamus, centrum semiovale and cerebrospinal fluid in the lateral ventricle. These values were compared with the normal prenatal ADC values from a radiological study published in the literature. bilateral supratentorial ventricular dilatation that was compatible with hydrocephalus. On conventional T1- and T2-weighted imaging, cerebral parenchyma had normal signal pattern and ADC values were significantly lower than those reported for fetuses with normal brain. These values were lower in hydrocephalic fetuses with statistical significance (P<.05-.01). Conclusion: DWI is a sensitive technique to investigate cerebral microstructure. The reduction in cerebral blood flow and alterations in cerebral energy metabolism in cases with hydrocephalus have been shown before. Changes in cerebral blood flow and energy metabolism, as a consequence of cerebral compression, may occur in hydrocephalus. Elevated ventricular pressure may cause cerebral ischemia. The anaerobic glycolysis seen in the hydrocephalic brain tissue by increasing the lactate concentration and intracellular fluid flux may be the reason for the reduced ADC values in hydrocephalic fetuses. However, long-term prospective trials on the correlation of ADC values and neurological outcome are necessary to exploit the full benefit of that novel technique. (c) 2007 Elsevier Inc. All rights reserved.en_US
dc.identifier.doi10.1016/j.mri.2007.03.028
dc.identifier.endpage1422en_US
dc.identifier.issn0730-725X
dc.identifier.issn1873-5894
dc.identifier.issue10en_US
dc.identifier.pmid17513078en_US
dc.identifier.scopus2-s2.0-36248972498en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage1417en_US
dc.identifier.urihttps://doi.org/10.1016/j.mri.2007.03.028
dc.identifier.urihttps://hdl.handle.net/11616/94399
dc.identifier.volume25en_US
dc.identifier.wosWOS:000251488500009en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Science Incen_US
dc.relation.ispartofMagnetic Resonance Imagingen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectfetalen_US
dc.subjecthydrocephalyen_US
dc.subjectdiffusion reductionen_US
dc.subjectdiffusion-weighted MRIen_US
dc.titleDiffusion-weighted imaging evaluation of subtle cerebral micro structural changes in intrauterine fetal hydrocephalusen_US
dc.typeArticleen_US

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