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Single-direction diffusion-weighted imaging may be a simple complementary sequence for evaluating fetal corpus callosum

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Abstract

Objectives

To explore the feasibility of single-direction diffusion-weighted imaging (DWI) for assessing the fetal corpus callosum (CC).

Methods

This prospective study included 67 fetuses with normal CC and 35 fetuses suspected with agenesis of the corpus callosum (ACC). The MR protocols included HASTE, TrueFISP, and single-direction DWI. Two radiologists independently evaluated the optimal visibility and the contrast ratio (CR) of the normal fetal CC. The Chi-squared test or Fisher’s exact test was used to compare the proportions of “good” visibility (score ≥ 3, and the CC was almost/entirely visible) between single-direction DWI and HASTE/TrueFISP. The CR difference between single-direction DWI and HASTE/TrueFISP was detected using the paired t-test. The diagnostic accuracies were determined by comparison with postnatal imaging. In fetuses suspected of ACC, we measured and compared the length and area of the mid-sagittal CC in the single-direction DWI images.

Results

The proportion of “good” visibility in single-direction DWI was higher than that in HASTE/TrueFISP, with p < 0.0001. The mean CR from single-direction DWI was also higher than that of TrueFISP and HASTE (both with p < 0.0001). The diagnostic accuracy of the single-direction DWI combined with HASTE/TrueFisp (97.1%, 34/35) was higher than that of the Haste/TrueFISP (74.3%, 26/35) (p = 0.013). The length and area of the PACC (p < 0.001, p = 0.001, respectively) and HCC (p < 0.001, p = 0.018, respectively) groups were significantly lower than those of the normal group.

Conclusions

The single-direction DWI is feasible in displaying fetal CC and can be a complementary sequence in diagnosing ACC.

Key Points

• We suggest a simple method for the display of the fetal CC.

• The optimal visibility and contrast ratio from single-direction DWI were higher than those from HASTE and TrueFISP.

• The diagnostic accuracy of the single-direction DWI combined with HASTE/TrueFISP sequences (97.1%, 34/35) was higher than that of the Haste/TrueFISP (74.3%, 26/35).

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Abbreviations

ACC:

Agenesis of the corpus callosum

ADC:

Apparent diffusion coefficient

CACC:

Complete agenesis of the corpus callosum

CC:

Corpus callosum

CI:

Confidence interval

CR:

Contrast ratio

DTI:

Diffusion-tensor magnetic resonance imaging

DWI:

Diffusion-weighted imaging

HASTE:

Half-Fourier single-shot turbo spin-echo

HCC:

Hypoplasia of the corpus callosum

ICC:

Intraclass correlation coefficient

MRI:

Magnetic resonance imaging

PACC:

Partial agenesis of the corpus callosum

ROI:

Region of interest

TrueFISP:

True fast imaging with steady-state precession

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Acknowledgements

We thank P. Ellen Grant, MD, formally affiliated with the Department of Radiology and Fetal-Neonatal Neuroimaging & Developmental Science Center (FNNDSC), Boston Children’s Hospital, Harvard Medical School, for helping me revise the manuscript. We are very grateful to all the participants and their families who consented to participate in this study. Besides, we thank the radiography staff at the Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, for their support in the imaging data collection.

Funding

This work was supported by the National Natural Science Foundation of China (81671668); and the Natural Science Foundation of Shandong Province (ZR201911150560).

Author information

Authors and Affiliations

  1. Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

    Cong Sun, Yufan Chen & Guangbin Wang

  2. Department of Radiology, Shandong Provincial Hospital Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China

    Xinjuan Zhang, Xin Chen & Guangbin Wang

  3. Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Tianjia Zhu & Hao Huang

  4. Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA

    Tianjia Zhu

  5. MR Collaboration, Siemens Healthcare Ltd., Beijing, China

    Jinxia Zhu

  6. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Hao Huang

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  1. Cong Sun
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Corresponding author

Correspondence to Guangbin Wang.

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The scientific guarantor of this publication is Guangbin Wang.

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One of the authors of this manuscript (Jinxia Zhu) is an employee of Siemens Healthcare. The remaining authors declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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Written informed consent was obtained from all subjects (patients) in this study.

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Sun, C., Zhang, X., Chen, X. et al. Single-direction diffusion-weighted imaging may be a simple complementary sequence for evaluating fetal corpus callosum. Eur Radiol 32, 1135–1143 (2022). https://doi.org/10.1007/s00330-021-08176-2

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