Dual-Imaging Modality Approach to Evaluate Cerebral Hemodynamics in Growth-Restricted Fetuses: Oxygenation and Perfusion Journal Articles uri icon

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  • <b><i>Objective:</i></b> To evaluate a dual-imaging modality approach to obtain a combined estimation of venous blood oxygenation (S<i>νO</i><sub>2</sub>) using susceptibility-weighted magnetic resonance imaging (SWI-MRI), and blood perfusion using power Dopp­ler ultrasound (PDU) and fractional moving blood volume (FMBV) in the brain of normal growth and growth-restricted fetuses. <b><i>Methods:</i></b> Normal growth (<i>n</i> = 33) and growth-restricted fetuses (<i>n</i> = 10) from singleton pregnancies between 20 and 40 weeks of gestation were evaluated. MRI was performed and S<i>νO</i><sub>2</sub> was calculated using SWI-MRI data obtained in the straight section of the superior sagittal sinus. Blood perfusion was estimated using PDU and FMBV from the frontal lobe in a mid-sagittal plane of the fetal brain. The association between fetal brain S<i>νO</i><sub>2</sub> and FMBV, and the distribution of S<i>νO</i><sub>2</sub> and FMBV values across gestation were calculated for both groups. <b><i>Results:</i></b> In growth-restricted fetuses, the brain S<i>νO</i><sub>2</sub> values were similar, and the FMBV values were higher across gestation as compared to normal growth fetuses. There was a significantly positive association between S<i>νO</i><sub>2</sub> and FMBV values (slope = 0.38 ± 0.12; <i>r</i> = 0.7; <i>p</i> = 0.02) in growth-restricted fetuses. In normal growth fetuses, S<i>νO</i><sub>2</sub> showed a mild decreasing trend (slope = –0.7 ± 0.4; <i>p</i> = 0.1), whereas FMBV showed a mild increasing trend (slope = 0.2 ± 0.2; <i>p</i> = 0.2) with advancing gestation, and a mild but significant negative association (slope = –0.78 ± 0.3; <i>r</i> = –0.4; <i>p</i> = 0.04) between these two estimates. <b><i>Conclusion:</i></b> Combined MRI (SWI) and ultrasound (FMBV) techniques showed a significant association between cerebral blood oxygenation and blood perfusion in normal growth and growth-restricted fetuses. This dual-imaging approach could contribute to the early detection of fetal “brain sparing” and brain oxygen saturation changes in high-risk pregnancies.


  • Yadav, Brijesh Kumar
  • Hernandez-Andrade, Edgar
  • Krishnamurthy, Uday
  • Buch, Sagar
  • Jella, Pavan
  • Trifan, Anabela
  • Yeo, Lami
  • Hassan, Sonia S
  • Haacke, Mark
  • Romero, Roberto
  • Neelavalli, Jaladhar

publication date

  • 2020

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