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Master Thesis

Évaluation quantitative du coefficient apparent de diffusion cérébral fœtal normal au cours du troisième trimestre : évolution et reproductibilité

Abstract : Context: over the past decade, fetal brain MRI has become an indispensable tool in addition to a full ultrasound assessment. Some studies have suggested that quantitative evaluation of the apparent diffusion coefficient of brain could allow for evaluation fetal maturation and the detection of possible anomalies. Objectives: the objective of this study was to propose a specific protocol using a diffusion-weighted imaging sequence with quantitative measurement of ADC of the fetal brain during the third trimester of pregnancy, first to evaluate the feasibility and reproducibility, and then to appreciate the variation regarding the location within the brain and the gestational age. Methods: we retrospectively analyzed the brain MRIs of normal fetuses taken between April 2017 and November 2018. For each fetus, measurements of the apparent coefficient of diffusion were taken at the level of the frontal and occipital white matter, the semioval centers, the thalami, the pons, and the cerebellum. These measurements were carried out by two different readers and on two different workstations. We evaluated the intra-operator, the inter-operator, and the inter-workstation reproducibility using a multivariate linear mixed model per anatomical site with a random intercept. Evaluation of the adc as a function of the term was performed using a univariate linear mixed model per anatomical site. Results: measurements of the adc could be made in all of the 19 patients included in the study. We found a significant difference but low inter-operator reproducibility at the level of the thalami (p=0.026), and the frontal (p=0.005) and the occipital (p=0.026) white matter. No significant difference was found between the two measurement consoles. The values for the left side and the right side were comparable. We also did not find that there was significant variation of the adc over the course of the third trimester, even though there was a decreasing trend at the level of the cerebellum, the occipital white matter, and the pons. There was an increasing trend at the level of the thalami and the frontal white matter. Conclusion: routine evaluation of the fetal brain adc appeared to be feasible, with an interpretability of 100% for the sample. There was significant inter-operator variability, but it was low for certain anatomical sites. We did not find evidence of significant variation of the adc over the course of the third trimester of pregnancy, although we did notice certain trends already described in the literature.
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  • HAL Id : dumas-02495960, version 1

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Christophe Delaby. Évaluation quantitative du coefficient apparent de diffusion cérébral fœtal normal au cours du troisième trimestre : évolution et reproductibilité. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02495960⟩

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