The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2026
Characteristics of white matter microstructure development and blood perfusion in the second and third trimesters of normal fetuses: application of intravoxel incoherent motion diffusion-weighted imaging.
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Lin Xiao-Mei, Yuan Xiao, Yu Mei, An Pan, Qu Xiao-Yan, Yue Cui, Wang Wen
Аннотация
OBJECTIVE: To characterize alterations in white matter and blood perfusion in normal fetuses using quantitative parameters derived from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI).
METHODS: A total of 138 fetuses underwent IVIM-MRI. Subjects were categorized into two groups: second trimester (24-28 weeks; n = 41) and third trimester (29-40 weeks; n = 97). A single voxel block was utilized as an ROI to acquire paired pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) in specific brain regions.
RESULTS: 1) D values decreased significantly with advancing gestational age in all brain regions except the bilateral frontal lobes. 2) D values were significantly lower in the third trimester compared to the second trimester in all regions except the bilateral frontal lobes. 3) Cerebral blood perfusion (f value) exhibited laterality in specific regions: The f value of the left thalamus was consistently higher than the right across all fetuses. This thalamic laterality was significant in the third trimester. Additionally, the left parietal lobe displayed a lower f value relative to the right during the second trimester.
CONCLUSION: The IVIM-derived D value provides a quantitative biomarker for assessing white matter maturational processes in the mid-to-late fetal stage of normal fetuses, offering potential clinical utility for early detection of delayed myelination. The f value metric revealed lateralized cerebral blood perfusion during normal fetal development, with laterality patterns evolving with gestational age.
METHODS: A total of 138 fetuses underwent IVIM-MRI. Subjects were categorized into two groups: second trimester (24-28 weeks; n = 41) and third trimester (29-40 weeks; n = 97). A single voxel block was utilized as an ROI to acquire paired pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) in specific brain regions.
RESULTS: 1) D values decreased significantly with advancing gestational age in all brain regions except the bilateral frontal lobes. 2) D values were significantly lower in the third trimester compared to the second trimester in all regions except the bilateral frontal lobes. 3) Cerebral blood perfusion (f value) exhibited laterality in specific regions: The f value of the left thalamus was consistently higher than the right across all fetuses. This thalamic laterality was significant in the third trimester. Additionally, the left parietal lobe displayed a lower f value relative to the right during the second trimester.
CONCLUSION: The IVIM-derived D value provides a quantitative biomarker for assessing white matter maturational processes in the mid-to-late fetal stage of normal fetuses, offering potential clinical utility for early detection of delayed myelination. The f value metric revealed lateralized cerebral blood perfusion during normal fetal development, with laterality patterns evolving with gestational age.