Title: 399: Diffusion MRI findings in monochorionic twin pregnancies after intra-uterine fetal death
Abstract: Monochorionic (MC) twin pregnancies, complicated by the death of one twin, are associated with substantial morbidity in the survivor. Prenatal sonography and conventional T2-weighted MRI might fail to detect brain lesions in the short period after the death of the co-twin. We aim to analyze our experience in Diffusion-weighted magnetic resonance imaging (DWI) in order to diagnose acute hypoxic-ischemic cerebral lesions in the survivor of a MC twin pregnancy. All cases of IUFD in MC pregnancies analyzed by fetal sonography, T2-weighted MRI and DWI during Sep/06-Jul/08 at Sheba Medical Center. 7cases were analyzed by the three modalities. Median gestational age at diagnosis of IUFD was 28. 5/7 cases were scanned and evaluated by MRI within 2-4 days after fetal death (patients 1-5:Table 1). In one case with recent (<4 days) IUFD US-Doppler suggested acute fetal anemia with normal brain anatomy. T2-weighted MRI was abnormal in two cases.Tabled 1GA@IUFDGA@MRIUS findingsDWI findingsT2-MRI findings13636Elevated MCA-PSVPositive - Recent posterior infarct (2d)Brain edema23232NormalPositive - Unilateral recent infarct (4d)Contra lateral previous infarct33232NormalNegative (4d)Normal42828NormalNegative (1d)Dilation of ant. Horn52324NormalPositive- Temporal horn infarct (4d)Normal62027NormalNegative (7w)Normal72428NormalNegative (4w)Normal Open table in a new tab DWI is able to detect acute cerebral ischemic lesions during fetal life even in the absence of sonographic or conventional MRI findings. This is particularly important in MC pregnancies with IUFD close to term when prompt delivery might be indicated.
Publication Year: 2008
Publication Date: 2008-12-01
Language: en
Type: article
Indexed In: ['crossref']
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Cited By Count: 1
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