1.南京医科大学第一附属医院放射科，江苏 南京 210029 ;2.上海科技大学生物医学工程学院，先进医疗材料和设备国家重点实验室，上海 201210 ;3.南京医科大学第一附属医院产科，江苏 南京 210029
R445.2
江苏省科教能力提升工程（JSDW202243）
1.Department of Radiology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029 ;2.School of Biomedical Engineering & State Key Laboratory of Advanced Medical Materials and Devices，Shanghai Tech University，Shanghai 201210 ;3.Department of Obstetrics，the First Affiliated Hospital of Nanjing Medical University， Nanjing 210029 ，China
目的：探讨胎盘体素内不相干运动（intravoxel incoherent motion，IVIM）MRI参数和胎儿脑体积对FGR中VLBWI的预测价值。方法：回顾性纳入23例FGR孕妇，依据胎儿出生体重分为VLBWI组（8例）和非极低出生体重儿（non-VLBWI）组 （15例）。比较两组胎儿侧脑室占颅内体积百分比以及胎盘IVIM参数［真扩散系数（D）、伪扩散系数（D* ）、血流灌注分数（f）及胎盘面积］。采用受试者工作特征（receiver operating characteristic，ROC）曲线分析各参数对VLBWI的预测效能。结果：VLBWI 组胎盘D值小于non-VLBWI组［（1.38±0.04）×10-3 mm2 /s vs.（1.44±0.07）×10-3 mm2 /s，t=-2.109，P=0.047］，胎盘面积小于non-VLBWI 组［（155.84±34.69）cm2 vs.（200.41±47.95）cm2 ，t=-2.315，P=0.031］，胎儿侧脑室占颅内体积百分比大于non-VLBWI 组［（3.00± 0.55）% vs.（2.53±0.33）%，t=2.591，P=0.017］。胎盘 D 值、胎盘面积和侧脑室占颅内体积百分比的 ROC 曲线下面积分别为 0.767、0.783和0.792。联合胎儿侧脑室占颅内体积百分比、胎盘D值和胎盘面积可将ROC曲线下面积提高至0.892。结论：胎盘IVIM参数和胎儿脑体积可能是帮助预测FGR中VLBWI的潜在有效影像标志物。
Objective：To evaluate the predictive value of placental intravoxel incoherent motion（IVIM）MRI parameters and fetal brain volume in predicting VLBWI in FGR. Methods：A retrospective analysis was conducted on 23 pregnant women with FGR， categorized into VLBWI group（n=8）and non-VLBWI group（n=15）based on birth weight. We compared brain structures as a percentage of intracranial volume and placental IVIM parameters［true diffusion coefficient（D），pseudo-diffusion coefficient（D* ）， perfusion fraction（f），and placental area］between the two groups. Receiver operating characteristic（ROC）curve analysis was used to assess the predictive efficacy of each parameter for VLBWI. Results：The placental D value in the VLBWI group was lower than that in the non-VLBWI group［（1.38±0.04）×10-3 mm2 /s vs.（1.44±0.07）×10-3 mm2 /s，t=-2.109，P=0.047］，and the placental area was smaller in the VLBWI group［（155.84 ± 34.69）cm2 vs.（200.41 ± 47.95）cm2 ，t=-2.315，P=0.031］，while the percentage of lateral ventricle volume relative to intracranial volume was greater in the VLBWI group［（3.00 ± 0.55）% vs.（2.53 ± 0.33）%，t=2.591，P=0.017］. The areas under the ROC curve for placental D value，placental area，and lateral ventricle as a percentage of intracranial volume were 0.767，0.783，and 0.792，respectively. Combining the fetal lateral ventricle as a percentage of intracranial volume，placental D value，and placental area improved the ROC curve area to 0.892. Conclusion：Placental IVIM parameters and fetal brain volume may serve as potentially effective imaging markers for distinguishing VLBWI in cases of FGR.
孔令男,黄世杰,张璇,季亮宇,周欣,吴飞云,赵萌.基于胎盘体素内不相干运动MRI和胎儿脑体积预测生长受限胎儿中的极低出生体重儿[J].南京医科大学学报（自然科学版）,2025,(3):360-366
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