Use of diffusion-weighted magnetic resonance imaging to distinguish between normal and small for gestational age pregnancies: comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient

Junshen He; Liqun Xu; Zhao Chen; Chunlin Chen; Ping Liu

doi:10.1093/bjr/tqaf136

Use of diffusion-weighted magnetic resonance imaging to distinguish between normal and small for gestational age pregnancies: comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient

Br J Radiol. 2025 Jun 23:tqaf136. doi: 10.1093/bjr/tqaf136. Online ahead of print.

Authors

Junshen He^{1

2

3}, Liqun Xu¹, Zhao Chen⁴, Chunlin Chen¹, Ping Liu¹

Affiliations

¹ Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
² Department of Obstetrics and Gynecology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
³ Auckland Bioengineering Institute, University of Auckland, New Zealand.
⁴ Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.

PMID: 40581622
DOI: 10.1093/bjr/tqaf136

Abstract

Objectives: We compared the predictive performance of apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) parameters in assessing small for gestational age (SGA) pregnancies.

Methods: Perspective study. Twenty-eight normal controls and 30 SGA pregnancies underwent IVIM scans on a 3.0 T MRI scanner. The diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) were calculated from the IVIM, and the ADC was derived from the IVIM sequence with monoexponential fitting of the IVIM data at b values of 0 and 800 s/mm. All four parameters and AUC within the placenta were compared between normal and SGA pregnancies.

Results: All of mean ADC ((1.69 ± 0.19) × 10-3 mm2/s vs. (1.42 ± 0.28) × 10-3 mm2/s), D (1901.08 ± 199.77 µm2/s vs. 1635.17 ± 244.18 µm2/s), D* (56445.78 ± 8125.91 µm2/s vs. 47600.62 ± 7642.15 µm2/s) and f (33.35% ± 3.36% vs. 27.30 ± 3.48%) were significantly decreased in SGA pregnancies (p < 0.001 for all). The diagnostic performance of f (AUC = 0.896; sensitivity, 80.00%; specificity, 92.86%; cut-off value, 29.28%) was significantly better than ADC (AUC = 0.788; sensitivity, 86.67%; specificity, 70.83%; cut-off value, 1.63 × 10-3 mm2/s; p = 0.035), D (AUC = 0.798; sensitivity, 70.00%; specificity, 82.14%; cut-off value, 1708.17 µm2/s; p = 0.041) and D* (AUC = 0.800; sensitivity, 63.33%; specificity, 89.29%; cut-off value, 48181.97 µm2/s; p = 0.044).

Conclusion: Our study suggested that f, a perfusion parameter derived from IVIM, was a more powerful independent predictor than ADC and other IVIM parameters of SGA pregnancies.

Advances in knowledge: This study compared the ADC and IVIM in diagnosing SGA.

Keywords: ADC; IVIM; MRI; SGA; placenta.

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