Twin discordance: a study of volumetric fetal brain MRI and neurodevelopmental outcome.


Journal

European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 18 06 2020
accepted: 11 02 2021
revised: 30 12 2020
pubmed: 17 3 2021
medline: 25 8 2021
entrez: 16 3 2021
Statut: ppublish

Résumé

This study employed magnetic resonance imaging (MRI) to compare brain volumes of discordant twins and examined their neurodevelopment after birth by using a validated exam. A prospective historical cohort study of discordant dichorionic diamniotic (DCDA) or monochorionic diamniotic (MCDA) twin fetuses, who undergone an MRI scan to evaluate growth restriction in the discordant twin (weight < 10 The volume of major brain structures was significantly larger in the appropriate-for-gestational-age twins (AGA) compared to the small-for-gestational-age (SGA) co-twins (p < 0.001). The birth weight discordance was 32.3% (24.9-48.6) and was significantly greater (p < 0.001) than the discordance of the prenatal supratentorial brain (13.6% [5.6-18]), cerebellum volume (21.7% [9.5-30.8]). Further neurodevelopmental outcome evaluation found no significant difference between the AGA twin and the SGA twin. In discordant twins, the smaller twin showed a "brain-preserving effect," which in our study was not associated with a worse neurodevelopmental outcome. The use of MRI in such cases may aid in decision-making and parental consultation. • Weight discordance at birth was significantly greater compared to intrauterine brain volume discordance measured by 3D MRI. • Small-for-gestational-age (SGA) fetuses preserve brain development. • In highly discordant twins, there was no long-term difference in neurodevelopmental outcome at a mean age of 4.9 years.

Identifiants

pubmed: 33723640
doi: 10.1007/s00330-021-07773-5
pii: 10.1007/s00330-021-07773-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

6676-6685

Informations de copyright

© 2021. European Society of Radiology.

Références

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Auteurs

Tom Halevy (T)

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, 52621, Ramat Gan, Israel. dr.tomhalevy@gmail.com.

Meirav Nezer (M)

Department of Obstetrics and Gynecology, Samson Assuta Ashdod University Hospital, Ashdod, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.

Jorden Halevy (J)

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, 52621, Ramat Gan, Israel.

Tomer Ziv-Baran (T)

School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Eran Barzilay (E)

Department of Obstetrics and Gynecology, Samson Assuta Ashdod University Hospital, Ashdod, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.

Eldad Katorza (E)

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, 52621, Ramat Gan, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

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