A semi-quantitative MRI study on brain developmental abnormalities in infants of gestational diabetic mothers

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• Clinical Article •

SUN Fei YU Jinhong LUO Hedan MIAO Yanwei

Cite this article as: SUN F, YU J H, LUO H D, et al. A semi-quantitative MRI study on brain developmental abnormalities in infants of gestational diabetic mothers[J]. Chin J Magn Reson Imaging, 2024, 15(12): 87-93. DOI:10.12015/issn.1674-8034.2024.12.013.

Abstract

[Abstract] Objective To investigate the value of semi-quantitative analysis based on T1WI, T2WI, T2 fluid attenuated inversion recovery (FLAIR), and diffusion-weighted imaging (DWI) sequences in exploring abnormal brain development changes in infants of gestational diabetic mothers (IDMs).Materials and Methods A total of 54 cases of DMs were retrospectively included as the observation group (IDMs group), while 70 infants born to mothers without high-risk perinatal factors during the same period served as the healthy control (HC) group. Based on whether the gestational age at birth was less than 37 weeks, the IDMs group and the HC group were further divided into preterm infants: 27 in the IDMs A group and 33 in the HC A group, and term infants: 27 in the IDMs B group and 37 in the HC B group. A 1.5 T MRI was performed using T1WI, T2WI, T2 FLAIR, and DWI sequences. Regions of interest (ROI) were manually drawn on the maximum slices of the cerebellar hemispheres, amygdala, hippocampus, temporal lobe white matter, globus pallidus, caudate nucleus, ventrolateral thalamic nucleus, posterior limb of the internal capsule, splenium of the corpus callosum, frontal white matter, occipital white matter, parietal white matter, centrum semiovale, and masseter muscles, measuring the signal intensity and apparent diffusion coefficient (ADC) values of each ROI. The mean signal intensity ratios (SIRT1, SIRT2, SIRT2 FLAIR) of each region/masseter muscle were calculated. Differences in these ratios and ADC values between groups were compared, and the diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves, with DeLong's test applied to compare the differences in the area under the curve (AUC). The relationship between MR intensity ratios and maternal 75 g oral glucose tolerance test (OGTT) blood glucose levels was also observed.Results Compared with the HC group, the IDMs group showed reduced SIRT1 in the occipital lobe, globus pallidus, caudate nucleus, posterior limb of the internal capsule, ventrolateral thalamic nucleus, parietal lobe, frontal lobe, and centrum semiovale, as well as lower SIRT2 in all regions, and lower SIRT2 FLAIR in all regions except for the occipital lobe and posterior limb of the internal capsule. The ADC values in the temporal lobe were also lower (P<0.05). After stratified analysis, it was found that SIRT1 in the cerebellar hemisphere, posterior limb of the internal capsule, ventrolateral thalamic nucleus, and centrum semiovale, as well as SIRT2 in all regions, and SIRT2 FLAIR in all areas except for the occipital lobe and splenium of the corpus callosum in the IDMs A group were lower than in the control group. In the IDMs B group, SIRT1 in the frontal and parietal lobes, SIRT2 in all regions, and ADC values in the cerebellar hemisphere and temporal lobe were lower than those in the HC B group (P<0.05). ROC curve analysis showed that the AUC values for SIRT2 in all regions in the IDMs group were the highest, with SIRT2 in the temporal lobe demonstrating good diagnostic efficacy (AUC=0.702). DeLong's test indicated statistically significant differences in AUC values between SIRT2 and SIRT1, SIRT2 FLAIR, or ADC in the cerebellar hemisphere, hippocampus, temporal lobe, occipital lobe, posterior limb of the internal capsule, and parietal lobe (P<0.05). SIRT2 in all regions of the IDMs group was negatively correlated with 1-hour blood glucose levels from the OGTT (P<0.05).Conclusions The relative signal intensity ratios of T1WI, T2WI, and T2 FLAIR, along with ADC values, are useful for the early detection of neurodevelopmental abnormalities in IDMs. Among these, SIRT2 demonstrates a higher diagnostic efficacy.

[Keywords] infant of gestational diabetic mothers；brain development；magnetic resonance imaging；diffusion-weighted imaging；signal intensity ratio

Contributor Information

SUN Fei^{1,
2} YU Jinhong² LUO Hedan^{2,
3} MIAO Yanwei^2*

¹ Department of Radiology, Dalian Women and Children Medical Group, Dalian116001, China

² Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian116011, China

³ Department of Radiology, Dalian Public Health Clinical Center, Dalian116031, China

Corresponding author: MIAO Y W, E-mail: ywmiao716@163.com

Conflicts of interest None.

Publication Information

Received 2024-04-29

Accepted 2024-12-16

DOI: 10.12015/issn.1674-8034.2024.12.013

Text

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