Abstract
Purpose: To describe and classify the range of brain injuries present at prenatal, in-utero magnetic resonance (MR) imaging in cotwin survivors of monochorionic (MC) twin pregnancies complicated by single intrauterine death (SIUD). Materials and Methods: This retrospective, observational study from six tertiary fetal medicine centers that perform tertiary-level prenatal in-utero MR studies reviewed cases in which prenatal in-utero MR imaging had shown a brain injury in a surviving co-twin of a twin pregnancy with a MC component complicated by SIUD. Results: Forty-two surviving MC twins were described. The primary distinction of brain abnormalities was into nonfocal and focal lesions. The nonfocal lesions included periventricular leukomalacia (group 1; two fetuses), generalized encephalomalacia (group 2; nine fetuses), posterior encephalomalacia (group 3; seven fetuses), and bilateral parasagittal and perisylvian injury (group 4; three fetuses). The focal lesions included nonhemorrhagic lesions (group 5; 14 fetuses) and hemorrhagic lesions (group 6; seven fetuses). Focal brain lesions were more likely to be found in the surviving MC pregnancies complicated by twin-twin transfusion syndrome (TTTS) (odds ratio, 2.4; 95% confidence interval: 1.3, 18.5; P = .01) and in fetuses that underwent an obstetric intervention (odds ratio, 2.8; 95% confidence interval: 1.8, 23.6; P = .006). Conclusion: Brain injury of the surviving co-twin after SIUD in MC pregnancies is usually of ischemic origin and spares the brainstem and cerebellum. Focal brain lesions are more frequent in pregnancies complicated by TTTS or in those where an intervention has been performed.
| Original language | English |
|---|---|
| Pages (from-to) | 582-590 |
| Number of pages | 9 |
| Journal | Radiology |
| Volume | 288 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Aug 1 2018 |
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ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
Brain-injured survivors of monochorionic twin pregnancies complicated by single intrauterine death : MR findings in a multicenter study. / Conte, Giorgio; Righini, Andrea; Griffiths, Paul D.; Rustico, Mariangela; Lanna, Mariano; Mackie, Fiona L.; Pinelli, Lorenzo; Prefumo, Federico; Persico, Nicola; Igra, Mark S.; Parazzini, Cecilia; Doneda, Chiara; Fichera, Anna; Ambrosi, Claudia; Kilby, Mark; Severino, Mariasavina; Triulzi, Fabio; Rossi, Andrea; Skipper, Nicholas.
In: Radiology, Vol. 288, No. 2, 01.08.2018, p. 582-590.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Brain-injured survivors of monochorionic twin pregnancies complicated by single intrauterine death
T2 - MR findings in a multicenter study
AU - Conte, Giorgio
AU - Righini, Andrea
AU - Griffiths, Paul D.
AU - Rustico, Mariangela
AU - Lanna, Mariano
AU - Mackie, Fiona L.
AU - Pinelli, Lorenzo
AU - Prefumo, Federico
AU - Persico, Nicola
AU - Igra, Mark S.
AU - Parazzini, Cecilia
AU - Doneda, Chiara
AU - Fichera, Anna
AU - Ambrosi, Claudia
AU - Kilby, Mark
AU - Severino, Mariasavina
AU - Triulzi, Fabio
AU - Rossi, Andrea
AU - Skipper, Nicholas
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Purpose: To describe and classify the range of brain injuries present at prenatal, in-utero magnetic resonance (MR) imaging in cotwin survivors of monochorionic (MC) twin pregnancies complicated by single intrauterine death (SIUD). Materials and Methods: This retrospective, observational study from six tertiary fetal medicine centers that perform tertiary-level prenatal in-utero MR studies reviewed cases in which prenatal in-utero MR imaging had shown a brain injury in a surviving co-twin of a twin pregnancy with a MC component complicated by SIUD. Results: Forty-two surviving MC twins were described. The primary distinction of brain abnormalities was into nonfocal and focal lesions. The nonfocal lesions included periventricular leukomalacia (group 1; two fetuses), generalized encephalomalacia (group 2; nine fetuses), posterior encephalomalacia (group 3; seven fetuses), and bilateral parasagittal and perisylvian injury (group 4; three fetuses). The focal lesions included nonhemorrhagic lesions (group 5; 14 fetuses) and hemorrhagic lesions (group 6; seven fetuses). Focal brain lesions were more likely to be found in the surviving MC pregnancies complicated by twin-twin transfusion syndrome (TTTS) (odds ratio, 2.4; 95% confidence interval: 1.3, 18.5; P = .01) and in fetuses that underwent an obstetric intervention (odds ratio, 2.8; 95% confidence interval: 1.8, 23.6; P = .006). Conclusion: Brain injury of the surviving co-twin after SIUD in MC pregnancies is usually of ischemic origin and spares the brainstem and cerebellum. Focal brain lesions are more frequent in pregnancies complicated by TTTS or in those where an intervention has been performed.
AB - Purpose: To describe and classify the range of brain injuries present at prenatal, in-utero magnetic resonance (MR) imaging in cotwin survivors of monochorionic (MC) twin pregnancies complicated by single intrauterine death (SIUD). Materials and Methods: This retrospective, observational study from six tertiary fetal medicine centers that perform tertiary-level prenatal in-utero MR studies reviewed cases in which prenatal in-utero MR imaging had shown a brain injury in a surviving co-twin of a twin pregnancy with a MC component complicated by SIUD. Results: Forty-two surviving MC twins were described. The primary distinction of brain abnormalities was into nonfocal and focal lesions. The nonfocal lesions included periventricular leukomalacia (group 1; two fetuses), generalized encephalomalacia (group 2; nine fetuses), posterior encephalomalacia (group 3; seven fetuses), and bilateral parasagittal and perisylvian injury (group 4; three fetuses). The focal lesions included nonhemorrhagic lesions (group 5; 14 fetuses) and hemorrhagic lesions (group 6; seven fetuses). Focal brain lesions were more likely to be found in the surviving MC pregnancies complicated by twin-twin transfusion syndrome (TTTS) (odds ratio, 2.4; 95% confidence interval: 1.3, 18.5; P = .01) and in fetuses that underwent an obstetric intervention (odds ratio, 2.8; 95% confidence interval: 1.8, 23.6; P = .006). Conclusion: Brain injury of the surviving co-twin after SIUD in MC pregnancies is usually of ischemic origin and spares the brainstem and cerebellum. Focal brain lesions are more frequent in pregnancies complicated by TTTS or in those where an intervention has been performed.
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U2 - 10.1148/radiol.2018171267
DO - 10.1148/radiol.2018171267
M3 - Article
VL - 288
SP - 582
EP - 590
JO - Radiology
JF - Radiology
SN - 0033-8419
IS - 2
ER -