Measurement of middle cerebral artery diameter as a method for assessment of brain sparing in intra-uterine growth-restricted discordant twins

Eran Barzilay*, Jigal Haas, Hila de Castro, Yoav Yinon, Reuven Achiron, Yinon Gilboa

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objectives: Blood vessel resistance is assessed by flow velocity indexes. However, the actual resistance should be more strongly correlated with vessel diameter rather than variations in flow velocity. We aimed to determine the utility of middle cerebral artery (MCA) diameter measurement as a tool for evaluating brain sparing effect in intrauterine growth-restricted (IUGR) discordant twins. Methods: Ten dichorionic-diamniotic twin pairs with weight discordance were included in the study. Fetal assessment included estimated fetal weight, umbilical artery flow, MCA flow and MCA diameter. Paired statistical analysis was used to compare MCA diameter and MCA pulsatility index (PI) between the discordant twins. Results: MCA diameter was significantly larger in the smaller twin (mean diameter 3.55±0.26 vs 2.71±0.22, P=0.018, mean ratio 1.39±0.14). There was no significant difference in MCA PI values within the twin pairs (mean PI 1.51±0.13 vs 1.57±0.07, P=0.878, mean ratio 0.99±0.11). Conclusions: Measurement of MCA diameter can potentially be used as a tool for assessing vessel resistance. Further studies are needed to assess the feasibility and sensitivity of this method as well as the clinical significance of MCA dilatation in the presence of normal Doppler flow indexes.

Original languageEnglish
Pages (from-to)137-141
Number of pages5
JournalPrenatal Diagnosis
Volume35
Issue number2
DOIs
StatePublished - 1 Feb 2015

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