The Current Knowledge of Cerebral Magnetic Resonance Imaging in Monochorionic Twins: A Systematic Review of the Last 20 Years
The distinct placental angioarchitecture in monochorionic (MC) pregnancies increases the risk of complications such as twin–twin transfusion syndrome (TTTS), twin anemia polycythemia sequence (TAPS), and selective fetal growth restriction (sFGR). The aim of this systematic review was to evaluate the...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/23/7211 |
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| author | Mathies Rondagh Enrico Lopriore Linda S. de Vries Femke Slaghekke Lisanne S. A. Tollenaar Jeanine M. M. van Klink Sophie G. Groene Sylke J. Steggerda |
| author_facet | Mathies Rondagh Enrico Lopriore Linda S. de Vries Femke Slaghekke Lisanne S. A. Tollenaar Jeanine M. M. van Klink Sophie G. Groene Sylke J. Steggerda |
| author_sort | Mathies Rondagh |
| collection | DOAJ |
| description | The distinct placental angioarchitecture in monochorionic (MC) pregnancies increases the risk of complications such as twin–twin transfusion syndrome (TTTS), twin anemia polycythemia sequence (TAPS), and selective fetal growth restriction (sFGR). The aim of this systematic review was to evaluate the incidence, type, and severity of cerebral injury and structural brain development on fetal and/or neonatal cerebral magnetic resonance imaging (MRI) in MC twins with or without complications. Twenty-three studies were included, covering a wide range of complications observed during MC pregnancies, with studies involving sIUFD (<i>n</i> = 12), TTTS (<i>n</i> = 7), mixed complications (<i>n</i> = 2), TAPS (<i>n</i> = 1), and uncomplicated MC pregnancy (<i>n</i> = 1). TAPS and sFGR were largely underrepresented in the current literature. The included studies reported that MC pregnancies with single intrauterine fetal demise (sIUFD) are most at risk for cerebral injury during the fetal period. The overall median incidence of cerebral injury after sIUFD was 28.3% (0–55%). Severe antenatal cerebral injury after sIUFD was detected antenatally in 6.5% (0–36%) of the cases. Three of the included studies described the incidence, type, and severity of cerebral injury on neonatal MRI in MC twins. Structural brain development based on cerebral biometry was only assessed in two studies, revealing significantly smaller biometric measurements of the cerebrum in cases of single sIUFD or smaller twins compared to singleton pregnancies. To enhance our understanding of the potential risks and pathophysiological mechanisms associated with cerebral injury and structural brain development in MC twins, there is a need for future studies and standardized protocols using serial fetal and neonatal MRI imaging in addition to routine ultrasound imaging. |
| first_indexed | 2024-03-09T01:49:25Z |
| format | Article |
| id | doaj.art-f55d226a03e044c3b8ec0c5a2b3b8b98 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T01:49:25Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-f55d226a03e044c3b8ec0c5a2b3b8b982023-12-08T15:18:34ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011223721110.3390/jcm12237211The Current Knowledge of Cerebral Magnetic Resonance Imaging in Monochorionic Twins: A Systematic Review of the Last 20 YearsMathies Rondagh0Enrico Lopriore1Linda S. de Vries2Femke Slaghekke3Lisanne S. A. Tollenaar4Jeanine M. M. van Klink5Sophie G. Groene6Sylke J. Steggerda7Department of Neonatology, Leiden University Medical Centre, J6-S, P.O. Box 9600, 2300 RC Leiden, The NetherlandsWillem-Alexander Children’s Hospital, Department of Paediatrics, Division of Neonatology, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsWillem-Alexander Children’s Hospital, Department of Paediatrics, Division of Neonatology, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsFetal Therapy, Department of Obstetrics, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsFetal Therapy, Department of Obstetrics, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsWillem-Alexander Children’s Hospital, Department of Paediatrics, Division of Neonatology, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsWillem-Alexander Children’s Hospital, Department of Paediatrics, Division of Neonatology, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsWillem-Alexander Children’s Hospital, Department of Paediatrics, Division of Neonatology, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsThe distinct placental angioarchitecture in monochorionic (MC) pregnancies increases the risk of complications such as twin–twin transfusion syndrome (TTTS), twin anemia polycythemia sequence (TAPS), and selective fetal growth restriction (sFGR). The aim of this systematic review was to evaluate the incidence, type, and severity of cerebral injury and structural brain development on fetal and/or neonatal cerebral magnetic resonance imaging (MRI) in MC twins with or without complications. Twenty-three studies were included, covering a wide range of complications observed during MC pregnancies, with studies involving sIUFD (<i>n</i> = 12), TTTS (<i>n</i> = 7), mixed complications (<i>n</i> = 2), TAPS (<i>n</i> = 1), and uncomplicated MC pregnancy (<i>n</i> = 1). TAPS and sFGR were largely underrepresented in the current literature. The included studies reported that MC pregnancies with single intrauterine fetal demise (sIUFD) are most at risk for cerebral injury during the fetal period. The overall median incidence of cerebral injury after sIUFD was 28.3% (0–55%). Severe antenatal cerebral injury after sIUFD was detected antenatally in 6.5% (0–36%) of the cases. Three of the included studies described the incidence, type, and severity of cerebral injury on neonatal MRI in MC twins. Structural brain development based on cerebral biometry was only assessed in two studies, revealing significantly smaller biometric measurements of the cerebrum in cases of single sIUFD or smaller twins compared to singleton pregnancies. To enhance our understanding of the potential risks and pathophysiological mechanisms associated with cerebral injury and structural brain development in MC twins, there is a need for future studies and standardized protocols using serial fetal and neonatal MRI imaging in addition to routine ultrasound imaging.https://www.mdpi.com/2077-0383/12/23/7211cerebral injurymagnetic resonance imagingmonochorionic twinsselective fetal growth restrictionsingle intrauterine fetal demisetwin anemia polycythemia sequence |
| spellingShingle | Mathies Rondagh Enrico Lopriore Linda S. de Vries Femke Slaghekke Lisanne S. A. Tollenaar Jeanine M. M. van Klink Sophie G. Groene Sylke J. Steggerda The Current Knowledge of Cerebral Magnetic Resonance Imaging in Monochorionic Twins: A Systematic Review of the Last 20 Years Journal of Clinical Medicine cerebral injury magnetic resonance imaging monochorionic twins selective fetal growth restriction single intrauterine fetal demise twin anemia polycythemia sequence |
| title | The Current Knowledge of Cerebral Magnetic Resonance Imaging in Monochorionic Twins: A Systematic Review of the Last 20 Years |
| title_full | The Current Knowledge of Cerebral Magnetic Resonance Imaging in Monochorionic Twins: A Systematic Review of the Last 20 Years |
| title_fullStr | The Current Knowledge of Cerebral Magnetic Resonance Imaging in Monochorionic Twins: A Systematic Review of the Last 20 Years |
| title_full_unstemmed | The Current Knowledge of Cerebral Magnetic Resonance Imaging in Monochorionic Twins: A Systematic Review of the Last 20 Years |
| title_short | The Current Knowledge of Cerebral Magnetic Resonance Imaging in Monochorionic Twins: A Systematic Review of the Last 20 Years |
| title_sort | current knowledge of cerebral magnetic resonance imaging in monochorionic twins a systematic review of the last 20 years |
| topic | cerebral injury magnetic resonance imaging monochorionic twins selective fetal growth restriction single intrauterine fetal demise twin anemia polycythemia sequence |
| url | https://www.mdpi.com/2077-0383/12/23/7211 |
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