Placental diffusion-weighted MRI in normal pregnancies and those complicated by placental dysfunction due to vascular malperfusion
Our aim was to assess placental function by diffusion-weighted magnetic resonance imaging (MRI) using intravoxel incoherent motion (IVIM) analysis in uncomplicated pregnancies and pregnancies complicated by placental dysfunction. 31 normal pregnancies and 9 pregnancies complicated by placental dysfu...
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| Veröffentlicht in: | Placenta (Eastbourne) 2020-02, Vol.91, p.52-58 |
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| creator | Kristi B, Anderson Ditte N, Hansen Caroline, Haals Marianne, Sinding Astrid, Petersen Jens B, Frøkjær David A, Peters Anne, Sørensen |
| description | Our aim was to assess placental function by diffusion-weighted magnetic resonance imaging (MRI) using intravoxel incoherent motion (IVIM) analysis in uncomplicated pregnancies and pregnancies complicated by placental dysfunction.
31 normal pregnancies and 9 pregnancies complicated by placental dysfunction (birthweight ≤ -2SD and histological signs of placental vascular malperfusion) were retrieved from our placental MRI research database. MRI was performed at gestational weeks 20.1–40.6 in a 1.5 T system using 10 b-values (0–1000 s/mm2). Regions of interest were drawn covering the entire placenta in five transverse slices. Diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) were estimated by IVIM analysis.
In normal pregnancies, placental f decreased linearly with gestational age (r = −0.522, p = 0.002) being 26.2% at week 20 and 18.8% at week 40. D and D* were 1.57 ± 0.03 and 31.7 ± 3.1 mm2/s (mean ± SD), respectively, and they were not correlated with gestational age.
In complicated pregnancies, f was significantly reduced (mean Z-score = −1.16; p = 0.02) when compared to the group of normal pregnancies, whereas D and D* did not differ significantly between groups.
Subgroup analysis demonstrated that f was predominantly reduced in dysfunctional placentas characterized by fetal vascular malperfusion (mean Z-score = −2.11, p |
| doi_str_mv | 10.1016/j.placenta.2020.01.009 |
| format | Article |
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31 normal pregnancies and 9 pregnancies complicated by placental dysfunction (birthweight ≤ -2SD and histological signs of placental vascular malperfusion) were retrieved from our placental MRI research database. MRI was performed at gestational weeks 20.1–40.6 in a 1.5 T system using 10 b-values (0–1000 s/mm2). Regions of interest were drawn covering the entire placenta in five transverse slices. Diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) were estimated by IVIM analysis.
In normal pregnancies, placental f decreased linearly with gestational age (r = −0.522, p = 0.002) being 26.2% at week 20 and 18.8% at week 40. D and D* were 1.57 ± 0.03 and 31.7 ± 3.1 mm2/s (mean ± SD), respectively, and they were not correlated with gestational age.
In complicated pregnancies, f was significantly reduced (mean Z-score = −1.16; p = 0.02) when compared to the group of normal pregnancies, whereas D and D* did not differ significantly between groups.
Subgroup analysis demonstrated that f was predominantly reduced in dysfunctional placentas characterized by fetal vascular malperfusion (mean Z-score = −2.11, p < 0.001) rather than maternal vascular malperfusion (mean Z-score = −0.40, p = 0.42). In addition, f was negatively correlated with uterine artery pulsatility index (r = −0.396, p = 0.01).
Among parameters obtained by the IVIM analysis, only f revealed significant differences between the normal and the dysfunctional placentas. Subgroup analysis suggests that placental f may be able to discriminate non-invasively between different histological types of vascular malperfusion.
•Diffusion weighted MRI can evaluate placental function in vivo.•In normal pregnancies, Perfusion Fraction decreases linearly with gestational age.•Perfusion Fraction is low only in dysfunctional placentas with fetal vascular malperfusion.•Perfusion Fraction is negatively correlated with Uterine Artery Pulsatility Index.</description><identifier>ISSN: 0143-4004</identifier><identifier>EISSN: 1532-3102</identifier><identifier>DOI: 10.1016/j.placenta.2020.01.009</identifier><identifier>PMID: 32174307</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adult ; Diffusion Magnetic Resonance Imaging ; Diffusion-weighted MRI ; Female ; Fetal Growth Retardation - diagnostic imaging ; Humans ; Intrauterine growth restriction ; Perfusion fraction ; Placenta - blood supply ; Placenta - diagnostic imaging ; Placenta - pathology ; Placenta Diseases - diagnostic imaging ; Placenta Diseases - pathology ; Placental dysfunction ; Placental MRI ; Pregnancy ; Ultrasonography, Prenatal ; Vascular malperfusion</subject><ispartof>Placenta (Eastbourne), 2020-02, Vol.91, p.52-58</ispartof><rights>2020 Elsevier Ltd</rights><rights>Copyright © 2020 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c368t-80d53eca447c8b3c99bf889d2f9ce023ee2adb7095b89526c8a4d5311234f2a03</citedby><cites>FETCH-LOGICAL-c368t-80d53eca447c8b3c99bf889d2f9ce023ee2adb7095b89526c8a4d5311234f2a03</cites><orcidid>0000-0002-2954-9000 ; 0000-0001-9069-7806 ; 0000-0002-1680-1879</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0143400420300199$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32174307$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kristi B, Anderson</creatorcontrib><creatorcontrib>Ditte N, Hansen</creatorcontrib><creatorcontrib>Caroline, Haals</creatorcontrib><creatorcontrib>Marianne, Sinding</creatorcontrib><creatorcontrib>Astrid, Petersen</creatorcontrib><creatorcontrib>Jens B, Frøkjær</creatorcontrib><creatorcontrib>David A, Peters</creatorcontrib><creatorcontrib>Anne, Sørensen</creatorcontrib><title>Placental diffusion-weighted MRI in normal pregnancies and those complicated by placental dysfunction due to vascular malperfusion</title><title>Placenta (Eastbourne)</title><addtitle>Placenta</addtitle><description>Our aim was to assess placental function by diffusion-weighted magnetic resonance imaging (MRI) using intravoxel incoherent motion (IVIM) analysis in uncomplicated pregnancies and pregnancies complicated by placental dysfunction.
31 normal pregnancies and 9 pregnancies complicated by placental dysfunction (birthweight ≤ -2SD and histological signs of placental vascular malperfusion) were retrieved from our placental MRI research database. MRI was performed at gestational weeks 20.1–40.6 in a 1.5 T system using 10 b-values (0–1000 s/mm2). Regions of interest were drawn covering the entire placenta in five transverse slices. Diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) were estimated by IVIM analysis.
In normal pregnancies, placental f decreased linearly with gestational age (r = −0.522, p = 0.002) being 26.2% at week 20 and 18.8% at week 40. D and D* were 1.57 ± 0.03 and 31.7 ± 3.1 mm2/s (mean ± SD), respectively, and they were not correlated with gestational age.
In complicated pregnancies, f was significantly reduced (mean Z-score = −1.16; p = 0.02) when compared to the group of normal pregnancies, whereas D and D* did not differ significantly between groups.
Subgroup analysis demonstrated that f was predominantly reduced in dysfunctional placentas characterized by fetal vascular malperfusion (mean Z-score = −2.11, p < 0.001) rather than maternal vascular malperfusion (mean Z-score = −0.40, p = 0.42). In addition, f was negatively correlated with uterine artery pulsatility index (r = −0.396, p = 0.01).
Among parameters obtained by the IVIM analysis, only f revealed significant differences between the normal and the dysfunctional placentas. Subgroup analysis suggests that placental f may be able to discriminate non-invasively between different histological types of vascular malperfusion.
•Diffusion weighted MRI can evaluate placental function in vivo.•In normal pregnancies, Perfusion Fraction decreases linearly with gestational age.•Perfusion Fraction is low only in dysfunctional placentas with fetal vascular malperfusion.•Perfusion Fraction is negatively correlated with Uterine Artery Pulsatility Index.</description><subject>Adult</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Diffusion-weighted MRI</subject><subject>Female</subject><subject>Fetal Growth Retardation - diagnostic imaging</subject><subject>Humans</subject><subject>Intrauterine growth restriction</subject><subject>Perfusion fraction</subject><subject>Placenta - blood supply</subject><subject>Placenta - diagnostic imaging</subject><subject>Placenta - pathology</subject><subject>Placenta Diseases - diagnostic imaging</subject><subject>Placenta Diseases - pathology</subject><subject>Placental dysfunction</subject><subject>Placental MRI</subject><subject>Pregnancy</subject><subject>Ultrasonography, Prenatal</subject><subject>Vascular malperfusion</subject><issn>0143-4004</issn><issn>1532-3102</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtv1DAUhS0EokPhL1Reskm4fkwS70AVj0pFRVVZW45903qU2MFOimbLL69HM4Ulq7v5znd0DyEXDGoGrPmwq-fRWAyLqTlwqIHVAOoF2bCt4JVgwF-SDTApKgkgz8ibnHdQCMn4a3ImOGulgHZD_vw4aUbq_DCs2cdQ_UZ__7Cgo99vr6gPNMQ0FWBOeB9MsB4zNcHR5SFmpDZO8-itOfD9ns7_fPs8rMEuxUjdinSJ9NFku44m0aKbMR3r3pJXgxkzvjvdc_Lzy-e7y2_V9c3Xq8tP15UVTbdUHbitQGukbG3XC6tUP3SdcnxQFoELRG5c34La9p3a8sZ2RpYEY1zIgRsQ5-T90Tun-GvFvOjJZ4vjaALGNWsu2rZpFagD2hxRm2LOCQc9Jz-ZtNcM9GF_vdPPj-rD_hqYLuuW4MWpY-0ndH9jz4MX4OMRwPLpo8ekc9kzWHQ-oV20i_5_HU_Wspzn</recordid><startdate>202002</startdate><enddate>202002</enddate><creator>Kristi B, Anderson</creator><creator>Ditte N, Hansen</creator><creator>Caroline, Haals</creator><creator>Marianne, Sinding</creator><creator>Astrid, Petersen</creator><creator>Jens B, Frøkjær</creator><creator>David A, Peters</creator><creator>Anne, Sørensen</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2954-9000</orcidid><orcidid>https://orcid.org/0000-0001-9069-7806</orcidid><orcidid>https://orcid.org/0000-0002-1680-1879</orcidid></search><sort><creationdate>202002</creationdate><title>Placental diffusion-weighted MRI in normal pregnancies and those complicated by placental dysfunction due to vascular malperfusion</title><author>Kristi B, Anderson ; Ditte N, Hansen ; Caroline, Haals ; Marianne, Sinding ; Astrid, Petersen ; Jens B, Frøkjær ; David A, Peters ; Anne, Sørensen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c368t-80d53eca447c8b3c99bf889d2f9ce023ee2adb7095b89526c8a4d5311234f2a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Diffusion-weighted MRI</topic><topic>Female</topic><topic>Fetal Growth Retardation - diagnostic imaging</topic><topic>Humans</topic><topic>Intrauterine growth restriction</topic><topic>Perfusion fraction</topic><topic>Placenta - blood supply</topic><topic>Placenta - diagnostic imaging</topic><topic>Placenta - pathology</topic><topic>Placenta Diseases - diagnostic imaging</topic><topic>Placenta Diseases - pathology</topic><topic>Placental dysfunction</topic><topic>Placental MRI</topic><topic>Pregnancy</topic><topic>Ultrasonography, Prenatal</topic><topic>Vascular malperfusion</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kristi B, Anderson</creatorcontrib><creatorcontrib>Ditte N, Hansen</creatorcontrib><creatorcontrib>Caroline, Haals</creatorcontrib><creatorcontrib>Marianne, Sinding</creatorcontrib><creatorcontrib>Astrid, Petersen</creatorcontrib><creatorcontrib>Jens B, Frøkjær</creatorcontrib><creatorcontrib>David A, Peters</creatorcontrib><creatorcontrib>Anne, Sørensen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Placenta (Eastbourne)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kristi B, Anderson</au><au>Ditte N, Hansen</au><au>Caroline, Haals</au><au>Marianne, Sinding</au><au>Astrid, Petersen</au><au>Jens B, Frøkjær</au><au>David A, Peters</au><au>Anne, Sørensen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Placental diffusion-weighted MRI in normal pregnancies and those complicated by placental dysfunction due to vascular malperfusion</atitle><jtitle>Placenta (Eastbourne)</jtitle><addtitle>Placenta</addtitle><date>2020-02</date><risdate>2020</risdate><volume>91</volume><spage>52</spage><epage>58</epage><pages>52-58</pages><issn>0143-4004</issn><eissn>1532-3102</eissn><abstract>Our aim was to assess placental function by diffusion-weighted magnetic resonance imaging (MRI) using intravoxel incoherent motion (IVIM) analysis in uncomplicated pregnancies and pregnancies complicated by placental dysfunction.
31 normal pregnancies and 9 pregnancies complicated by placental dysfunction (birthweight ≤ -2SD and histological signs of placental vascular malperfusion) were retrieved from our placental MRI research database. MRI was performed at gestational weeks 20.1–40.6 in a 1.5 T system using 10 b-values (0–1000 s/mm2). Regions of interest were drawn covering the entire placenta in five transverse slices. Diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) were estimated by IVIM analysis.
In normal pregnancies, placental f decreased linearly with gestational age (r = −0.522, p = 0.002) being 26.2% at week 20 and 18.8% at week 40. D and D* were 1.57 ± 0.03 and 31.7 ± 3.1 mm2/s (mean ± SD), respectively, and they were not correlated with gestational age.
In complicated pregnancies, f was significantly reduced (mean Z-score = −1.16; p = 0.02) when compared to the group of normal pregnancies, whereas D and D* did not differ significantly between groups.
Subgroup analysis demonstrated that f was predominantly reduced in dysfunctional placentas characterized by fetal vascular malperfusion (mean Z-score = −2.11, p < 0.001) rather than maternal vascular malperfusion (mean Z-score = −0.40, p = 0.42). In addition, f was negatively correlated with uterine artery pulsatility index (r = −0.396, p = 0.01).
Among parameters obtained by the IVIM analysis, only f revealed significant differences between the normal and the dysfunctional placentas. Subgroup analysis suggests that placental f may be able to discriminate non-invasively between different histological types of vascular malperfusion.
•Diffusion weighted MRI can evaluate placental function in vivo.•In normal pregnancies, Perfusion Fraction decreases linearly with gestational age.•Perfusion Fraction is low only in dysfunctional placentas with fetal vascular malperfusion.•Perfusion Fraction is negatively correlated with Uterine Artery Pulsatility Index.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>32174307</pmid><doi>10.1016/j.placenta.2020.01.009</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2954-9000</orcidid><orcidid>https://orcid.org/0000-0001-9069-7806</orcidid><orcidid>https://orcid.org/0000-0002-1680-1879</orcidid></addata></record> |
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| ispartof | Placenta (Eastbourne), 2020-02, Vol.91, p.52-58 |
| issn | 0143-4004 1532-3102 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Diffusion Magnetic Resonance Imaging Diffusion-weighted MRI Female Fetal Growth Retardation - diagnostic imaging Humans Intrauterine growth restriction Perfusion fraction Placenta - blood supply Placenta - diagnostic imaging Placenta - pathology Placenta Diseases - diagnostic imaging Placenta Diseases - pathology Placental dysfunction Placental MRI Pregnancy Ultrasonography, Prenatal Vascular malperfusion |
| title | Placental diffusion-weighted MRI in normal pregnancies and those complicated by placental dysfunction due to vascular malperfusion |
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