PurposeTo assess which microstructural models best explain the diffusion‐weighted MRI signal in the human placenta.MethodsThe placentas of nine healthy pregnant subjects were scanned with a multishell, multidirectional diffusion protocol at 3T. A range of multicompartment biophysical models were fit to the data, and ranked using the Bayesian information criterion.ResultsAnisotropic extensions to the intravoxel incoherent motion model, which consider the effect of coherent orientation in both microvascular structure and tissue microstructure, consistently had the lowest Bayesian information criterion values. Model parameter maps and model selection results were consistent with the physiology of the placenta and surrounding tissue.ConclusionAnisotropic intravoxel incoherent motion models explain the placental diffusion signal better than apparent diffusion coefficient, intravoxel incoherent motion, and diffusion tensor models, in information theoretic terms, when using this protocol. Future work will aim to determine if model‐derived parameters are sensitive to placental pathologies associated with disorders, such as fetal growth restriction and early‐onset pre‐eclampsia. Magn Reson Med 80:756–766, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

During the second and third trimesters of human gestation, rapid neurodevelopment is underpinned by fundamental processes including neuronal migration, cellular organization, cortical layering, and myelination. In this time, white matter growth and maturation lay the foundation for an efficient network of structural connections. Detailed knowledge about this developmental trajectory in the healthy human fetal brain is limited, in part, due to the inherent challenges of acquiring high-quality MRI data from this population. Here, we use state-of-the-art high-resolution multishell motion-corrected diffusion-weighted MRI (dMRI), collected as part of the developing Human Connectome Project (dHCP), to characterize the in utero maturation of white matter microstructure in 113 fetuses aged 22 to 37 wk gestation. We define five major white matter bundles and characterize their microstructural features using both traditional diffusion tensor and multishell multitissue models. We found unique maturational trends in thalamocortical fibers compared with association tracts and identified different maturational trends within specific sections of the corpus callosum. While linear maturational increases in fractional anisotropy were seen in the splenium of the corpus callosum, complex nonlinear trends were seen in the majority of other white matter tracts, with an initial decrease in fractional anisotropy in early gestation followed by a later increase. The latter is of particular interest as it differs markedly from the trends previously described in ex utero preterm infants, suggesting that this normative fetal data can provide significant insights into the abnormalities in connectivity which underlie the neurodevelopmental impairments associated with preterm birth.

Placental dysfunction underlies the cause of pregnancies complicated by preeclampsia. The use of placental magnetic resonance imaging to provide an insight into the pathophysiology of preeclampsia and thus assess its potential use to inform prognosis and clinical management was explored. In this prospective observational cohort study, 14 women with preterm preeclampsia and 48 gestation-matched controls using 3-Tesla magnetic resonance imaging at median of 31.6 weeks (interquartile range [IQR], 28.6–34.6) and 32.2 weeks (IQR, 28.6–33.8), respectively, were imaged. The acquired data included T2-weighted images and T2* maps of the placenta, the latter an indicative measure of placental oxygenation. Placentae in women with preeclampsia demonstrated advanced lobulation, varied lobule sizes, high granularity, and substantial areas of low-signal intensity on T2-weighted imaging, with reduced entire placental mean T2* values for gestational age (2 sample t test, t=7.49) correlating with a reduction in maternal PlGF (placental growth factor) concentrations (Spearman rank correlation coefficient 0.76) and increased lacunarity values (t=3.26). Median mean T2* reduced from 67 ms (IQR, 54–73) at 26.0 to 29.8 weeks’ gestation to 38 ms (IQR, 28–40) at 34.0 to 37.9 weeks’ gestation in the control group. In women with preeclampsia, median T2* was 23 ms (IQR, 20–23) at 26.0 to 29.8 weeks’ gestation and remained low (22 ms [IQR, 20–26] at 34.0–37.8 weeks’ gestation). Histological features of maternal vascular malperfusion were only found in placentae from women with preeclampsia. Placental volume did not differ between the control group and women with preeclampsia. Placental magnetic resonance imaging allows both objective quantification of placental function in vivo and elucidation of the complex mechanisms underlying preeclampsia development.

PurposeTo develop a purpose‐built quiet echo planar imaging capability for fetal functional and diffusion scans, for which acoustic considerations often compromise efficiency and resolution as well as angular/temporal coverage.MethodsThe gradient waveforms in multiband‐accelerated single‐shot echo planar imaging sequences have been redesigned to minimize spectral content. This includes a sinusoidal read‐out with a single fundamental frequency, a constant phase encoding gradient, overlapping smoothed CAIPIRINHA blips, and a novel strategy to merge the crushers in diffusion MRI. These changes are then tuned in conjunction with the gradient system frequency response function.ResultsMaintained image quality, SNR, and quantitative diffusion values while reducing acoustic noise up to 12 dB (A) is illustrated in two adult experiments. Fetal experiments in 10 subjects covering a range of parameters depict the adaptability and increased efficiency of quiet echo planar imaging.ConclusionPurpose‐built for highly efficient multiband fetal echo planar imaging studies, the presented framework reduces acoustic noise for all echo planar imaging‐based sequences. Full optimization by tuning to the gradient frequency response functions allows for a maximally time‐efficient scan within safe limits. This allows ambitious in‐utero studies such as functional brain imaging with high spatial/temporal resolution and diffusion scans with high angular/spatial resolution to be run in a highly efficient manner at acceptable sound levels. Magn Reson Med 79:1447–1459, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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