Magnetic resonance image findings of placental lake: report of two cases

Abstract

Two cases with a large cystic mass within the placenta are reported. By ultrasonography, it was found that both women had a subchorionic hypoechoic lesion (11.0 x 4.8 x 4.0 cm and 6.6 x 3.7 x 2.2 cm, respectively) at 24 and 35 weeks of gestation, respectively. In both cases, turbulent blood flow generated by a pulsatile jet flow (pulse rate; 40 to 60 beats per minute) into the cystic lesion seen on real-time imaging and lesions being low intensity on T1-weighted and isointensity on T2-weighted magnetic resonance image suggested that they contained fresh maternal blood. In both cases, the sonolucency of the lesions did not change until cesarean deliveries of females, both of whom were small-for-gestational-age infants (1940 g at 37 weeks and 2195 g at 37 weeks, respectively). Biochemical analysis of the fluid in the cystic lesion sampled during the cesarean section in the latter case confirmed that the fluid had originated from the maternal blood. These lesions histologically corresponded to large avillous areas surrounded by normal villi. Thus, a huge placental lake was diagnosed in both cases.

Structured evaluation and reporting in imaging of placenta and umbilical cord

“…Grade 2/3 placental lacunae are depicted as heterogeneous and T2 dark intraplacental signal, due to hemorrhage, and contribute to the heterogeneity. Grade I lacunae are not clearly visualized and might appear isointense to the normal placenta (55) resulting into homogenous signal intensity. They may manifest as low intensity areas on T1W imaging sometimes surrounded by high intensity due to turbulent blood flow.…”

Fetus Disi Degerlendirme: Plasenta, Umbilikal Kord, Amniyon, Serviks

“…Genellikle klinik önemleri yoktur [18]. İlk ya da erken ikinci trimesterde ortaya çıkanlar, çok yaygın olanlar ya da çok büyük boyuta (>4-5 cm) ulaşanlar İUGG, ani fetal ölüm, postpartum kanama nedeni olabilirler [19][20][21]. Eşlik eden fetal ya da maternal hastalık, kalın plasenta, yüksek serum AFP ya da anormal uterin arter Doppler bulgusu olanlarda bu riskler daha fazladır [22].…”