Placental transverse relaxation time (T2) estimated by MRI: Normal values and the correlation with birthweight

Anderson, Kristi Bøgh; Andersen, Anna S.; Hansen, Ditte Nymark; Sinding, Marianne; Peters, David; Frøkjær, Jens Brøndum; Sørensen, Anne

doi:10.1111/aogs.14057

Cited by 9 publications

(11 citation statements)

References 37 publications

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“…Our group performed the first studies that combined dynamic contrast enhanced (DCE-) MRI with quantitative T2* mapping [ 30 , 31 ] in pregnant nonhuman primates (NHPs), demonstrating that the heterogeneity in placental T2* arises from spatial gradients in intervillous maternal placental blood (MPB) oxygen saturation within functional lobules. Since this early animal work, placental T2* has been measured in several small pilot studies in both uncomplicated human pregnancies and human pregnancies with adverse outcomes [ 32 – 39 ], verifying the decreasing trend with gestational age observed in NHP studies. These human studies also found reduced placental T2* and reduced placental perfusion fraction in pregnancies complicated by small for gestational age [ 40 – 42 ] in preterm preeclampsia.…”

Section: Introductionmentioning

confidence: 62%

Quantitative longitudinal T2* mapping for assessing placental function and association with adverse pregnancy outcomes across gestation

et al. 2022

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Existing methods for evaluating in vivo placental function fail to reliably detect pregnancies at-risk for adverse outcomes prior to maternal and/or fetal morbidity. Here we report the results of a prospective dual-site longitudinal clinical study of quantitative placental T2* as measured by blood oxygen-level dependent magnetic resonance imaging (BOLD-MRI). The objectives of this study were: 1) to quantify placental T2* at multiple time points across gestation, and its consistency across sites, and 2) to investigate the association between placental T2* and adverse outcomes. 797 successful imaging studies, at up to three time points between 11 and 38 weeks of gestation, were completed in 316 pregnancies. Outcomes were stratified into three groups: (UN) uncomplicated/normal pregnancy, (PA) primary adverse pregnancy, which included hypertensive disorders of pregnancy, birthweight <5th percentile, and/or stillbirth or fetal death, and (SA) secondary abnormal pregnancy, which included abnormal prenatal conditions not included in the PA group such as spontaneous preterm birth or fetal anomalies. Of the 316 pregnancies, 198 (62.6%) were UN, 70 (22.2%) PA, and 48 (15.2%) SA outcomes. We found that the evolution of placental T2* across gestation was well described by a sigmoid model, with T2* decreasing continuously from a high plateau level early in gestation, through an inflection point around 30 weeks, and finally approaching a second, lower plateau in late gestation. Model regression revealed significantly lower T2* in the PA group than in UN pregnancies starting at 15 weeks and continuing through 33 weeks. T2* percentiles were computed for individual scans relative to UN group regression, and z-scores and receiver operating characteristic (ROC) curves calculated for association of T2* with pregnancy outcome. Overall, differences between UN and PA groups were statistically significant across gestation, with large effect sizes in mid- and late- pregnancy. The area under the curve (AUC) for placental T2* percentile and PA pregnancy outcome was 0.71, with the strongest predictive power (AUC of 0.76) at the mid-gestation time period (20–30 weeks). Our data demonstrate that placental T2* measurements are strongly associated with pregnancy outcomes often attributed to placental insufficiency. Trial registration: ClinicalTrials.gov: NCT02749851.

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Section: Introductionmentioning

confidence: 62%

Quantitative longitudinal T2* mapping for assessing placental function and association with adverse pregnancy outcomes across gestation

et al. 2022

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“…Recently, an increasing number of papers have been reported that MRI is also a useful tool for in vivo quantitative noninvasive assessment of the placenta 7–10 . DWI has been reported to be applicable for various placental lesions 10–12 .…”

Section: Introductionmentioning

confidence: 99%

“…6 Recently, an increasing number of papers have been reported that MRI is also a useful tool for in vivo quantitative noninvasive assessment of the placenta. [7][8][9][10] DWI has been reported to be applicable for various placental lesions. [10][11][12] Several recent reports have demonstrated that ADC values are decreased in the placenta with fetal growth restriction.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9][10] DWI has been reported to be applicable for various placental lesions. [10][11][12] Several recent reports have demonstrated that ADC values are decreased in the placenta with fetal growth restriction. [13][14][15] Placental MRI has also been reported to be beneficial in the evaluation of preeclampsia, and a placental dysfunction-related disorder.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of placental abruption with diffusion‐weighted imaging

Mizutani

Kotani

Kato

et al. 2022

J of Obstet and Gynaecol

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Aim: To investigate whether placental abruption without fetal distress could be assessed by apparent diffusion coefficient (ADC) values in magnetic resonance imaging (MRI). Methods: We conducted a retrospective case-control study at a single center. ADC values at the lesions of placental abruption in the abruption group (n = 8) were compared to those in the control group (n = 32). In the abruption group, ADC values at the sites of abruption were also compared to those at the nonabruption sites within the same placenta. Results: The ADC values in the placental area above the abruption site in the abruption group showed lower values than those in the control group when the slice containing the umbilical cord insertion site was set as the reference, and those values were compared in each corresponding slice. Compared with average ADC values, those above the abruption site in the abruption group were also significantly lower than those in the control group (p < 0.001). Furthermore, ADC values at the area above abruption were lower than those at the nonabruption area of all planes in the abruption group. Conclusions: ADC values at the lesions above the placental abruption site were reduced compared to those in the normal placenta and those in the nonabruption area. Thus, it would be helpful to understand the pathophysiology of placental abruption in expectant management, although further investigations would be needed.

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“…Placental T2* has been measured throughout gestation in both uncomplicated human pregnancies and human pregnancies with adverse outcomes by a number of groups (38)(39)(40)(41)(42)(43)(44).…”

Section: Introductionmentioning

confidence: 99%

Assessing placental function across gestation: a multi-institutional study of BOLD-MRI for the prediction of adverse pregnancy outcomes

Schabel

Roberts

Gibbins

et al. 2021

Preprint

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The placenta is a remarkable organ that coordinates and regulates maternal-fetal interactions during pregnancy to optimize fetal development. A host of obstetric complications are associated with placental dysfunction, and existing methods for evaluating in vivo placental function fail to reliably detect at-risk pregnancies prior to maternal or fetal morbidity. Although routinely used as a monitoring tool, the predictive power of ultrasound for identifying compromised pregnancies is poor. Recent preclinical studies performed in our laboratory, using blood oxygen-level dependent magnetic resonance imaging (BOLD-MRI) in the pregnant nonhuman primate (NHP), established a strong correlation between placental T2* values and maternal-fetal oxygen transport. Here we extend this work to a large, longitudinal, two-site study of quantitative in vivo T2* mapping in human pregnancies across 11 to 38 weeks of gestation to characterize the evolution of placental oxygenation in uncomplicated pregnancies and to elucidate the relationship between aberrant placental T2* and adverse obstetric outcomes attributable to placental dysfunction. This methodology has high discriminatory power and strong potential diagnostic utility.

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Placental transverse relaxation time (T2) estimated by MRI: Normal values and the correlation with birthweight

Cited by 9 publications

References 37 publications

Quantitative longitudinal T2* mapping for assessing placental function and association with adverse pregnancy outcomes across gestation

Quantitative longitudinal T2* mapping for assessing placental function and association with adverse pregnancy outcomes across gestation

Assessment of placental abruption with diffusion‐weighted imaging

Assessing placental function across gestation: a multi-institutional study of BOLD-MRI for the prediction of adverse pregnancy outcomes

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