Using dynamic contrast‐enhanced MRI to quantitatively characterize maternal vascular organization in the primate placenta

Frias, Antonio E.; Schabel, Matthias C.; Roberts, Victoria H. J.; Tudorica, Alina; Grigsby, Peta L.; Oh, Karen Y.; Kroenke, Christopher D.

doi:10.1002/mrm.25264

Cited by 57 publications

(88 citation statements)

References 43 publications

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“…Similar to US in nongravid patients, limitations include patient-dependent resolution and lack of ability to obtain functional data. Magnetic resonance (MR) imaging allows non-contrast material-enhanced imaging of the fetus and placenta for detailed evaluation of the anatomy and is being studied for use in advanced fetal applications, including gated fetal cardiac imaging and the assessment of placental function and fetal structural brain development (1)(2)(3). When imaging the morbidly adherent placenta with MR imaging, gadolinium chelate use is controversial but may increase specificity and be valuable for assessing the degree of placental invasion (4)(5)(6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

Gadolinium Chelate Contrast Material in Pregnancy: Fetal Biodistribution in the Nonhuman Primate

Roberts

Schabel

et al. 2015

Radiology

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Purpose:To determine the extent to which gadolinium chelate is found in nonhuman primate fetal tissues and amniotic fluid at 19-45 hours after intravenous injection of a weight-appropriate maternal dose of the contrast agent gadoteridol. Materials and Methods:Gravid Japanese macaques (n = 14) were maintained as approved by the institutional animal care and utilization committee. In the 3rd trimester of pregnancy, the macaques were injected with gadoteridol (0.1 mmol per kilogram of maternal weight). Fetuses were delivered by means of cesarean section within 24 hours of maternal injection (range, 19-21 hours; n = 11) or 45 hours after injection (n = 3). Gadolinium chelate levels in the placenta, fetal tissues, and amniotic fluid were obtained by using inductively coupled plasma mass spectrometry. The Wilcoxon rank sum test was used for quantitative comparisons. Results:Gadoteridol was present in the fetoplacental circulation at much lower quantities than in the mother. At both time points, the distribution of gadolinium chelate in the fetus was comparable to that expected in an adult. The highest concentration of the injected dose (ID) was found in the fetal kidney (0.0161% ID per gram in the 19-21-hour group). The majority of the in utero gadolinium chelate was found in the amniotic fluid and the placenta (mean, 0.1361% ID per organ 6 0.076 [standard deviation] and 0.0939% ID per organ 6 0.0494, respectively). Data acquired 45 hours after injection showed a significant decrease in the gadolinium chelate concentration in amniotic fluid compared with that in the 19-21-hour group (from 0.0017% to 0.0007% ID per gram; P = .01). Conclusion:Amounts of gadolinium chelate in the fetal tissues and amniotic fluid were minimal compared with the maternal ID. This may impact future clinical studies on the safety of gadolinium contrast agent use in pregnancy.q RSNA, 2015

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Section: Discussionmentioning

confidence: 99%

Gadolinium Chelate Contrast Material in Pregnancy: Fetal Biodistribution in the Nonhuman Primate

Roberts

Schabel

et al. 2015

Radiology

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“…Maternal perfusion of the placental intervillous space was evaluated using DCE-MRI as well as T 2 * measurements, and this revealed differences between ethanol exposed animals and controls. Through the analysis of DCE-MRI measurements, it is possible to identify individual spiral arteries, and quantify maternal volume blood flow, F, into the placenta through each of them 13 . The total volumetric blood flow to all placental cotyledons was smaller in the ethanol exposed group versus controls (Table 3), consistent with the semi-quantitative measures of the cQuta, in animals evaluated at G110, but not G135.…”

Section: Placental Perfusion and Oxygenationmentioning

confidence: 99%

“…Recently, we demonstrated that T 2 * based MRI measurements can also be used to characterize the entire placenta at the level of individual spiral artery perfusion domains. Specifically, whereas DCE-MRI provides estimates of blood flow, F, through each spiral artery 13 , we have proposed an analysis of T 2 * parameter maps to estimate the flow-permeability ratio, F/(vPS) for each spiral artery 14 . We observed that ethanol exposed animals which exhibited reduced placental blood flow at G110 by DCE-MRI also demonstrated reduced average T 2 * and corresponding F/(vPS).…”

Section: Commentmentioning

confidence: 99%

“…However, this method cannot be used to assess blood flow within the placental intervillous space, the site of maternal-fetal oxygen and nutrient exchange. Recent work with pregnant nonhuman primates (NHP) has identified MRI based methods to characterize maternal blood flow and oxygen exchange in the placenta with the fetal vasculature 13,14 . Maternal perfusion of the placenta can be quantified using dynamic contrast-enhanced MRI (DCE-MRI), which requires intravenous administration of an MRI contrast reagent 13 .…”

Section: Introductionmentioning

confidence: 99%

“…Recent work with pregnant nonhuman primates (NHP) has identified MRI based methods to characterize maternal blood flow and oxygen exchange in the placenta with the fetal vasculature 13,14 . Maternal perfusion of the placenta can be quantified using dynamic contrast-enhanced MRI (DCE-MRI), which requires intravenous administration of an MRI contrast reagent 13 . Although we have shown that maternal gadolinium (Prohance ® ) administration in rhesus macaques results in minimal fetal exposure 15 , methods for antenatal in vivo hemodynamic assessment not requiring gadolinium-based contrast reagents are clinically desirable.…”

Section: Introductionmentioning

confidence: 99%

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28: First trimester alcohol exposure alters placental perfusion and fetal oxygen availability affecting fetal growth and development in a non-human primate model

Schabel

Wang

et al. 2017

American Journal of Obstetrics and Gynecology

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Objective-Prenatal alcohol exposure leads to impaired fetal growth, brain development, and stillbirth. Placental impairment likely contributes to these adverse outcomes, but the mechanisms and specific vasoactive effects of alcohol linking altered placental function to impaired fetal development remain areas of active research. Recently, we developed MRI techniques in nonhuman primates to characterize placental blood oxygenation through measurements of T 2 *, and perfusion using dynamic contrast-enhanced (DCE) MRI. The objective of this study was to evaluate the effects of first trimester alcohol exposure on macaque placental function and to characterize fetal brain development, in vivo.Study Design-Timed-pregnant Rhesus macaques (n=12) were divided into 2 groups: control (n=6) and ethanol exposed (n=6). Animals were trained to orally self-administer either 1.5g/kg/day of a 4% ethanol solution (equivalent to 6 drinks/day) or an isocaloric control fluid from pre-conception until gestational day 60 (G60, term is G168). All underwent Doppler ultrasound (D-US) followed by MRI consisting of T 2 * and DCE measurements. D-US was used to measure uterine artery (Uta) and umbilical vein velocimetry and diameter to calculate Uta volume Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.The authors report no conflicts of interest.Presented orally at the 37 th Society of Maternal Fetal Medicine Annual Meetings in Las Vegas, Nevada, January 23-28 th , 2017Reprints will not be available. HHS Public Access Author Manuscript Author Manuscript Author ManuscriptAuthor Manuscript blood flow (cQuta) and placental volume blood flow (cQuv). After non-invasive imaging, animals underwent C-section delivery for placenta collection and fetal necropsy at G110 (n=6) or G135 (n=6).Results-Fetal weight and biparietal diameter were significantly smaller in ethanol exposed compared to controls at G110. By D-US, cQuta was decreased (p=0.1) and cQuv was significantly lower (p=0.04) at both G110 and G135 in ethanol exposed versus control animals. A significant reduction in placental blood flow was evident by DCE-MRI. As we demonstrated recently, T 2 * values vary throughout the placenta, and reveal gradients in blood deoxyhemoglobin concentration ranging from highly oxygenated blood (long T 2 *) proximal to spiral arteries to highly deoxygenated blood (short T 2 *). Distributions of T 2 * throughout the placenta show significant global reduction in T 2 * (and hence high blood deoxyhemoglobin concentration) in ethanol exposed vs. control at G110 (p=0.02). Fetal brain measurements indicated impaired grow...

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In vivo assessment of the placental anatomy and perfusion in a mouse model of intrauterine inflammation

Lei

Jia

et al. 2017

Magnetic Resonance Imaging

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Using dynamic contrast‐enhanced MRI to quantitatively characterize maternal vascular organization in the primate placenta

Cited by 57 publications

References 43 publications

Gadolinium Chelate Contrast Material in Pregnancy: Fetal Biodistribution in the Nonhuman Primate

Gadolinium Chelate Contrast Material in Pregnancy: Fetal Biodistribution in the Nonhuman Primate

28: First trimester alcohol exposure alters placental perfusion and fetal oxygen availability affecting fetal growth and development in a non-human primate model

In vivo assessment of the placental anatomy and perfusion in a mouse model of intrauterine inflammation

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