Xingfeng Shao1, Dapeng Liu2, Thomas Martin2, Teresa Chanlaw3, Sherin U Devaskar3, Carla Janzen4, Aisling M Murphy4, Daniel Margolis2, Kyunghyun Sung2, Danny J J Wang1. 1. Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. 2. Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. 3. Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. 4. Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Abstract
BACKGROUND: Placenta influences the health of both a woman and her fetus during pregnancy. Maternal blood supply to placenta can be measured noninvasively using arterial spin labeling (ASL). PURPOSE: To present a multidelay pseudocontinuous arterial spin labeling (pCASL) combined with a fast 3D inner-volume gradient- and spin-echo (GRASE) imaging technique to simultaneously measure placental blood flow (PBF) and arterial transit time (ATT), and to study PBF and ATT evolution with gestational age during the second trimester. The PBF values were compared with uterine arterial Doppler ultrasound to assess its potential clinical utility. STUDY TYPE: This was a prospective study. SUBJECTS: Thirty-four pregnant women. FIELD STRENGTH/SEQUENCE: Multidelay 3D inner-volume GRASE pCASL sequence on 3T MR scanners. ASSESSMENT: Subjects underwent two longitudinal MRI scans within the second trimester, conducted between 14-16 and 19-22 weeks of gestational age, respectively. Placental perfusion was measured using the free-breathing pCASL sequence at three postlabeling delays (PLDs), followed by offline motion correction and model fitting for estimation of PBF and ATT. STATISTICAL TESTS: A paired t-test was conducted to evaluate the significance of PBF/ATT variations with placental development. A two-sample t-test was conducted to evaluate the significance of PBF difference in subjects with and without early diastolic notch. RESULTS: The mean PBF and ATT for the second trimester were 111.4 ± 26.7 ml/100g/min and 1387.5 ± 88.0 msec, respectively. The average PBF increased by 10.4% (P < 0.05), while no significant change in ATT (P = 0.72) was found along gestational ages during the second trimester. PBF decreased 20.3% (P < 0.01) in subjects with early diastolic notches in ultrasound flow waveform patterns. DATA CONCLUSION: Multidelay pCASL with inner-volume 3D GRASE is promising for noninvasive assessment of PBF during pregnancy. Its clinical use for the detection of aberrations in placental function and prediction of fetal developmental disorders awaits evaluation. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1667-1676.
BACKGROUND: Placenta influences the health of both a woman and her fetus during pregnancy. Maternal blood supply to placenta can be measured noninvasively using arterial spin labeling (ASL). PURPOSE: To present a multidelay pseudocontinuous arterial spin labeling (pCASL) combined with a fast 3D inner-volume gradient- and spin-echo (GRASE) imaging technique to simultaneously measure placental blood flow (PBF) and arterial transit time (ATT), and to study PBF and ATT evolution with gestational age during the second trimester. The PBF values were compared with uterine arterial Doppler ultrasound to assess its potential clinical utility. STUDY TYPE: This was a prospective study. SUBJECTS: Thirty-four pregnant women. FIELD STRENGTH/SEQUENCE: Multidelay 3D inner-volume GRASE pCASL sequence on 3T MR scanners. ASSESSMENT: Subjects underwent two longitudinal MRI scans within the second trimester, conducted between 14-16 and 19-22 weeks of gestational age, respectively. Placental perfusion was measured using the free-breathing pCASL sequence at three postlabeling delays (PLDs), followed by offline motion correction and model fitting for estimation of PBF and ATT. STATISTICAL TESTS: A paired t-test was conducted to evaluate the significance of PBF/ATT variations with placental development. A two-sample t-test was conducted to evaluate the significance of PBF difference in subjects with and without early diastolic notch. RESULTS: The mean PBF and ATT for the second trimester were 111.4 ± 26.7 ml/100g/min and 1387.5 ± 88.0 msec, respectively. The average PBF increased by 10.4% (P < 0.05), while no significant change in ATT (P = 0.72) was found along gestational ages during the second trimester. PBF decreased 20.3% (P < 0.01) in subjects with early diastolic notches in ultrasound flow waveform patterns. DATA CONCLUSION: Multidelay pCASL with inner-volume 3D GRASE is promising for noninvasive assessment of PBF during pregnancy. Its clinical use for the detection of aberrations in placental function and prediction of fetal developmental disorders awaits evaluation. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1667-1676.
Authors: J S Choi; H K Ahn; J Y Han; Y J Han; D O Kwak; E Y Velazquez-Armenta; A A Nava-Ocampo Journal: J Obstet Gynaecol Date: 2015-06-02 Impact factor: 1.246
Authors: Danny J J Wang; Jeffry R Alger; Joe X Qiao; Matthias Gunther; Whitney B Pope; Jeffrey L Saver; Noriko Salamon; David S Liebeskind Journal: Neuroimage Clin Date: 2013-07-06 Impact factor: 4.881
Authors: Anne Sørensen; Marianne Sinding; David A Peters; Astrid Petersen; Jens B Frøkjær; Ole B Christiansen; Niels Uldbjerg Journal: Physiol Rep Date: 2015-10
Authors: Joshua S Greer; Xinzeng Wang; Yiming Wang; Marco C Pinho; Joseph A Maldjian; Ivan Pedrosa; Ananth J Madhuranthakam Journal: Magn Reson Med Date: 2019-06-23 Impact factor: 4.668
Authors: Kai D Ludwig; Sean B Fain; Sydney M Nguyen; Thaddeus G Golos; Scott B Reeder; Ian M Bird; Dinesh M Shah; Oliver E Wieben; Kevin M Johnson Journal: Magn Reson Med Date: 2018-10-25 Impact factor: 4.668
Authors: Stephanie A Giza; Simran Sethi; Lauren M Smith; Mary-Ellen E T Empey; Lindsay E Morris; Charles A McKenzie Journal: J Dev Orig Health Dis Date: 2020-12-14 Impact factor: 2.401
Authors: Sophie Couper; Alys Clark; John M D Thompson; Dimitra Flouri; Rosalind Aughwane; Anna L David; Andrew Melbourne; Ali Mirjalili; Peter R Stone Journal: J Physiol Date: 2021-01-18 Impact factor: 6.228
Authors: Andrew Melbourne; Rosalind Aughwane; Magdalena Sokolska; David Owen; Giles Kendall; Dimitra Flouri; Alan Bainbridge; David Atkinson; Jan Deprest; Tom Vercauteren; Anna David; Sebastien Ourselin Journal: Magn Reson Med Date: 2018-09-21 Impact factor: 4.668
Authors: Anita A Harteveld; Jana Hutter; Suzanne L Franklin; Laurence H Jackson; Mary Rutherford; Joseph V Hajnal; Matthias J P van Osch; Clemens Bos; Enrico De Vita Journal: Magn Reson Med Date: 2020-03-06 Impact factor: 3.737