Andrew A Badachhape1, Aarav Kumar2, Ketan B Ghaghada3, Igor V Stupin4, Mayank Srivastava5, Laxman Devkota6, Zbigniew Starosolski7, Eric A Tanifum8, Verghese George9, Karin A Fox10, Chandrasekhar Yallampalli11, Ananth V Annapragada12. 1. Department of Radiology, Baylor College of Medicine, Houston, TX, 77030, USA; The Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, 77030, USA. Electronic address: badachha@bcm.edu. 2. The Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, 77030, USA. Electronic address: kumar.aarav2002@gmail.com. 3. The Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, 77030, USA. Electronic address: kbghagha@texaschildrens.org. 4. The Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, 77030, USA. Electronic address: ivstupin@texaschildrens.org. 5. The Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, 77030, USA. Electronic address: mxsrivas@texaschildrens.org. 6. The Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, 77030, USA; Baylor College of Medicine, Houston, TX, 77030, USA. Electronic address: laxman.devkota@bcm.edu. 7. The Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, 77030, USA; Baylor College of Medicine, Houston, TX, 77030, USA. Electronic address: zbigniew.starosolski@bcm.edu. 8. The Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, 77030, USA. Electronic address: eatanifu@texaschildrens.org. 9. The Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, 77030, USA. Electronic address: vxgeorge@texaschildrens.org. 10. Department of Obstetrics and Gynecology, Texas Children's Hospital, Houston, TX, 77030, USA. Electronic address: kafox@bcm.edu. 11. Department of Obstetrics and Gynecology, Texas Children's Hospital, Houston, TX, 77030, USA. Electronic address: chandrasekhar.yallampalli@bcm.edu. 12. The Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, 77030, USA. Electronic address: avannapr@texaschildrens.org.
Abstract
INTRODUCTION: Visualization of the retroplacental clear space (RPCS) may provide critical insight into the development of abnormally invasive placenta (AIP). In this pre-clinical study, we characterized the appearance of the RPCS on magnetic resonance imaging (MRI) during the second half of gestation using a liposomal gadolinium contrast agent (liposomal-Gd). MATERIALS AND METHODS: Studies were performed in fifteen pregnant C57BL/6 mice at 10, 12, 14, 16, and 18 days of gestation. MRI was performed on a 1T permanent magnet scanner. Pre-contrast and post-contrast images were acquired using T1-weighted gradient-recalled echo (T1w-GRE) and T2-weighted fast spin echo (T2w-FSE) sequences. Animals were euthanized after imaging and feto-placental units harvested for histological examination. Visualization of the RPCS was scored by a maternal-fetal radiologist and quantified by measuring the contrast-to-noise ratio (CNR) on T1w images. Feto-placental features were segmented for analysis of volumetric changes during gestation. RESULTS: Contrast-enhanced T1w images enabled the visualization of structural changes in placental development between days 10-18 of gestation. Although the placental margin on the fetal side was clearly visible at all time points, the RPCS was partially visible at day 10 of gestation, and clearly visible by day 12. Hematoxylin and eosin (H&E) staining of the placental tissue corroborated MRI findings of structural and morphological changes in the placenta. CONCLUSIONS: Contrast-enhanced MR imaging using liposomal-Gd enabled adequate visualization of the retroplacental clear space starting at day 12 of gestation. The agent also enabled characterization of placental structure and morphological changes through gestation.
INTRODUCTION: Visualization of the retroplacental clear space (RPCS) may provide critical insight into the development of abnormally invasive placenta (AIP). In this pre-clinical study, we characterized the appearance of the RPCS on magnetic resonance imaging (MRI) during the second half of gestation using a liposomal gadolinium contrast agent (liposomal-Gd). MATERIALS AND METHODS: Studies were performed in fifteen pregnant C57BL/6 mice at 10, 12, 14, 16, and 18 days of gestation. MRI was performed on a 1T permanent magnet scanner. Pre-contrast and post-contrast images were acquired using T1-weighted gradient-recalled echo (T1w-GRE) and T2-weighted fast spin echo (T2w-FSE) sequences. Animals were euthanized after imaging and feto-placental units harvested for histological examination. Visualization of the RPCS was scored by a maternal-fetal radiologist and quantified by measuring the contrast-to-noise ratio (CNR) on T1w images. Feto-placental features were segmented for analysis of volumetric changes during gestation. RESULTS: Contrast-enhanced T1w images enabled the visualization of structural changes in placental development between days 10-18 of gestation. Although the placental margin on the fetal side was clearly visible at all time points, the RPCS was partially visible at day 10 of gestation, and clearly visible by day 12. Hematoxylin and eosin (H&E) staining of the placental tissue corroborated MRI findings of structural and morphological changes in the placenta. CONCLUSIONS: Contrast-enhanced MR imaging using liposomal-Gd enabled adequate visualization of the retroplacental clear space starting at day 12 of gestation. The agent also enabled characterization of placental structure and morphological changes through gestation.
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