Nickie Andescavage1, Wonsang You2, Marni Jacobs3, Kushal Kapse2, Jessica Quistorff2, Dorothy Bulas4, Homa Ahmadzia5, Alexis Gimovsky5, Ahmet Baschat6, Catherine Limperopoulos7. 1. Division of Neonatology, Children's National Hospital, 111 Michigan Ave, NW, Washington, DC, 20010, USA; Department of Pediatrics, George Washington University School of Medicine, 2300 Eye St. NW, Washington, DC, 20052, USA. 2. Division of Diagnostic Imaging & Radiology, Children's National Hospital, 111 Michigan Ave, NW, Washington, DC, 20010, USA. 3. Division of Biostatistics & Study Methodology, George Washington University School of Medicine, 2300 Eye St. NW, Washington, DC, 20052, USA; Department of Pediatrics, George Washington University School of Medicine, 2300 Eye St. NW, Washington, DC, 20052, USA. 4. Division of Diagnostic Imaging & Radiology, Children's National Hospital, 111 Michigan Ave, NW, Washington, DC, 20010, USA; Department of Radiology, George Washington University School of Medicine, 2300 Eye St. NW, Washington, DC, 20052, USA. 5. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, George Washington University School of Medicine, 2300 Eye St. NW, Washington, DC, 20052, USA. 6. Department of Gynecology and Obstetrics, Johns Hopkins Center for Fetal Therapy, 600 North Wolfe Street, Nelson 228, Baltimore, MD, 21287, USA. 7. Division of Diagnostic Imaging & Radiology, Children's National Hospital, 111 Michigan Ave, NW, Washington, DC, 20010, USA; Department of Pediatrics, George Washington University School of Medicine, 2300 Eye St. NW, Washington, DC, 20052, USA; Department of Radiology, George Washington University School of Medicine, 2300 Eye St. NW, Washington, DC, 20052, USA. Electronic address: climpero@childrensnational.org.
Abstract
INTRODUCTION: Gross and microstructural changes in placental development can influence placental function and adversely impact fetal growth and well-being; however, there is a paucity of invivo tools available to reliably interrogate in vivo placental microstructural development. The objective of this study is to characterize invivo placental microstructural diffusion and perfusion in healthy and growth-restricted pregnancies (FGR) using non-invasive diffusion-weighted imaging (DWI). METHODS: We prospectively enrolled healthy pregnant women and women whose pregnancies were complicated by FGR. Each woman underwent DWI-MRI between 18 and 40 weeks gestation. Placental measures of small (D) and large (D*) scale diffusion and perfusion (f) were estimated using the intra-voxel incoherent motion (IVIM) model. RESULTS: We studied 137 pregnant women (101 healthy; 36 FGR). D and D* are increased in late-onset FGR, and the placental perfusion fraction, f, is decreased (p < 0.05 for all). DISCUSSION: Placental DWI revealed microstructural alterations of the invivo placenta in FGR, particularly in late-onset FGR. Early and reliable identification of placental pathology in vivo may better guide future interventions.
INTRODUCTION: Gross and microstructural changes in placental development can influence placental function and adversely impact fetal growth and well-being; however, there is a paucity of invivo tools available to reliably interrogate in vivo placental microstructural development. The objective of this study is to characterize invivo placental microstructural diffusion and perfusion in healthy and growth-restricted pregnancies (FGR) using non-invasive diffusion-weighted imaging (DWI). METHODS: We prospectively enrolled healthy pregnant women and women whose pregnancies were complicated by FGR. Each woman underwent DWI-MRI between 18 and 40 weeks gestation. Placental measures of small (D) and large (D*) scale diffusion and perfusion (f) were estimated using the intra-voxel incoherent motion (IVIM) model. RESULTS: We studied 137 pregnant women (101 healthy; 36 FGR). D and D* are increased in late-onset FGR, and the placental perfusion fraction, f, is decreased (p < 0.05 for all). DISCUSSION: Placental DWI revealed microstructural alterations of the invivo placenta in FGR, particularly in late-onset FGR. Early and reliable identification of placental pathology in vivo may better guide future interventions.
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