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Hutter J, Slator PJ, Avena Zampieri C, Hall M, Rutherford M, Story L. Multi-modal MRI reveals changes in placental function following preterm premature rupture of membranes. Magn Reson Med 2023; 89:1151-1159. [PMID: 36255151 PMCID: PMC10091779 DOI: 10.1002/mrm.29483] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE Preterm premature rupture of membranes complicates up to 40% of premature deliveries. Fetal infection may occur in the absence of maternal symptoms, delaying diagnosis and increasing morbidity and mortality. A noninvasive antenatal assessment of early signs of placental inflammation is therefore urgently required. METHODS Sixteen women with preterm premature rupture of membranes < 34 weeks gestation and 60 women with uncomplicated pregnancies were prospectively recruited. A modified diffusion-weighted spin-echo single shot EPI sequence with a diffusion preparation acquiring 264 unique parameter combinations in < 9 min was obtained on a clinical 3 Tesla MRI scanner. The data was fitted to a 2-compartment T 2 * $$ {\mathrm{T}}_2^{\ast } $$ -intravoxel incoherent motion model comprising fast and slowly circulating fluid pools to obtain quantitative information on perfusion, density, and tissue composition. Z values were calculated, and correlation with time from between the rupture of membranes and the scan, gestational age at delivery, and time between scan and delivery assessed. RESULTS Placental T 2 * $$ {\mathrm{T}}_2^{\ast } $$ was significantly reduced in preterm premature rupture of membranes, and the 2-compartmental model demonstrated that this decline is mainly linked to the perfusion component observed in the placental parenchyma. Multi-modal MRI measurement of placental function is linked to gestational age at delivery and time from membrane rupture. CONCLUSION More complex models and data acquisition can potentially improve fitting of the underlying etiology of preterm birth compared with individual single-contrast models and contribute to additional insights in the future. This will need validation in larger cohorts. A multi-modal MRI acquisition between rupture of the membranes and delivery can be used to measure placental function and is linked to gestational age at delivery.
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Affiliation(s)
- Jana Hutter
- Centre for the Developing Brain, King's College London, London, United Kingdom.,Centre for Medical Engineering, King's College London, London, United Kingdom
| | | | - Carla Avena Zampieri
- Centre for the Developing Brain, King's College London, London, United Kingdom.,Centre for Medical Engineering, King's College London, London, United Kingdom
| | - Megan Hall
- Centre for the Developing Brain, King's College London, London, United Kingdom.,Institute for Women's and Children's Health, King's College London, London, United Kingdom.,Fetal Medicine Unit, St Thomas' Hospital, London, United Kingdom
| | - Mary Rutherford
- Centre for the Developing Brain, King's College London, London, United Kingdom.,Centre for Medical Engineering, King's College London, London, United Kingdom
| | - Lisa Story
- Centre for the Developing Brain, King's College London, London, United Kingdom.,Institute for Women's and Children's Health, King's College London, London, United Kingdom.,Fetal Medicine Unit, St Thomas' Hospital, London, United Kingdom
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Jacquier M, Arthuis C, Grévent D, Bussières L, Henry C, Millischer-Bellaiche AE, Mahallati H, Ville Y, Siauve N, Salomon LJ. Dynamic contrast enhanced magnetic resonance imaging: A review of its application in the assessment of placental function. Placenta 2021; 114:90-99. [PMID: 34507031 DOI: 10.1016/j.placenta.2021.08.055] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 06/02/2021] [Accepted: 08/23/2021] [Indexed: 01/02/2023]
Abstract
It is important to develop a better understanding of placental insufficiency given its role in common maternofetal complications such as preeclampsia and fetal growth restriction. Functional magnetic resonance imaging offers unprecedented techniques for exploring the placenta under both normal and pathological physiological conditions. Dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) is an established and very robust method to investigate the microcirculatory parameters of an organ and more specifically its perfusion. It is currently a gold standard in the physiological and circulatory evaluation of an organ. Its application to the human placenta could enable to access many microcirculatory parameters relevant to the placental function such as organ blood flow, fractional blood volume, and permeability surface area, by the acquisition of serial images, before, during, and after administration of an intravenous contrast agent. Widely used in animal models with gadolinium-based contrast agents, its application to the human placenta could be possible if the safety of contrast agents in pregnancy is established or they are confirmed to not cross the placenta.
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Affiliation(s)
- Mathilde Jacquier
- Obstetrics and Gynecology Department, Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, 149 Rue de Sèvres, 75015, Paris, France; EA FETUS 7328 and LUMIERE Unit, Université de Paris, France
| | - Chloé Arthuis
- EA FETUS 7328 and LUMIERE Unit, Université de Paris, France; Obstetrics and Gynecology Department, CHU Nantes, 38 Boulevard Jean Monnet, 44000, Nantes, France
| | - David Grévent
- EA FETUS 7328 and LUMIERE Unit, Université de Paris, France; Radiology Department, Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, 149 Rue de Sèvres, 75015, Paris, France
| | - Laurence Bussières
- Obstetrics and Gynecology Department, Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, 149 Rue de Sèvres, 75015, Paris, France; EA FETUS 7328 and LUMIERE Unit, Université de Paris, France
| | - Charline Henry
- EA FETUS 7328 and LUMIERE Unit, Université de Paris, France
| | - Anne-Elodie Millischer-Bellaiche
- EA FETUS 7328 and LUMIERE Unit, Université de Paris, France; Radiology Department, Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, 149 Rue de Sèvres, 75015, Paris, France
| | - Houman Mahallati
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Yves Ville
- Obstetrics and Gynecology Department, Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, 149 Rue de Sèvres, 75015, Paris, France; EA FETUS 7328 and LUMIERE Unit, Université de Paris, France
| | - Nathalie Siauve
- Radiology Department, Assistance Publique - Hôpitaux de Paris, Hôpital Louis Mourier, 178 Rue des Renouillers, 92700, Colombes, France; INSERM, U970, Paris Cardiovascular Research Center - PARCC, Paris, France
| | - Laurent J Salomon
- Obstetrics and Gynecology Department, Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, 149 Rue de Sèvres, 75015, Paris, France; EA FETUS 7328 and LUMIERE Unit, Université de Paris, France.
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Torkzad MR, Masselli G. Editorial on "Human Placenta Blood Flow During Early Gestation With Pseudocontinuous Arterial Spin Labeling MRI". J Magn Reson Imaging 2019; 51:1258-1259. [PMID: 31837081 DOI: 10.1002/jmri.27031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/05/2019] [Accepted: 12/05/2019] [Indexed: 11/06/2022] Open
Affiliation(s)
- Michael R Torkzad
- Karolinska University Hospital, Radiology, Sweden.,Royal Marsden Hospital NHS Trust, London, UK.,European Telemedicine Clinic SL, Barcelona, Catalunya, Espania
| | - Gabriele Masselli
- Radiology Department, Umberto I Hospital, Sapienza University, Rome, Italy
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