Abstract
PurposeTo study placental function—both perfusion and an oxygenation surrogate (T2*)—simultaneously and quantitatively in‐vivo.MethodsFifteen pregnant women were scanned on a 3T MR scanner. For perfusion measurements, a velocity selective arterial spin labeling preparation module was placed before a multi‐echo gradient echo EPI readout to integrate T2* and perfusion measurements in 1 joint perfusion‐oxygenation (PERFOX) acquisition. Joint motion correction and quantification were performed to evaluate changes in T2* and perfusion over GA.ResultsThe optimized integrated PERFOX protocol and post‐processing allowed successful visualization and quantification of perfusion and T2* in all subjects. Areas of high T2* and high perfusion appear to correspond to placental sub‐units and show a systematic offset in location along the maternal‐fetal axis. The areas of highest perfusion are consistently closer to the maternal basal plate and the areas of highest T2* closer to the fetal chorionic plate. Quantitative results show a strong negative correlation of gestational age with T2* and weak negative correlation with perfusion.ConclusionsA strength of the joint sequence is that it provides truly simultaneous and co‐registered estimates of local T2* and perfusion, however, to achieve this, the time per slice is prolonged compared to a perfusion only scan which can potentially limit coverage. The achieved interlocking can be particularly useful when quantifying transient physiological effects such as uterine contractions. PERFOX opens a new avenue to elucidate the relationship between maternal supply and oxygen uptake, both of which are central to placental function and dysfunction.
Highlights
The human placenta constitutes the only link between mother and fetus
The sequence consists of a velocity‐selective tagging module, parametrized by the cutoff (Vc) and a post‐label delay (PLD), a background suppression (BGS) module consisting of 2 inversion pulses, and the EPI read‐out module
A better alignment is observed after motion correction (C), depicting both the alignment of similar structures and, shown by orange arrows, the consistent signal changes from label to control on 1 select area of high perfusion
Summary
The human placenta constitutes the only link between mother and fetus. It supplies the fetus with oxygen and nutrients and ensures the elimination of waste products. It has essential endocrine and immunological functions. Major pregnancy complications such as pre‐eclampsia, fetal growth restriction, and preterm birth—all carrying a substantial risk of increased morbidity and mortality for both mother and child—are linked with placental insufficiency. The fetal villi contain extensive arterial‐capillary‐venous systems originating from the umbilical cord, and are bathed in maternal blood. Ongoing maturation across gestation leads to denser, more capillarized vascular trees and decreasing thickness of the cellular layer which separates villi and maternal blood
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