Role of diffusion MR imaging (DWI) and three-dimensional ultrasound (3DUS) in the assessment of placental insufficiency in the gestational hypertension

Sahar Mansour,Safia Sayed,Soha Hamed,Shreen Hosny

doi:10.1186/s43055-019-0062-3

Sahar Mansour, Safia Sayed + Show 2 more

Open Access

https://doi.org/10.1186/s43055-019-0062-3

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Abstract

BackgroundDWI is a non-invasive MR modality that is not contrast-based. In the current study, we aimed to evaluate DWI in correlation with 3DUS in the detection of placental insufficiency in high-risk pregnancies complicated with hypertension.This prospective analysis included 80 pregnancies; 40 hypertensive and 40 controls, gestational age ranged from 22 to 34 weeks. All cases had undergone 3DUS aided by power Doppler scanning and DWI. There is no given contrast. Data were correlated to histopathology.ResultsDoppler US showed a significant relation between RI of the right uterine artery of cases and control (P = 0.014). There was also a positive correlation between the presence of the diastolic notch and RI value. The mean ADC value in the controls was 1.87 ± 0.26 mm2/s, while in hypertensive was 1.36 ± 0.09 mm2/s. In DWI images, there was a significant difference between patients with normal and those with abnormal placental signals (P value = 0.047). Also, there was a significant difference between the measurement of placental volume by MRI and US among cases and controls (P values ≤0.001 and 0.017, respectively).ConclusionDiffusion-weighted imaging can detect early subtle findings and signs of placental dysfunction more than detected with 3DUS, so it can add to the diagnostic accuracy of US in imaging of pregnancies at high risk of placental insufficiency.

Highlights

DWI is a non-invasive magnetic resonance (MR) modality that is not contrast-based
Placental insufficiency is a process that causes a progressive deterioration in the placental function and may cause preeclampsia in hypertensive pregnant females [1]
B) Inclusion criteria for the included patients (n = 40): Pregnant patients were at high risk for placental insufficiency regarding their clinical history of either one or all of the following: (1) History of gestational hypertension, (2) previous history of preeclampsia, (3) previous history of recurrent abortions, and (4) previous history of intra-uterine fetal death (IUFD) and placental abruption

Summary

Introduction

DWI is a non-invasive MR modality that is not contrast-based. We aimed to evaluate DWI in correlation with 3DUS in the detection of placental insufficiency in high-risk pregnancies complicated with hypertension. This prospective analysis included 80 pregnancies; 40 hypertensive and 40 controls, gestational age ranged from 22 to 34 weeks. All cases had undergone 3DUS aided by power Doppler scanning and DWI. Ultrasound is the first choice modality in the case of placental evaluation [3]. Pregnancies with increased vascular impedance on the placental, fetal, and maternal sides can be detected by Doppler examinations of both uterine and the umbilical arteries [5]. Fast MR sequences allow accurate volumetry of the uteroplacental unit [6]

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