Human placental perfusion measured using dynamic contrast enhancement MRI

Area of Science:

• Medical Imaging
• Obstetrics and Gynecology
• Fetal Medicine

Background:

• Placental perfusion is crucial for fetal development.
• Assessing placental function in vivo is challenging.
• Previous methods for measuring placental perfusion have limitations.

Purpose of the Study:

• To evaluate the feasibility of dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) for measuring in vivo placental perfusion.
• To establish reference values for placental perfusion across gestational ages.
• To compare placental perfusion in fetuses with and without intrauterine growth restriction (IUGR).

Main Methods:

• Dynamic contrast-enhanced MRI (DCE MRI) using gadolinium-chelate was performed in pregnant women.
• Quantitative analysis employed one-compartment intravascular modeling.
• Perfusion parameters were analyzed in relation to gestational age and fetal growth (IUGR vs. appropriate for gestational age - AGA).

Main Results:

• DCE MRI is a feasible method for measuring placental perfusion in vivo.
• Mean placental blood flow in normal karyotype pregnancies was 129±61 mL/min/100ml.
• Fetuses with IUGR exhibited significantly lower placental blood flow compared to AGA fetuses (122±88 mL/min vs. 259±34 mL/min, p=0.002).
• DCE perfusion parameters showed a linear correlation with gestational age.

Conclusions:

• DCE MRI is a viable technique for in vivo placental perfusion measurement.
• This study provides initial DCE MRI values for placental perfusion, serving as a potential standard for future research.
• Altered placental functional parameters are suggested in pregnancies complicated by IUGR.