Quantitative evaluation of placental microvascular blood flow and microstructure in fetal growth restriction with IVIM MRI.

IF 2.1 3区医学 Q2 PEDIATRICS

Pediatric Radiology Pub Date : 2025-03-01 Epub Date: 2025-01-24 DOI:10.1007/s00247-024-06151-9

Caroline J Walsh, Mariana L Meyers, Neal Chandnani, Alex J Barker, Takashi Fujiwara, David M Mirsky, Erin K Englund

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引用次数: 0

Abstract

Background: Intravoxel incoherent motion (IVIM) MRI uses diffusion-weighted (DW) MRI acquisitions to evaluate the microvascular and cellular environments of tissue. Due to these properties, IVIM has been increasingly utilized to evaluate abnormal placentation.

Objective: Our primary objective was to compare IVIM parameters in the placenta of patients with fetal growth restriction and appropriate for gestational age controls across gestational ages. Our secondary aim was to quantify IVIM parameters in fetal versus maternal placental aspects to evaluate microvascular and parenchymal differences.

Materials and methods: With IRB approval, pregnant individuals with a diagnosis of fetal growth restriction (n=24) and controls (n=22) were retrospectively analyzed. DW-MRI data were collected at 1.5 T with nine b-values (range, 0 s/mm² to 1,000 s/mm²). Data were processed by one non-blinded reader to obtain mean perfusion fraction (f), pseudo-diffusion coefficient (D*), their product fD*, and diffusion coefficient (D) in maternal and fetal aspects of the placenta, defined by bisecting the thickness of the placenta. Repeated measures of two-way ANOVAs were used to compare IVIM parameters in fetal and maternal placental aspects between participant groups. Correlations between IVIM parameters and gestational age were also evaluated in both groups.

Results: The average gestational age at MRI was 27±4 weeks for both groups. The percentile estimated fetal weight was 5.4±5.9% for the fetal growth restriction group and 42.8±28.5% for controls (P<0.001). The parameters D* and fD*, related to microvascular blood flow and tissue perfusion, were significantly lower in participants with fetal growth restriction compared to controls (D*, 40.5 vs. 52.4×10^-3 mm²/s, P=0.043; fD*, 14.7 vs. 21.0×10^-3 mm²/s, P=0.019). No other differences were observed, nor associations between gestational age and IVIM parameters in either group.

Conclusion: Our results suggest reduced microvascular flow in placentas of patients with fetal growth restriction compared to controls.

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胎儿生长受限时胎盘微血管血流及微结构的IVIM MRI定量评价。

背景：体素内非相干运动（IVIM） MRI使用弥散加权（DW） MRI采集来评估组织的微血管和细胞环境。由于这些特性，IVIM越来越多地用于评估异常胎盘。目的：我们的主要目的是比较不同胎龄的胎儿生长受限和适宜胎龄控制的患者胎盘中的IVIM参数。我们的第二个目的是量化胎儿和母亲胎盘方面的IVIM参数，以评估微血管和实质的差异。材料和方法：经IRB批准，回顾性分析诊断为胎儿生长受限的孕妇（n=24）和对照组（n=22）。DW-MRI数据在1.5 T时收集9个b值（范围0 s/mm2至1000 s/mm2）。数据由一名非盲阅读器处理，得到胎盘母胎两方面的平均灌注分数(f)、伪扩散系数（D*）、它们的乘积fD*和扩散系数(D)，通过平分胎盘的厚度来定义。采用双因素方差分析的重复测量来比较参与者组间胎儿和母体胎盘方面的IVIM参数。两组的IVIM参数与胎龄的相关性也进行了评估。结果：两组患者MRI平均胎龄均为27±4周。胎儿生长受限组的百分位数估计胎儿体重为5.4±5.9%，对照组为42.8±28.5% (P-3 mm2/s， P=0.043；fD*, 14.7 vs. 21.0×10-3 mm2/s， P=0.019)。在两组中没有观察到其他差异，也没有观察到胎龄和IVIM参数之间的关联。结论：我们的研究结果表明，与对照组相比，胎儿生长受限患者的胎盘微血管流量减少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.