Toward Clinical Implementation of Magnetic Resonance Imaging for Placental Function.

Abstract

Placental insufficiency is a critical condition in perinatal medicine, clinically manifesting as fetal growth restriction or preeclampsia. In addition to ultrasound and Doppler velocimetry, MRI has been assessed intensively for its potential to evaluate placental function directly. Several methods investigated to date include anthropometry, visual assessments using T2-weighted images, and quantitative evaluations based on T2 values, hypoxia indicators (T2* values and blood oxygenation level-dependent imaging), and perfusion metrics (intravoxel incoherent motion and arterial spin labeling). Anthropometry and visual assessments are easily implemented clinically because they require no specific technique or post-processing. By contrast, quantitative approaches provide objective numerical indicators, making them promising imaging biomarkers. Despite their potential, translating these methods into clinical practice presents challenges, especially for quantitative techniques, because of limited availability, lack of standardization, and inadequate clinician awareness. This review was conducted to overview the clinical aspects of placental insufficiency, summarize the anthropometry, visual assessments, and quantitative methods reported, and highlight the latest advancements. It also presents discussion of related challenges and future prospects for clinical implementation.