Intravoxel incoherent motion MR imaging analysis for diagnosis of placenta accrete spectrum disorders: A pilot feasibility study

Leon, Rachel L.; Brown, Brandon P.; Persohn, Scott A.; Norris, Carrie D.; Steinhardt, Nicole P.; Lin, Chen; Territo, Paul R.

doi:10.1016/j.mri.2021.03.007

Cited by 5 publications

(3 citation statements)

References 35 publications

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“…Placental pathology may provide input into a stroke risk stratification algorithm, but the timeframe required for placental examination will be a limiting factor until new techniques are developed that can offer real-time, clinically-relevant information. In order to establish preventative strategies, advanced methods of in utero assessment are needed, such as the many emerging methods in advanced placental magnetic resonance imaging (43)(44)(45)(46).…”

Section: Discussionmentioning

confidence: 99%

Placental pathologic lesions associated with stroke in term neonates

et al. 2022

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ObjectiveTo determine the birth prevalence of perinatal stroke in term born infants at our high-volume delivery center and assess the frequency of both gross and histologic placental pathologies associated with perinatal stroke using the Amsterdam Placental Workshop Group Consensus Statement guidelines and definitions.Study DesignA single-center retrospective cohort study spanning 2010-2020.ResultsThere were 129,759 live births at Parkland Hospital during the study period and a total of 18 term born infants leading to a birth prevalence of 1 in 6,829 infants. Perinatal risk factors were found in all but one patient, and 74% presented with seizures. Pathologic placental examination was available in 56% of the cohort and only one patient had normal placental examination. Acute histologic chorioamnionitis was described in five placentas (50%) and an additional two had isolated umbilical and/or chorionic plate vasculitis with or without funisitis compared to a rate of 28% with acute inflammation in a Control group. Chronic inflammation in the form of villitis of unknown etiology was described in three of the acutely inflamed placentas and was high-grade in each of those while none of the placentas from our Control group showed evidence of any chronic lesion.ConclusionBoth acute and chronic placental inflammation are common in perinatal stroke; placental examination should be considered an essential component to the diagnostic workup.

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Section: Discussionmentioning

confidence: 99%

Placental pathologic lesions associated with stroke in term neonates

et al. 2022

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“…Application of MRI to the placenta has increased our knowledge about its normal structure, including its typical growth throughout gestation, 84 the textural analysis as it matures, 85,86 and new perfusion sequences are providing information on maternal perfusion of the placenta. 6,87 Recent MRI studies in the CHD placenta not only confirm morphometric and structural abnormalities, 4,7 but also reveal impaired functional characteristics. 6,88 While predominantly utilized for research purposes, current MRI modalities exploit placental vascularity and oxygenation as surrogates for overall placental function.…”

Section: Abnormal In Vivo Placental Functionmentioning

confidence: 91%

“…Fetal magnetic resonance imaging (MRI) is increasingly acknowledged as an adjunct that provides additional information beyond the capabilities of Doppler alone. Application of MRI to the placenta has increased our knowledge about its normal structure, including its typical growth throughout gestation, 84 the textural analysis as it matures, 85,86 and new perfusion sequences are providing information on maternal perfusion of the placenta 6,87 . Recent MRI studies in the CHD placenta not only confirm morphometric and structural abnormalities, 4,7 but also reveal impaired functional characteristics 6,88 .…”

Section: Clinical Insights Into a Placental Origin Of Chdmentioning

confidence: 99%

Interdependence of placenta and fetal cardiac development

Leon,

Bitar,

Rajagopalan

et al. 2024

Prenatal Diagnosis

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The placenta and fetal heart undergo development concurrently during early pregnancy, and, while human studies have reported associations between placental abnormalities and congenital heart disease (CHD), the nature of this relationship remains incompletely understood. Evidence from animal studies suggests a plausible cause and effect connection between placental abnormalities and fetal CHD. Biomechanical models demonstrate the influence of mechanical forces on cardiac development, whereas genetic models highlight the role of confined placental mutations that can cause some forms of CHD. Similar definitive studies in humans are lacking; however, placental pathologies such as maternal and fetal vascular malperfusion and chronic deciduitis are frequently observed in pregnancies complicated by CHD. Moreover, maternal conditions such as diabetes and pre‐eclampsia, which affect placental function, are associated with increased risk of CHD in offspring. Bridging the gap between animal models and human studies is crucial to understanding how placental abnormalities may contribute to human fetal CHD. The next steps will require new methodologies and multidisciplinary approaches combining innovative imaging modalities, comprehensive genomic testing, and histopathology. These studies may eventually lead to preventative strategies for some forms of CHD by targeting placental influences on fetal heart development.

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