Placental diffusion-weighted MRI in normal pregnancies and those complicated by placental dysfunction due to vascular malperfusion

Anderson, Kristi Bøgh; Hansen, Ditte Nymark; Caroline, Haals; Sinding, Marianne; Petersen, Astrid; B, Frøkjær Jens; A, Peters David; Sørensen, Anne

doi:10.1016/j.placenta.2020.01.009

Cited by 23 publications

(13 citation statements)

References 44 publications

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“…Traditionally, most of the prior investigations [ 18 – 22 , 24 , 35 , 36 ] measured DWI parameters from manually placed ROIs on one or several representative slices of the placenta, which may lead to interobserver variability in ROI selection. In addition, inappropriate ROI selection may not accurately reflect the physiological features of the placenta.…”

Section: Discussionmentioning

confidence: 99%

“…Jakab’s study also demonstrated that f was moderately increasing during gestation [ 25 ]. However, Derwig’s study reported that f did not change with GA [ 36 ], Sohlberg’s and Kristi B’s study reported that f decreased with GA [ 18 , 22 ]. The inconsistency of the results from the above researches may arise from different ROI selections and different IVIM protocols.…”

Section: Discussionmentioning

confidence: 99%

“…IVIM, first proposed by Le Bihan et al [ 16 ], is a biexponential model that separates microvascular perfusion from water diffusivity within the tissue [ 16 , 17 ]. Some researchers have investigated the feasibility of IVIM in pregnancies complicated by placental dysfunction due to vascular malperfusion [ 18 ], placenta accreta [ 19 – 21 ], preeclampsia [ 22 ], growth-restricted pregnancy [ 23 ], and normal pregnancies [ 24 – 26 ].…”

Section: Introductionmentioning

confidence: 99%

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Monoexponential, biexponential and diffusion kurtosis MR imaging models: quantitative biomarkers in the diagnosis of placenta accreta spectrum disorders

Lü

Wang

Guo

et al. 2022

BMC Pregnancy Childbirth

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Background To investigate the diagnostic value of monoexponential, biexponential, and diffusion kurtosis MR imaging (MRI) in differentiating placenta accreta spectrum (PAS) disorders. Methods A total of 65 patients with PAS disorders and 27 patients with normal placentas undergoing conventional DWI, IVIM, and DKI were retrospectively reviewed. The mean, minimum, and maximum parameters including the apparent diffusion coefficient (ADC) and exponential ADC (eADC) from standard DWI, diffusion kurtosis (MK), and mean diffusion coefficient (MD) from DKI and pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) from IVIM were measured from the volumetric analysis and compared between patients with PAS disorders and patients with normal placentas. Univariate and multivariated logistic regression analyses were used to evaluate the value of the above parameters for differentiating PAS disorders. Receiver operating characteristics (ROC) curve analyses were used to evaluate the diagnostic efficiency of different diffusion parameters for predicting PAS disorders. Results Multivariate analysis demonstrated that only D mean and D max differed significantly among all the studied parameters for differentiating PAS disorders when comparisons between accreta lesions in patients with PAS (AP) and whole placentas in patients with normal placentas (WP-normal) were performed (all p < 0.05). For discriminating PAS disorders, a combined use of these two parameters yielded an AUC of 0.93 with sensitivity, specificity, and accuracy of 83.08, 88.89, and 83.70%, respectively. Conclusion The diagnostic performance of the parameters from accreta lesions was better than that of the whole placenta. D mean and D max were associated with PAS disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Monoexponential, biexponential and diffusion kurtosis MR imaging models: quantitative biomarkers in the diagnosis of placenta accreta spectrum disorders

Lü

Wang

Guo

et al. 2022

BMC Pregnancy Childbirth

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“…The D* value reflects the status of microcirculation perfusion of tumor. The perfusion fraction f is a reflection of the volume of blood flowing into the capillaries 38 and has been shown to be well correlated with microvessel density, a key biomarker for angiogenesis. 39 Our study demonstrated that tumor with a high perfusion status might be associated with a good response in HNSCC patients.…”

Section: Discussionmentioning

confidence: 99%

Intravoxel Incoherent Motion Magnetic Resonance Imaging for Prediction of Induction Chemotherapy Response in Locally Advanced Hypopharyngeal Carcinoma: Comparison With Model‐Free Dynamic Contrast‐Enhanced Magnetic Resonance Imaging

Guo

Ouyang

et al. 2021

Magnetic Resonance Imaging

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Background: Multiparametric intravoxel incoherent motion (IVIM) provides diffusion and perfusion information for the treatment prediction of cancer. However, the superiority of IVIM over dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in locally advanced hypopharyngeal carcinoma (LAHC) remains unclear. Purpose: To compare the diagnostic performance of IVIM and model-free DCE in assessing induction chemotherapy (IC) response in patients with LAHC. Study Type: Prospective. Population: Forty-two patients with LAHC. Field Strength/Sequence: 3.0 T MRI, including IVIM (12 b values, 0-800 seconds/mm 2 ) with a single-shot echo planar imaging sequence and DCE-MRI with a volumetric interpolated breath-hold examination sequence. IVIM MRI is a commercially available sequence and software for calculation and analysis from vendor. Assessment: The IVIM-derived parameters (diffusion coefficient [D], pseudodiffusion coefficient [D*], and perfusion fraction [f]) and DCE-derived model-free parameters (Wash-in, time to maximum enhancement [Tmax], maximum enhancement [Emax], area under enhancement curve [AUC] over 60 seconds [AUC 60 ], and whole area under enhancement curve [AUC w ]) were measured. At the end of IC, patients with complete or partial response were classified as responders according to the Response Evaluation Criteria in Solid Tumors.Statistical Tests: The differences of parameters between responders and nonresponders were assessed using Mann-Whitney U tests. The performance of parameters for predicting IC response was evaluated by the receiver operating characteristic curves. Results: Twenty-three (54.8%) patients were classified as responders. Compared with nonresponders, the perfusion parameters D*, f, f × D*, and AUC w were significantly higher whereas Wash-in was lower in responders (all P-values <0.05). The f × D* outperformed other parameters, with an AUC of 0.84 (95% confidence interval [CI]: 0.69-0.93), sensitivity of 79.0% (95% CI: 54.4-93.9), and specificity of 82.6% (95% CI: 61.2-95.0).

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“…From a biological viewpoint placental lesions suggestive for FVM have been associated with reduced blood movement in the intervillous space in diffusion-weighted magnetic resonance imaging studies of dysfunctional placentas, suggesting that this type of lesion correlates to the severity of growth failure. 35 Intravillous hemorrhage leads to coagulation necrosis of villi and to the formation of intervillous thrombi, both lesions impairing fetomaternal exchanges in FGR pregnancies. 30,33 The main strengths of the study involve the type of the study and the methods used.…”

Section: Discussionmentioning

confidence: 99%

Placental Histological Features and Neurodevelopmental Outcomes at Two Years in Very-Low-Birth-Weight Infants

Spinillo

Dominoni

Caporali

et al. 2021

Pediatric Neurology

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Background: We evaluated the rates of placental pathologic lesions and their relationship with two-year neurodevelopmental outcomes in very-low-birth-weight (VLBW) infants. Methods: This is a cohort observational study comprising 595 VLBW infants during 2007 to 2015. Neurodevelopmental assessment was carried out at 24 months corrected age. Results: In univariate analysis the rates of survival with normal neurodevelopmental outcomes were lower in pregnancies with severe histologic chorioamnionitis (38 of 43, 88.4% when compared with 305 of 450, 67.8%), severe maternal vascular malperfusion (MVM) (17 of 37, 45.9% when compared with 326/ 492, 66.3%), and intravillous hemorrhage (37 of 82, 45.1% when compared with 306 of 449, 68.1%). In logistic models, severe MVM (adjusted odds ratio [adj. OR] ¼ 0.45, 95% confidence interval [CI] ¼ 0.22 to 0.92), severe fetal vascular malperfusion (FVM) (adj. OR ¼ 0.46, 95% CI ¼ 0.22 to 0.45), and intravillous hemorrhage (adj. OR ¼ 0.38, 95% CI ¼ 0.22 to 0.62) were associated with lower rates of infant survival with normal neurodevelopmental outcome. FVM (adj. OR ¼ 0.46, 95% CI ¼ 0.21 to 0.97) and intravillous hemorrhage (adj. OR ¼ 0.37, 95% CI ¼ 0.22 to 0.62) were also the only placental lesions that were independent predictors of a lower rate of intact survival in stepwise analysis for prognostic factors of the entire cohort. Conclusions: Placental pathologic findings such as severe MVM, FVM, and intravillous hemorrhage are significant predictors of neonatal survival and subsequent adverse neurodevelopmental outcomes. Data on the placental pathology could be useful in the neurodevelopmental follow-up of VLBW infants.

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Placental diffusion-weighted MRI in normal pregnancies and those complicated by placental dysfunction due to vascular malperfusion

Cited by 23 publications

References 44 publications

Monoexponential, biexponential and diffusion kurtosis MR imaging models: quantitative biomarkers in the diagnosis of placenta accreta spectrum disorders

Monoexponential, biexponential and diffusion kurtosis MR imaging models: quantitative biomarkers in the diagnosis of placenta accreta spectrum disorders

Intravoxel Incoherent Motion Magnetic Resonance Imaging for Prediction of Induction Chemotherapy Response in Locally Advanced Hypopharyngeal Carcinoma: Comparison With Model‐Free Dynamic Contrast‐Enhanced Magnetic Resonance Imaging

Placental Histological Features and Neurodevelopmental Outcomes at Two Years in Very-Low-Birth-Weight Infants

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