Perfusion and apparent oxygenation in the human placenta (PERFOX)
Hutter, Jana; Harteveld, Anita A; Jackson, Laurence H; Franklin, Suzanne; Bos, Clemens; van Osch, Matthias J P; O'Muircheartaigh, Jonathan; Ho, Alison; Chappell, Lucy; Hajnal, Joseph V; Rutherford, Mary; De Vita, Enrico
(2020) Magnetic Resonance in Medicine, volume 83, issue 2, pp. 549 - 560
(Article)
Abstract
PURPOSE: To study placental function-both perfusion and an oxygenation surrogate ( T 2 * )-simultaneously and quantitatively in-vivo. METHODS: Fifteen pregnant women were scanned on a 3T MR scanner. For perfusion measurements, a velocity selective arterial spin labeling preparation module was placed before a multi-echo gradient echo EPI readout to
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integrate T 2 * and perfusion measurements in 1 joint perfusion-oxygenation (PERFOX) acquisition. Joint motion correction and quantification were performed to evaluate changes in T 2 * and perfusion over GA. RESULTS: The optimized integrated PERFOX protocol and post-processing allowed successful visualization and quantification of perfusion and T 2 * in all subjects. Areas of high T 2 * and high perfusion appear to correspond to placental sub-units and show a systematic offset in location along the maternal-fetal axis. The areas of highest perfusion are consistently closer to the maternal basal plate and the areas of highest T 2 * closer to the fetal chorionic plate. Quantitative results show a strong negative correlation of gestational age with T 2 * and weak negative correlation with perfusion. CONCLUSIONS: A strength of the joint sequence is that it provides truly simultaneous and co-registered estimates of local T 2 * and perfusion, however, to achieve this, the time per slice is prolonged compared to a perfusion only scan which can potentially limit coverage. The achieved interlocking can be particularly useful when quantifying transient physiological effects such as uterine contractions. PERFOX opens a new avenue to elucidate the relationship between maternal supply and oxygen uptake, both of which are central to placental function and dysfunction.
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Keywords: Arterial Spin Labeling (ASL), perfusion, placenta, pre‐eclampsia, relaxometry, velocity‐selective ASL, velocity-selective ASL, pre-eclampsia, Radiology Nuclear Medicine and imaging, Research Support, Non-U.S. Gov't, Journal Article, Research Support, N.I.H., Extramural
ISSN: 0740-3194
Publisher: John Wiley and Sons Inc.
Note: Funding Information: We thank the midwives, obstetricians, and radiographers who played a key role in obtaining the data sets. We would also like to thank all participating mothers. This work received funding from the NIH (Human Placenta Project?grant 1U01HD087202-01), the Wellcome Trust (Sir Henry Wellcome Fellowship, 201374/Z/16/Z), and the EPSRC (grants N018702 and M020533). This work was also supported by the Wellcome/EPSRC Centre for Medical Engineering [WT 203148/Z/16/Z]. Publisher Copyright: © 2019 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
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