TY - JOUR
T1 - T2∗ Placental Magnetic Resonance Imaging in Preterm Preeclampsia
T2 - An Observational Cohort Study
AU - Ho, Alison E.P.
AU - Hutter, Jana
AU - Jackson, Laurence H.
AU - Seed, Paul T.
AU - McCabe, Laura
AU - Al-Adnani, Mudher
AU - Marnerides, Andreas
AU - George, Simi
AU - Story, Lisa
AU - Hajnal, Joseph V.
AU - Rutherford, Mary A.
AU - Chappell, Lucy C.
N1 - Funding Information:
This work is funded by the National Institutes of Health (NIH) Human Placenta Project grant 1U01HD087202-01, the National Institute for Health Research (NIHR) Research Professorship (L.C. Chappell; RP-2014-05-019), Tommy’s (Registered charity no. 1060508) and Holbeck Charitable Trust with support from the Wellcome EPSRC Centre for Medical Engineering at King’s College London (WT 203148/Z/16/Z) and by the National Institute for Health Research Biomedical Research Centre based at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. P. Seed is partly funded by Tommy’s and by CLAHRC South London (NIHR). J. Hutter is funded by the Wellcome Trust through a Sir Henry Wellcome Fellowship (201374).
Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Placental dysfunction underlies the cause of pregnancies complicated by preeclampsia. The use of placental magnetic resonance imaging to provide an insight into the pathophysiology of preeclampsia and thus assess its potential use to inform prognosis and clinical management was explored. In this prospective observational cohort study, 14 women with preterm preeclampsia and 48 gestation-matched controls using 3-Tesla magnetic resonance imaging at median of 31.6 weeks (interquartile range [IQR], 28.6-34.6) and 32.2 weeks (IQR, 28.6-33.8), respectively, were imaged. The acquired data included T2-weighted images and T2∗ maps of the placenta, the latter an indicative measure of placental oxygenation. Placentae in women with preeclampsia demonstrated advanced lobulation, varied lobule sizes, high granularity, and substantial areas of low-signal intensity on T2-weighted imaging, with reduced entire placental mean T2∗ values for gestational age (2 sample t test, t=7.49) correlating with a reduction in maternal PlGF (placental growth factor) concentrations (Spearman rank correlation coefficient 0.76) and increased lacunarity values (t=3.26). Median mean T2∗ reduced from 67 ms (IQR, 54-73) at 26.0 to 29.8 weeks' gestation to 38 ms (IQR, 28-40) at 34.0 to 37.9 weeks' gestation in the control group. In women with preeclampsia, median T2∗ was 23 ms (IQR, 20-23) at 26.0 to 29.8 weeks' gestation and remained low (22 ms [IQR, 20-26] at 34.0-37.8 weeks' gestation). Histological features of maternal vascular malperfusion were only found in placentae from women with preeclampsia. Placental volume did not differ between the control group and women with preeclampsia. Placental magnetic resonance imaging allows both objective quantification of placental function in vivo and elucidation of the complex mechanisms underlying preeclampsia development.
AB - Placental dysfunction underlies the cause of pregnancies complicated by preeclampsia. The use of placental magnetic resonance imaging to provide an insight into the pathophysiology of preeclampsia and thus assess its potential use to inform prognosis and clinical management was explored. In this prospective observational cohort study, 14 women with preterm preeclampsia and 48 gestation-matched controls using 3-Tesla magnetic resonance imaging at median of 31.6 weeks (interquartile range [IQR], 28.6-34.6) and 32.2 weeks (IQR, 28.6-33.8), respectively, were imaged. The acquired data included T2-weighted images and T2∗ maps of the placenta, the latter an indicative measure of placental oxygenation. Placentae in women with preeclampsia demonstrated advanced lobulation, varied lobule sizes, high granularity, and substantial areas of low-signal intensity on T2-weighted imaging, with reduced entire placental mean T2∗ values for gestational age (2 sample t test, t=7.49) correlating with a reduction in maternal PlGF (placental growth factor) concentrations (Spearman rank correlation coefficient 0.76) and increased lacunarity values (t=3.26). Median mean T2∗ reduced from 67 ms (IQR, 54-73) at 26.0 to 29.8 weeks' gestation to 38 ms (IQR, 28-40) at 34.0 to 37.9 weeks' gestation in the control group. In women with preeclampsia, median T2∗ was 23 ms (IQR, 20-23) at 26.0 to 29.8 weeks' gestation and remained low (22 ms [IQR, 20-26] at 34.0-37.8 weeks' gestation). Histological features of maternal vascular malperfusion were only found in placentae from women with preeclampsia. Placental volume did not differ between the control group and women with preeclampsia. Placental magnetic resonance imaging allows both objective quantification of placental function in vivo and elucidation of the complex mechanisms underlying preeclampsia development.
KW - magnetic resonance imaging
KW - placenta
KW - preeclampsia
KW - pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85084694822&partnerID=8YFLogxK
U2 - 10.1161/HYPERTENSIONAHA.120.14701
DO - 10.1161/HYPERTENSIONAHA.120.14701
M3 - Article
C2 - 32336233
AN - SCOPUS:85084694822
SN - 0194-911X
VL - 75
SP - 1523
EP - 1531
JO - Hypertension
JF - Hypertension
IS - 6
ER -