دورية أكاديمية
Longitudinal assessment of placental perfusion in normal and hypertensive pregnancies using pseudo-continuous arterial spin-labeled MRI: preliminary experience.
| العنوان: | Longitudinal assessment of placental perfusion in normal and hypertensive pregnancies using pseudo-continuous arterial spin-labeled MRI: preliminary experience. |
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| المؤلفون: | Herrera CL; Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, USA.; Parkland Health and Hospital System, Dallas, TX, USA., Wang Y; Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9061, USA., Udayakumar D; Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9061, USA.; Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA., Xi Y; Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9061, USA.; Department of Clinical Science, UT Southwestern Medical Center, Dallas, TX, USA., Do QN; Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9061, USA., Lewis MA; Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9061, USA., Owen DM; Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, USA.; Parkland Health and Hospital System, Dallas, TX, USA., Fei B; Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9061, USA.; Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA.; Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA., Spong CY; Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, USA.; Parkland Health and Hospital System, Dallas, TX, USA., Twickler DM; Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, USA.; Parkland Health and Hospital System, Dallas, TX, USA.; Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9061, USA., Madhuranthakam AJ; Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9061, USA. Ananth.Madhuranthakam@UTSouthwestern.edu.; Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA. Ananth.Madhuranthakam@UTSouthwestern.edu. |
| المصدر: | European radiology [Eur Radiol] 2023 Dec; Vol. 33 (12), pp. 9223-9232. Date of Electronic Publication: 2023 Jul 19. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Country of Publication: Germany NLM ID: 9114774 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1084 (Electronic) Linking ISSN: 09387994 NLM ISO Abbreviation: Eur Radiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Berlin : Springer International, c1991- |
| مواضيع طبية MeSH: | Placental Insufficiency* , Hypertension*, Pregnancy ; Female ; Humans ; Infant ; Placenta/diagnostic imaging ; Spin Labels ; Contrast Media ; Magnetic Resonance Imaging/methods ; Perfusion ; Biomarkers |
| مستخلص: | Objectives: To evaluate longitudinal placental perfusion using pseudo-continuous arterial spin-labeled (pCASL) MRI in normal pregnancies and in pregnancies affected by chronic hypertension (cHTN), who are at the greatest risk for placental-mediated disease conditions. Methods: Eighteen normal and 23 pregnant subjects with cHTN requiring antihypertensive therapy were scanned at 3 T using free-breathing pCASL-MRI at 16-20 and 24-28 weeks of gestational age. Results: Mean placental perfusion was 103.1 ± 48.0 and 71.4 ± 18.3 mL/100 g/min at 16-20 and 24-28 weeks respectively in normal pregnancies and 79.4 ± 27.4 and 74.9 ± 26.6 mL/100 g/min in cHTN pregnancies. There was a significant decrease in perfusion between the first and second scans in normal pregnancies (p = 0.004), which was not observed in cHTN pregnancies (p = 0.36). The mean perfusion was not statistically different between normal and cHTN pregnancies at both scans, but the absolute change in perfusion per week was statistically different between these groups (p = 0.044). Furthermore, placental perfusion was significantly lower at both time points (p = 0.027 and 0.044 respectively) in the four pregnant subjects with cHTN who went on to have infants that were small for gestational age (52.7 ± 20.4 and 50.4 ± 20.9 mL/100 g/min) versus those who did not (85 ± 25.6 and 80.0 ± 25.1 mL/100 g/min). Conclusion: pCASL-MRI enables longitudinal assessment of placental perfusion in pregnant subjects. Placental perfusion in the second trimester declined in normal pregnancies whereas it remained unchanged in cHTN pregnancies, consistent with alterations due to vascular disease pathology. Perfusion was significantly lower in those with small for gestational age infants, indicating that pCASL-MRI-measured perfusion may be an effective imaging biomarker for placental insufficiency. Clinical Relevance Statement: pCASL-MRI enables longitudinal assessment of placental perfusion without administering exogenous contrast agent and can identify placental insufficiency in pregnant subjects with chronic hypertension that can lead to earlier interventions. Key Points: • Arterial spin-labeled (ASL) magnetic resonance imaging (MRI) enables longitudinal assessment of placental perfusion without administering exogenous contrast agent. • ASL-MRI-measured placental perfusion decreased significantly between 16-20 week and 24-28 week gestational age in normal pregnancies, while it remained relatively constant in hypertensive pregnancies, attributed to vascular disease pathology. • ASL-MRI-measured placental perfusion was significantly lower in subjects with hypertension who had a small for gestational age infant at 16-20-week gestation, indicating perfusion as an effective biomarker of placental insufficiency. (© 2023. The Author(s), under exclusive licence to European Society of Radiology.) |
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| معلومات مُعتمدة: | K23 HD103876 United States HD NICHD NIH HHS; K25 HD104004 United States HD NICHD NIH HHS; L30 HD109864 United States HD NICHD NIH HHS |
| فهرسة مساهمة: | Keywords: Hypertension; Perfusion; Perfusion-weighted MRI; Placenta; Preeclampsia |
| المشرفين على المادة: | 0 (Spin Labels) 0 (Contrast Media) 0 (Biomarkers) |
| تواريخ الأحداث: | Date Created: 20230719 Date Completed: 20231127 Latest Revision: 20240702 |
| رمز التحديث: | 20240702 |
| مُعرف محوري في PubMed: | PMC10796849 |
| DOI: | 10.1007/s00330-023-09945-x |
| PMID: | 37466705 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1432-1084 |
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| DOI: | 10.1007/s00330-023-09945-x |