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Review
. 2015 Mar;39(2):113-23.
doi: 10.1053/j.semperi.2015.01.004. Epub 2015 Mar 9.

Advanced MR imaging of the placenta: Exploring the in utero placenta-brain connection

Nickie Niforatos Andescavage  1 , Adre du Plessis  2 , Catherine Limperopoulos  3
Affiliations
Review

Advanced MR imaging of the placenta: Exploring the in utero placenta-brain connection

Nickie Niforatos Andescavage et al. Semin Perinatol. 2015 Mar.

Abstract

The placenta is a vital organ necessary for the healthy neurodevelopment of the fetus. Despite the known associations between placental dysfunction and neurologic impairment, there is a paucity of tools available to reliably assess in vivo placental health and function. Existing clinical tools for placental assessment remain insensitive in predicting and evaluating placental well-being. Advanced MRI techniques hold significant promise for the dynamic, non-invasive, real-time assessment of placental health and identification of early placental-based disorders. In this review, we summarize the available clinical tools for placental assessment, including ultrasound, Doppler, and conventional MRI. We then explore the emerging role of advanced placental MR imaging techniques for supporting the developing fetus and appraise the strengths and limitations of quantitative MRI in identifying early markers of placental dysfunction for improved pregnancy monitoring and fetal outcomes.

Keywords: Fetal brain; Magnetic resonance imaging; Placenta.

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Figures

Figure 1
Figure 1
T2-weighted image of the placenta from a healthy 21 week fetus. Note the large field of view that captures the length of the placenta and the smooth contours. The placenta has relatively high-signal intensity and the implantation site can be distinguished from the maternal myometrium (white arrow).
Figure 2
Figure 2
2A: T2-weighted image of a 26 week healthy placenta. Note the homogeneous high-signal intensity throughout the organ. 2B: T2-weighted image of a 26 week placenta from a growth-restricted fetus. Note the heterogeneity in signal intensity, thought to correlate with areas of infarction, necrosis or fibrosis.
Figure 3
Figure 3
3A: T2-weighted image of 36 week fetus, with the placenta outlined in red. 3B: Final 3D reconstruction of the placenta, which can be used for quantitative analysis, such as placental volume.
Figure 4
Figure 4
Relationship between placental volume and gestational age in healthy fetuses.
Figure 5
Figure 5
Diffusion weighted Image of a healthy fetus and placenta (5A) with the placenta highlighted in red (5B).
Figure 6
Figure 6
1H-NMS placental spectra in a 35 week fetus depicting choline and lipid peaks.
See this image and copyright information in PMC

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