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. 2016;15(2):212-9.
doi: 10.2463/mrms.mp.2015-0051. Epub 2015 Nov 25.

MR Imaging of Fetuses to Evaluate Placental Insufficiency

Yoshimitsu Ohgiya  1 , Hiroshi Nobusawa, Noritaka Seino, Osamu Miyagami, Naomi Yagi, Sasamori Hiroto, Jiro Munechika, Masanori Hirose, Nobuyuki Takeyama, Nobuyuki Ohike, Ryu Matsuoka, Akihiko Sekizawa, Takehiko Gokan
Affiliations

MR Imaging of Fetuses to Evaluate Placental Insufficiency

Yoshimitsu Ohgiya et al. Magn Reson Med Sci. 2016.

Abstract

Purpose: To evaluate morphological and signal intensity (SI) changes of placental insufficiency on magnetic resonance imaging (MRI) and to assess morphological changes and decreased flow voids (FVs) on T2-weighted rapid acquisition with relaxation enhancement (RARE) images for diagnosing placental insufficiency.

Methods: Fifty singleton fetuses underwent MRI using a 1.5-T MR scanner. Placental thickness, area, volume, SI, amniotic fluid SI, and size of FVs between the uterus and the placenta were measured on MR images. Two radiologists reviewed T2-weighted RARE images for globular appearance of the placenta and FVs between the uterus and the placenta. Data were analyzed using t-tests, McNemar's tests, and areas under the receiver operating characteristic curve (AUCs) at 5% level of significance.

Results: Twenty-five of the 50 pregnancies were categorized as having an insufficient placenta. Significant differences were observed between insufficient and normal placentas in mean placental thickness, area, volume, placenta to amniotic fluid SI ratio, and size of FVs (49.0 mm vs. 36.9 mm, 1.62 × 10(4) mm(2) vs. 2.67 × 10(4) mm(2), 5.13 × 10(5) mm(3) vs. 6.56 × 10(5) mm(3), 0.549 vs. 0.685, and 3.4 mm vs. 4.3 mm, respectively). The sensitivity and accuracy using globular appearance plus decreased FVs were greater than those using decreased FVs (P < 0.01). There was no significant difference among AUCs using globular appearance and decreased FVs, and globular appearance plus decreased FVs.

Conclusions: Placental insufficiency was associated with placental thickness, area, volume, placenta to amniotic fluid SI ratio, and size of FVs. Evaluating FVs on T2-weighted RARE images can be useful for detecting placental insufficiency, particularly in placentas without globular appearance on MR images.

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Figures

Fig. 1.
Fig. 1.
A 35-year-old female with a normal functional placenta with no fetal growth restriction. T2-weighted half-Fourier rapid acquisition with relaxation enhancement magnetic resonance image shows a large surface area of attachment to the uterus, with tapered edges (arrow).
Fig. 2.
Fig. 2.
A 28-year-old female with insufficient placenta with fetal growth restriction. T2-weighted half-Fourier rapid acquisition with relaxation enhancement magnetic resonance image shows a decreased size and number of flow voids (arrow) between the uterus and the placenta.
Fig. 3.
Fig. 3.
A 31-year-old female with a normal functional placenta with no fetal growth restriction. T2-weighted half-Fourier rapid acquisition with relaxation enhancement magnetic resonance image shows several clear flow voids (arrows) between the uterus and the placenta.
See this image and copyright information in PMC

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