In vivo assessment of placental microstructure in normal pregnancy and gestational hypertension: An IVIM-based MRI study

Yajing Mao¹, Jialu Xu², Shengyi Gu³, Huanrong Liu⁴, Sheng Wan³, Xiping Hong⁵, Jiejun Cheng⁶, Xiaolin Hua⁷

Affiliations

¹ Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China; Department of Obstetrics, Jiading Maternal and Child Health Hospital, Shanghai, 201821, China.
² Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China; Department of Radiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
³ Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
⁴ Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
⁵ Department of Obstetrics, Jiading Maternal and Child Health Hospital, Shanghai, 201821, China.
⁶ Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China; Department of Radiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China. Electronic address: drchjj@163.com.
⁷ Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China. Electronic address: lindahua@sjtu.edu.cn.

PMID: 41576879
DOI: 10.1016/j.placenta.2026.01.014

Free article

In vivo assessment of placental microstructure in normal pregnancy and gestational hypertension: An IVIM-based MRI study

Yajing Mao et al. Placenta. 2026.

Free article

. 2026 Jan 20:175:33-39.

doi: 10.1016/j.placenta.2026.01.014. Online ahead of print.

Authors

Yajing Mao¹, Jialu Xu², Shengyi Gu³, Huanrong Liu⁴, Sheng Wan³, Xiping Hong⁵, Jiejun Cheng⁶, Xiaolin Hua⁷

Affiliations

¹ Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China; Department of Obstetrics, Jiading Maternal and Child Health Hospital, Shanghai, 201821, China.
² Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China; Department of Radiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
³ Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
⁴ Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
⁵ Department of Obstetrics, Jiading Maternal and Child Health Hospital, Shanghai, 201821, China.
⁶ Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China; Department of Radiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China. Electronic address: drchjj@163.com.
⁷ Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China. Electronic address: lindahua@sjtu.edu.cn.

PMID: 41576879
DOI: 10.1016/j.placenta.2026.01.014

Abstract

Objective: Our aim was to evaluate placental function using IVIM diffusion-weighted MRI in both normal pregnancies and gestational hypertension, and develop a combined predictive model for severe fetal growth restriction (sFGR).

Method: We studied 32 healthy pregnant women and 40 with gestational hypertension (20 with sFGR, 20 without). Five IVIM-based parameters were calculated: perfusion fraction (f), true diffusion coefficient (D), pseudo-diffusion coefficient (D∗), diffusion distribution coefficient (DDC), and superdiffusion index (γ). These parameters were compared between the groups. Predictive efficiency was evaluated using logistic regression analysis and receiver operating characteristic (ROC) curve analysis.

Results: Compared to controls, gestational hypertension cases exhibited lower f, D, DDC values and higher γ value (all p < 0.05). Both f value (OR: 0.257, 95 % CI: 0.069-0.957; p = 0.043) and γ value (OR: 0.343, 95 % CI: 0.128-0.918; p = 0.033) independently predicted sFGR. A combined predictive model (f, D∗, DDC and γ) achieved superior prediction (AUC: 0.838).

Conclusion: IVIM-derived parameters effectively quantify placental microcirculation differences and show strong potential as non-invasive biomarkers for sFGR prediction in gestational hypertension.

Keywords: Fetal growth restriction; Intravoxel incoherent motion; Placenta.

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Declaration of competing interest The author reports no conflicts of interest in this work.

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In vivo assessment of placental microstructure in normal pregnancy and gestational hypertension: An IVIM-based MRI study

Affiliations

In vivo assessment of placental microstructure in normal pregnancy and gestational hypertension: An IVIM-based MRI study

Authors

Affiliations

Abstract

Conflict of interest statement

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Full Text Sources