Placental MRI and its application to fetal intervention
Placental MRI and its application to fetal intervention
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DOI：
10.1002/pd.5526
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发表时间：
2019-07-28
影响因子：
3
通讯作者：
Melbourne, Andrew
中科院分区：
文献类型：
--
作者：
Aughwane, Rosalind;Ingram, Emma;Melbourne, Andrew
目的胎盘侵犯的磁共振成像（MRI）已成为临床实践的一部分多年。使用MRI能够更好地评估胎盘血管化和功能的可能性具有多种潜在应用。本文综述了最新的研究胎盘功能使用不同的MRI模式。方法：我们讨论了如何组合这些MRI技术有很大的贡献，胎儿条件适合治疗，如单胎高风险胎儿生长受限（FGR）和单绒毛膜双胎妊娠计划手术和咨询选择性生长受限和输血条件。结果MRI能清晰显示胎盘的全貌，与羊水分界清楚，胎盘-子宫分界不清。诸如扩散加权成像、弛豫测量、血氧水平依赖性MRI和通过动态对比增强MRI、动脉自旋标记或光谱技术进行的流量和代谢物测量等对比有助于我们更广泛地了解胎盘功能。结论胎盘MRI的未来是令人兴奋的，随着多种对比剂和新模型的日益可用，这将提高MRI测量血氧饱和度和胎盘交换的能力，使复杂妊娠中胎盘功能的检查成为可能。
Objective Magnetic resonance imaging (MRI) of placental invasion has been part of clinical practice for many years. The possibility of being better able to assess placental vascularization and function using MRI has multiple potential applications. This review summarises up-to-date research on placental function using different MRI modalities. Method We discuss how combinations of these MRI techniques have much to contribute to fetal conditions amenable for therapy such as singletons at high risk for fetal growth restriction (FGR) and monochorionic twin pregnancies for planning surgery and counselling for selective growth restriction and transfusion conditions. Results The whole placenta can easily be visualized on MRI, with a clear boundary against the amniotic fluid, and a less clear placental-uterine boundary. Contrasts such as diffusion weighted imaging, relaxometry, blood oxygenation level dependent MRI and flow and metabolite measurement by dynamic contrast enhanced MRI, arterial spin labeling, or spectroscopic techniques are contributing to our wider understanding of placental function. Conclusion The future of placental MRI is exciting, with the increasing availability of multiple contrasts and new models that will boost the capability of MRI to measure oxygen saturation and placental exchange, enabling examination of placental function in complicated pregnancies.