Placental magnetic resonance imaging in chronic hypertension: A case-control study.
Placental magnetic resonance imaging in chronic hypertension: A case-control study.
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DOI：
10.1016/j.placenta.2020.12.006
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发表时间：
2021-01-15
期刊：
影响因子：
3.8
通讯作者：
Chappell LC
中科院分区：
文献类型：
--
作者：
Ho A;Hutter J;Slator P;Jackson L;Seed PT;Mccabe L;Al-Adnani M;Marnerides A;George S;Story L;Hajnal JV;Rutherford M;Chappell LC
我们的目的是探索在体内使用磁共振成像（MRI）作为一种工具来阐明慢性高血压妇女的胎盘表型。在病例对照研究中，慢性高血压妇女和无并发症妊娠妇女使用3T Achieva或1.5T Ingenia扫描仪进行成像。获取T2加权图像、扩散加权图像和T1/T2*弛豫测量数据。计算胎盘T2*、T1和表观扩散系数（ADC）图。129名妇女（43名患有慢性高血压，86名无并发症妊娠）在中位妊娠27.7周（四分位间距（IQR） 23.9-32.1）和28.9 （IQR 26.1-32.9）时分别进行了影像学检查。T2加权成像的视觉分析显示，慢性高血压妇女的胎盘适合妊娠或有晚期分叶化，与妊娠匹配的对照组相比，在给定妊娠期，胎盘平均T2*值的范围更大。在健康孕妇中，斜度和峰度（来自整个胎盘T2*值的直方图）随着孕龄的增加而增加；患有慢性高血压的妇女的数值与对照组的范围重叠。目测显示，平均ADC在妊娠晚期下降，胎盘平均T2*值也相应下降，慢性高血压妇女与对照组的数值有重叠。联合胎盘MR检查包括T2加权成像、T2*、T1定位和扩散成像，显示慢性高血压女性队列中胎盘表型不同，与对照组重叠。MRI可以评估胎盘对不良妊娠结局的影响。对慢性高血压妇女进行胎盘MRI检查。与对照组相比，t2加权成像显示胎盘视觉外观不同。注意到平均T2*、T1、ADC和T2*直方图衍生测量值的重叠。MRI可以阐明胎盘功能障碍和不良后果的发展。
We aimed to explore the use of magnetic resonance imaging (MRI) in vivo as a tool to elucidate the placental phenotype in women with chronic hypertension. In case-control study, women with chronic hypertension and those with uncomplicated pregnancies were imaged using either a 3T Achieva or 1.5T Ingenia scanner. T2-weighted images, diffusion weighted and T1/T2* relaxometry data was acquired. Placental T2*, T1 and apparent diffusion coefficient (ADC) maps were calculated. 129 women (43 with chronic hypertension and 86 uncomplicated pregnancies) were imaged at a median of 27.7 weeks’ gestation (interquartile range (IQR) 23.9–32.1) and 28.9 (IQR 26.1–32.9) respectively. Visual analysis of T2-weighted imaging demonstrated placentae to be either appropriate for gestation or to have advanced lobulation in women with chronic hypertension, resulting in a greater range of placental mean T2* values for a given gestation, compared to gestation-matched controls. Both skew and kurtosis (derived from histograms of T2* values across the whole placenta) increased with advancing gestational age at imaging in healthy pregnancies; women with chronic hypertension had values overlapping those in the control group range. Upon visual assessment, the mean ADC declined in the third trimester, with a corresponding decline in placental mean T2* values and showed an overlap of values between women with chronic hypertension and the control group. A combined placental MR examination including T2 weighted imaging, T2*, T1 mapping and diffusion imaging demonstrates varying placental phenotypes in a cohort of women with chronic hypertension, showing overlap with the control group. MRI enables evaluation of the placental contribution of adverse pregnancy outcomes. Placental MRI examination was undertaken in women with chronic hypertension. T2-weighted imaging showed varied placental visual appearance compared to controls. Overlap in mean T2*, T1, ADC and T2* histogram derived measures was noted. MRI may elucidate placental dysfunction and development of adverse outcomes.
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作者：
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通讯作者：
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