Perfusion and apparent oxygenation in the human placenta (PERFOX)

• Published in: Magnetic resonance in medicine Vol. 83; no. 2; pp. 549 - 560
• Main Authors: Hutter, Jana, Harteveld, Anita A., Jackson, Laurence H., Franklin, Suzanne, Bos, Clemens, Osch, Matthias J. P., O'Muircheartaigh, Jonathan, Ho, Alison, Chappell, Lucy, Hajnal, Joseph V., Rutherford, Mary, De Vita, Enrico
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.02.2020; John Wiley and Sons Inc
• Subjects: Algorithms; Arterial Spin Labeling (ASL); Blood Circulation; Contrast Media; Echo-Planar Imaging; Female; Fetuses; Fourier Analysis; Full Papers—Imaging Methodology; Gestational Age; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Image Processing, Computer-Assisted; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Motion; Oxygen - metabolism; Oxygenation; Perfusion; Physiological effects; Placenta; Placenta - physiology; Preeclampsia; Pregnancy; Prenatal development; pre‐eclampsia; relaxometry; Spin labeling; Spin Labels; Uterus; velocity‐selective ASL; placenta; pre-eclampsia; perfusion; relaxometry; velocity-selective ASL; Arterial Spin Labeling (ASL)
• ISSN: 0740-3194; 1522-2594; 1522-2594
• DOI: 10.1002/mrm.27950

Purpose To study placental function—both perfusion and an oxygenation surrogate (T2*)—simultaneously and quantitatively in‐vivo. Methods Fifteen pregnant women were scanned on a 3T MR scanner. For perfusion measurements, a velocity selective arterial spin labeling preparation module was placed before a multi‐echo gradient echo EPI readout to integrate T2* and perfusion measurements in 1 joint perfusion‐oxygenation (PERFOX) acquisition. Joint motion correction and quantification were performed to evaluate changes in T2* and perfusion over GA. Results The optimized integrated PERFOX protocol and post‐processing allowed successful visualization and quantification of perfusion and T2* in all subjects. Areas of high T2* and high perfusion appear to correspond to placental sub‐units and show a systematic offset in location along the maternal‐fetal axis. The areas of highest perfusion are consistently closer to the maternal basal plate and the areas of highest T2* closer to the fetal chorionic plate. Quantitative results show a strong negative correlation of gestational age with T2* and weak negative correlation with perfusion. Conclusions A strength of the joint sequence is that it provides truly simultaneous and co‐registered estimates of local T2* and perfusion, however, to achieve this, the time per slice is prolonged compared to a perfusion only scan which can potentially limit coverage. The achieved interlocking can be particularly useful when quantifying transient physiological effects such as uterine contractions. PERFOX opens a new avenue to elucidate the relationship between maternal supply and oxygen uptake, both of which are central to placental function and dysfunction.