Placental MRI and its application to fetal intervention |
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| Authors: | Rosalind Aughwane Emma Ingram Edward D Johnstone Laurent J Salomon Anna L David Andrew Melbourne |
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| Institution: | 1. Institute for Women's Health, University College London, London, UK;2. Division of Developmental Biology & Medicine, University of Manchester, Manchester, UK;3. Hôpital Necker-Enfants Malades, AP-HP, EHU PACT and LUMIERE Platform, Université Paris Descartes, Paris, France;4. Institute for Women's Health, University College London, London, UK
National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London, UK;5. School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK |
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| Abstract: | 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. |
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