Placental perfusion imaging on 3Tesla magnetic resonance imaging using pseudo-continuous arterial spin labelling: an initial experience

Abstract

Abstract Background During pregnancy, the placenta plays an important role in the development of the fetus by supplying it with oxygen and nutrition, eliminating waste, and acting as an immunological barrier. Pseudo-continuous arterial spin labelling (pCASL) MRI was recently shown to be a promising sequence for measuring perfusion in the placenta. The aim was to obtain the perfusion measurements of the placenta in normal pregnancies using 3 Tesla MRI from 19 to 38 weeks of gestational age. Results This was a cohort observational study. One hundred and sixty (160) singleton pregnancies from 19 to 38 weeks of gestational age were included. A 3D pCASL sequence was performed in the axial plane for placental blood flow (PBF). Data post-processing was performed on a workstation using Ready View software for 3D ASL with automated generation of quantitative placental pattern-based morphometry (PBM). The mean values of placental perfusion were extracted by averaging the data obtained. A significant positive correlation was observed between the PBF and increasing GA using Karl Pearson’s coefficient of correlation values (r-value 0.77, p-value < 0.001), respectively. Average PBF values from 19 to 38 weeks were (89.4 ± 13.5 to 155.3 ± 2.8 ml/100 g/min). According to our intra-class correlation coefficient (ICC), inter-observer reproducibility of placental blood flow shows good agreement between observers (0.98). Conclusions Normal PBF values using ASL in 3 T MRI from 19 to 38 weeks of gestational age were provided. Statistical analysis revealed a significant positive correlation between gestational age and placental blood flow. In the future, it may help to identify placental perfusion abnormalities like placental insufficiency, preeclampsia, and fetal growth restriction (FGR).

Keywords

• Arterial spin labelling
• ASL
• Placenta
• Placental blood flow
• PBF
• Placental MRI