Perfusion and apparent oxygenation in the human placenta (PERFOX)

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To study placental function—both perfusion and an oxygenation surrogate (T*2)—simultaneously and quantitatively in‐vivo.

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 T*2 and perfusion measurements in 1 joint perfusion‐oxygenation (PERFOX) acquisition. Joint motion correction and quantification were performed to evaluate changes in T*2 and perfusion over GA.

The optimized integrated PERFOX protocol and post‐processing allowed successful visualization and quantification of perfusion and T*2 in all subjects. Areas of high T*2 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 T*2 closer to the fetal chorionic plate. Quantitative results show a strong negative correlation of gestational age with T*2 and weak negative correlation with perfusion.

A strength of the joint sequence is that it provides truly simultaneous and co‐registered estimates of local T*2 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.
Original languageEnglish
Pages (from-to)549-560
Number of pages12
JournalMagnetic resonance in medicine
Issue number2
Early online date21 Aug 2019
Publication statusPublished - Feb 2020


  • Arterial Spin Labeling (ASL)
  • perfusion
  • placenta
  • pre-eclampsia
  • relaxometry
  • velocity-selective ASL


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