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Placental magnetic resonance imaging in chronic hypertension: A case-control study

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Alison Ho, Jana Hutter, Paddy Slator, Laurence Jackson, Paul T Seed, Laura Mccabe, Mudher Al-Adnani, Andreas Marnerides, Simi George, Lisa Story, Joseph V Hajnal, Mary Rutherford, Lucy C Chappell

Original languageEnglish
Pages (from-to)138-145
Number of pages8
JournalPlacenta
Volume104
Early online date13 Dec 2020
DOIs
E-pub ahead of print13 Dec 2020
Published15 Jan 2021

Bibliographical note

Funding Information: This work is funded by the NIH Human Placenta Project grant 1U01HD087202-01 , the National Institute for Health Research (NIHR) Research Professorship (Chappell; RP-2014-05-019 ), Tommy's (Registered charity no. 1060508 ) and Holbeck Charitable Trust with support from the Wellcome EPSRC Centre for Medical Engineering at Kings College London ( WT 203148/Z/16/Z ) and by the National Institute for Health Research Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. PTS is partly funded by King's Health Partners Institute of Women and Children's Health , Tommy's (Registered charity no. 1060508 ) and by ARC South London (NIHR). JH is funded by the Wellcome Trust through a Sir Henry Wellcome Fellowship (201,374). Publisher Copyright: © 2020 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

INTRODUCTION: 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.

METHODS: 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.

RESULTS: 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.

DISCUSSION: 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.

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