1. MR Imaging of Fetuses to Evaluate Placental Insufficiency
- Author
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Nobuyuki Takeyama, Naomi Yagi, Nobuyuki Ohike, Hiroshi Nobusawa, Jiro Munechika, Masanori Hirose, Takehiko Gokan, Osamu Miyagami, Yoshimitsu Ohgiya, Sasamori Hiroto, Ryu Matsuoka, Noritaka Seino, and Akihiko Sekizawa
- Subjects
medicine.medical_specialty ,Amniotic fluid ,Uterus ,flow void ,Placental insufficiency ,030218 nuclear medicine & medical imaging ,fetal growth restriction ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Placenta ,medicine ,magnetic resonance imaging ,placental insufficiency ,Humans ,Radiology, Nuclear Medicine and imaging ,Fetus ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Magnetic resonance imaging ,medicine.disease ,Mr imaging ,fetus ,medicine.anatomical_structure ,Female ,Radiology ,business ,Nuclear medicine ,Major Paper - Abstract
PURPOSE To evaluate morphological and signal intensity (SI) changes of placental insufficiency on magnetic resonance imaging (MRI) and to assess morphological changes and decreased flow voids (FVs) on T2-weighted rapid acquisition with relaxation enhancement (RARE) images for diagnosing placental insufficiency. METHODS Fifty singleton fetuses underwent MRI using a 1.5-T MR scanner. Placental thickness, area, volume, SI, amniotic fluid SI, and size of FVs between the uterus and the placenta were measured on MR images. Two radiologists reviewed T2-weighted RARE images for globular appearance of the placenta and FVs between the uterus and the placenta. Data were analyzed using t-tests, McNemar's tests, and areas under the receiver operating characteristic curve (AUCs) at 5% level of significance. RESULTS Twenty-five of the 50 pregnancies were categorized as having an insufficient placenta. Significant differences were observed between insufficient and normal placentas in mean placental thickness, area, volume, placenta to amniotic fluid SI ratio, and size of FVs (49.0 mm vs. 36.9 mm, 1.62 × 10(4) mm(2) vs. 2.67 × 10(4) mm(2), 5.13 × 10(5) mm(3) vs. 6.56 × 10(5) mm(3), 0.549 vs. 0.685, and 3.4 mm vs. 4.3 mm, respectively). The sensitivity and accuracy using globular appearance plus decreased FVs were greater than those using decreased FVs (P < 0.01). There was no significant difference among AUCs using globular appearance and decreased FVs, and globular appearance plus decreased FVs. CONCLUSIONS Placental insufficiency was associated with placental thickness, area, volume, placenta to amniotic fluid SI ratio, and size of FVs. Evaluating FVs on T2-weighted RARE images can be useful for detecting placental insufficiency, particularly in placentas without globular appearance on MR images.
- Published
- 2015