Two-Compartment Perfusion MR IVIM Model to Investigate Normal and Pathological Placental Tissue.
J Magn Reson Imaging
; 59(3): 879-891, 2024 Mar.
Article
em En
| MEDLINE
| ID: mdl-37329218
ABSTRACT
BACKGROUND:
Perfusion and diffusion coexist in the placenta and can be altered by pathologies. The two-perfusion model, where f1 and, f2 are the perfusion-fraction of the fastest and slowest perfusion compartment, respectively, and D is the diffusion coefficient, may help differentiate between normal and impaired placentas.PURPOSE:
Investigate the potential of the two-perfusion IVIM model in differentiating between normal and abnormal placentas. STUDY-TYPE Retrospective, case-control. POPULATION 43 normal pregnancy, 9 fetal-growth-restriction (FGR), 6 small-for-gestational-age (SGA), 4 accreta, 1 increta and 2 percreta placentas. FIELD STRENGTH/SEQUENCE Diffusion-weighted-echo planar imaging sequence at 1.5 T. ASSESSMENT Voxel-wise signal-correction and fitting-controls were used to avoid overfitting obtaining that two-perfusion model fitted the observed data better than the IVIM model (Akaike weight 0.94). The two-perfusion parametric-maps were quantified from ROIs in the fetal and maternal placenta and in the accretion zone of accreta placentas. The diffusion coefficient D was evaluated using a b ≥ 200 sec/mm2 -mono-exponential decay fit. IVIM metrics were quantified to fix f1 + f2 = fIVIM . STATISTICAL-TESTS ANOVA with Dunn-Sidák's post-hoc correction and Cohen's d test were used to compare parameters between groups. Spearman's coefficient was evaluated to study the correlation between variables. A P-value<0.05 indicated a statistically significant difference.RESULTS:
There was a significant difference in f1 between FGR and SGA, and significant differences in f2 and fIVIM between normal and FGR. The percreta + increta group showed the highest f1 values (Cohen's d = -2.66). The f2 between normal and percreta + increta groups showed Cohen's d = 1.12. Conversely, fIVIM had a small effective size (Cohen's d = 0.32). In the accretion zone, a significant correlation was found between f2 and GA (ρ = 0.90) whereas a significant negative correlation was found between fIVIM and D (ρ = -0.37 in fetal and ρ = -0.56 in maternal side) and f2 and D (ρ = -0.38 in fetal and ρ = -0.51 in maternal side) in normal placentas.CONCLUSION:
The two-perfusion model provides complementary information to IVIM parameters that may be useful in identifying placenta impairment. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE 1.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Placenta
/
Placenta Acreta
Tipo de estudo:
Prognostic_studies
Limite:
Female
/
Humans
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Pregnancy
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article