Ling Jiang^1,2, Taotao Sun^1,2, Yuhao Liao³, Yi Sun⁴, Yi Zhang³, Zhaoxia Qian^1,2, and Dan Wu^3
1Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China, ²Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China, ³Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China, ⁴MR Collaboration, Siemens Healthcare Ltd., Shanghai, China

Intravoxel incoherent motion (IVIM) imaging is frequently used to evaluate microcirculatory flow. With the conventional diffusion MRI, IVIM effects include both pseudo-diffusive microcirculatory flow and bulk (or ballistic) blood flow. We propose a joint use of flow-compensated (FC) and non-FC diffusion gradient waveforms to specifically probe the fraction and velocity of ballistic flow in the placenta. The measured ballistic flow velocity showed a high correlation with umbilical flow based on Doppler ultrasound and a negative correlation with gestational age. These results demonstrated the potential of using FC/NC dMRI to noninvasively measure flow velocity inside the placenta.

Quyen N. Do¹, Christina Herrera², Matthew A. Lewis¹, Yin Xi^1,3, Catherine Y. Spong², Diane M. Twickler^1,2, and Ananth J. Madhuranthakam^1,4
1Radiology, UT Southwestern Medical Center, Dallas, TX, United States, ²Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, United States, ³Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, United States, ⁴Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, United States

Quantitative measurement of placental perfusion is important for the assessment of placental function. We have developed and optimized a non-contrast perfusion MR imaging technique utilizing pseudo-continuous arterial spin labeling (pCASL) to quantitatively measure human placental perfusion at 3T. Placental perfusion was also assessed using flow-sensitive alternating inversion recovery (FAIR). The average placental blood flow (108±47 mL/100g/min) was comparable to published literature values.

Jana Hutter¹, Kathleen Colford¹, Anthony Price¹, Johannes Steinweg¹, Lisa Story¹, Kuberan Pushparajah¹, Laura McCabe¹, Alison Ho², Adam J Lewandowski³, Joseph Hajnal¹, Lucy Chappell², Pablo Lamata¹, and Mary Rutherford^1
1Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ²Academic Women's Health, King's College London, London, United Kingdom, ³Division of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom

Pre-eclampsia (PE)  is one of the most common, yet serious, complications of pregnancy. Its manifestations during pregnancy -high blood pressure, proteinuria and placental lesions- are associated with both maternal and fetal morbidity and mortality. Maternal symptoms resolve after delivery but a lifelong elevated risk for cardiovascular disease (CVD) remains. The CARP study combines functional placental and fetal MRI with (maternal) cardiovascular MR during pregnancy at the time of maximal stress to the maternal heart, in an attempt to disentangle the complex cardiac and placental interactions in disease etiology and to predict maternal cardiovascular risk in later life.

Fan Huang¹, Shi-Ming Wang², Guohui Yan³, Zhihao Wen⁴, Yuhao Liao¹, Yi Zhang¹, Yu Zou³, and Dan Wu^1
1Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China, ²Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan, ³Department of Radiology,Women's Hospital,School of Medicine, Zhejiang University, Hangzhou, China, ⁴Purple-river software corporation, Shenzhen, China

Q-space learning has shown its potential in accelerating Q-space sampling in diffusion MRI. This study proposed a new deep learning framework to accelerate intravoxel incoherent motion (IVIM) imaging and to estimate IVIM parameters from a small number of b values in the human placenta. The results demonstrated the feasibility of a reduced IVIM protocol using the proposed framework, which may help to accelerate the acquisition and reduce motion for placental IVIM.

Jeffrey N Stout¹, Shahin Rouhani^1,2, Congyu Liao³, Esra Abaci Turk¹, Christopher G Ha¹, Karen Rich⁴, Lawrence L. Wald³, William H. Barth, Jr⁵, Drucilla J. Roberts², Elfar Adalsteinsson⁶, and P. Ellen Grant^1
1Fetal-Neonatal Neuroimaging & Developmental Sciences Center, Boston Children's Hospital, Boston, MA, United States, ²Department of Pathology, Massachusetts General Hospital, Boston, MA, United States, ³A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States, ⁴Department of Radiology, Massachusetts General Hospital, Boston, MA, United States, ⁵Maternal-Fetal Medicine, Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, United States, ⁶Institute for Medical Engineering and Science; Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, United States

The placenta is a challenging MRI target. Acquisition schemes developed for other organs, with implicit assumptions about motion, tissue composition and perfusion, should be vetted for applicability to the placenta. We have developed an ex vivo placental perfusion chamber with integrated MRI receive coil for high SNR and imaging acceleration to validate in vivo acquisitions in a controlled environment. Here we examine the effect of flowing spins on MRF relaxometry. We offer evidence that T1 is sensitive to overall fluid volume, while T2 is additionally sensitive spin inflow. Our placental perfusion system appears promising for validating in vivo quantitative MRI.

Esra Abaci Turk¹, Jeffrey N. Stout¹, Borjan Gagoski¹, Mary Katherine Manhard², Elfar Adalsteinsson^3,4,5, Kawin Setsompop², Polina Golland^3,6, Drucilla J. Roberts⁷, William H. Barth Jr⁸, and P. Ellen Grant^1
1Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, United States, ²Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States, ³Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, United States, ⁴Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, United States, ⁵Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States, ⁶Computer Science and Artificial Intelligence Laboratory (CSAIL), Massachusetts Institute of Technology, Cambridge, MA, United States, ⁷Pathology, Massachusetts General Hospital, Boston, MA, United States, ⁸Maternal-Fetal Medicine, Massachusetts General Hospital, Boston, MA, United States

T₂^* relaxometry has been proposed as a semi-quantitative measure for placental oxygen transport. However, to use T₂^* as a diagnostic tool, it is necessary to define the normal range of results and factors that influence those results. In this study we investigated the effect of maternal position, breath-holds and oxygen state on placental T₂^*. We observed lower T₂^* with breath-hold protocol compared to no breath-hold protocol in left lateral position. Additionally, lower T₂^* was measured in supine position during normoxic episode compared to left lateral position with no breath-hold protocol. Further studies are needed to understand these factors better.

Cong Sun¹, Xin Chen¹, Jinxia Zhu², Robert Grimm³, and Guangbin Wang^1
1Shandong Medical Imaging Research Institute, Shandong University, Jinan, China, ²MR Collaboration, Healthcare Siemens Ltd., Beijing, China, Beijing, China, ³Healthcare GmbH, Erlangen, Germany, Erlangen, Germany

To determine whether placental perfusion alterations are evident in utero in fetuses with congenital heart disease (CHD), we quantitatively investigated perfusion in 28 fetuses with CHD and 39 healthy gestational age–matched controls using intravoxel incoherent motion imaging (IVIM). We found that the f values were significantly higher in the CHD group compared with the normal pregnancy group (37.8% vs. 30.2%, p＜0.0001), and there was no significant difference in the D value and D* value between the two groups. The increased placental perfusion in fetuses with CHD might represent an attempt to compensate for a perfusion deficit in fetal circulation.

Nada Mufti^1,2, Patrick O'Brien³, George Attilakos³, Magdalena Sokolska⁴, Priya Narayanan³, Rosalind Aughwane¹, Neil Sebire⁵, Imen Ben-Salha³, Nafisa Wilkinson³, Giles Kendall^1,3, Jan Deprest^1,3,6, David Atkinson⁷, Tom Vercauteren^2,6, Sebastien Ourselin², Anna L David^1,3,6, and Andrew Melbourne^2,8
1Institute for Women's Health, University College London (UCL), London, United Kingdom, ²School of Biomedical Engineering and Imaging Sciences (BMEIS), Kings College London, London, United Kingdom, ³University College London Hospital, London, United Kingdom, ⁴Department of Medical Physics and Biomedical Engineering, University College London Hospital (UCLH), London, United Kingdom, ⁵Great Ormond Street Hospital for Children, London, United Kingdom, ⁶University Hospitals, KU Leuven, Leuven, Belgium, ⁷Centre for Medical Imaging (CMI), University College London (UCL), London, United Kingdom, ⁸Department of Medical Physics and Biomedical Engineering, University College London (UCL), London, United Kingdom

Uterine scarring from caesarean section (CS) can lead to subsequent abnormally adherent or invasive placenta. Failure to recognise Placenta Accreta Spectrum disorders prior to delivery can potentially cause catastrophic bleeding and death. Complex surgical interventions may be required to remove placental invasion of the uterine myometrium and nearby organs. Antenatal detection and correct PAS grading are important to plan delivery. Current ultrasound and MRI imaging are limited to subjective assessment of vascular invasion. We propose a multi-compartment model1 that can quantify vascularity and proportion of abnormal placentation across the previous CS scar for objective diagnosis and to assist surgical planning.

Daniel Seiter¹, Kai D. Ludwig¹, Sydney Nguyen^2,3,4, Megan E Murphy^2,3,4, Kathleen M Antony^2,3,4, Ruiming Chen¹, Terry K Morgan⁵, Ante Zhu^6,7, Archana Dhyani⁸, Sean B Fain^1,6,7, Kevin M Johnson^1,7, Thaddeus G. Golos^2,3,4, and Oliver Wieben^1,7
1Medical Physics, University of Wisconsin-Madison, Madison, WI, United States, ²Comparative Biosciences, University of Wisconsin-Madison, Madison, WI, United States, ³Wisconsin National Primate Research Center, University of Wisconsin-Madison, Madison, WI, United States, ⁴Obstetrics & Gynecology, University of Wisconsin-Madison, Madison, WI, United States, ⁵Pathology, Oregon Health & Science University, Portland, OR, United States, ⁶Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States, ⁷Radiology, University of Wisconsin-Madison, Madison, WI, United States, ⁸Computer Science, University of Wisconsin-Madison, Madison, WI, United States

Proper placental development is crucial to fetal health. Here we report preliminary results characterizing the effects of Zika virus on the placenta of the rhesus macaque using dynamic contrast enhanced (DCE) MRI scans. DCE data were processed to identify individual cotyledons, their volume, and blood flow at three time points during gestation and were compared with pathological findings from term placenta dissection. Analysis shows a statistically significant decrease in cotyledon volume with pathology, measurable as early as 64 days gestation.

Qingjia Bao¹, Eddy Solomon¹, Ron Hadas¹, Stefan Markovic¹, Odelia Chitrit¹, Maxime Yon¹, Michal Neeman¹, and Lucio Frydman^1
1Weizmann Institute of Science, Rehovot, Israel

  DWI can evaluate pregnancy-related dysfunctions, yet EPI’s sensitivity to motions and air/water/fat heterogeneities complicate these studies in preclinical settings. We have developed DWI methodologies based on SPatiotemporal ENcoding (SPEN) for overcoming these obstacles, delivering single-shot images at ≈100µm in-plane resolutions. These methods were used to monitor fetoplacental differences between naïve and knockout mice strains mimicking preeclampsia and IUGR. High definition ADC/DTI maps could resolve the placental layers (maternal, fetal, trophoblastic), umbilical cords, and various brain compartments in the developing fetuses. Daily monitoring also showed differences in the development of placental and fetal (e.g. brain) structures among normal and disease models.