Placental pathologies in fetal MRI with pathohistological correlation.
BACKGROUND
The purpose of this study was to evaluate whether currently available fetal Magnetic Resonance Imaging (MRI/MR) techniques are sufficient for the assessment of placental pathologies. We hypothesized that placental pathologies as detected and evaluated by MRI, would correlate with histological findings.


METHODS
In a retrospective study, 45 singleton pregnancies from 19 to 35 gestational weeks, with placental pathologies on MR scans, were included. MRI was performed on a 1.5T unit using T2-, T1-, and diffusion-weighted and echo-planar sequences. Pathologies were categorized into infarction with/without hemorrhagic components, subchorionic/intervillous thrombi/hemorrhages, retroplacental hematoma, massive perivillous fibrin deposition, and chorioamnionitis. Pathohistological examination was performed postnatally within a median of seven days between MR examination and delivery.


CONCLUSIONS
Pathologically, 26 placentas showed infarctions (96.2% on MR scans), two retroplacental hematomas were detected by MRI and confirmed by pathology, and 9 of 14 subchorionic hematomas were confirmed. Six of eight intervillous hemorrhages were seen on MRI, and three of six cases of severe chorioamnionitis were diagnosed prenatally. Placental hemorrhages (retroplacental hematoma, intervillous thrombi, subchorionic hematoma), and ischemic lesions could be detected with fetal MRI, while chorioamnionitis and even massive perivillous fibrin deposition showed few signal changes, probably reflecting small macroscopic changes in the placenta. Fetal MRI, therefore, seems to be a promising tool for the assessment of placental insufficiency.
Linduska
N
N
Division of General Pediatrics and Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria. nina.linduska@meduniwien.ac.at
Dekan
S
S
Messerschmidt
A
A
Kasprian
G
G
Brugger
P C
PC
Chalubinski
K
K
Weber
M
M
Prayer
D
D
D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005333:Fetus / Q000000981:diagnostic imaging*; D006801:Humans; D018810:Magnetic Resonance Angiography; D010922:Placenta Diseases / Q000175:diagnosis* / Q000473:pathology*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity