title: Magnetic resonance imaging-estimated placental perfusion in fetal growth assessment.
abstract: OBJECTIVE
  To evaluate in-vivo placental perfusion fraction, estimated by magnetic resonance imaging (MRI), as a marker of placental function.
  
  
  METHODS
  A study population of 35 pregnant women, of whom 13 had pre-eclampsia (PE), were examined at 22-40 weeks' gestation. Within a 24-h period, each woman underwent an MRI diffusion-weighted sequence (from which we calculated the placental perfusion fraction), venous blood sampling and an ultrasound examination including estimation of fetal weight, amniotic fluid index and Doppler velocity measurements. The perfusion fractions in pregnancies with and without fetal growth restriction were compared and correlations between the perfusion fraction and ultrasound estimates and plasma markers were estimated using linear regression. The associations between the placental perfusion fraction and ultrasound estimates were modified by the presence of PE (P  <  0.05) and therefore we included an interaction term between PE and covariates in the models.
  
  
  RESULTS
  The median placental perfusion fractions in pregnancies with and without fetal growth restriction were 21% and 32%, respectively (P = 0.005). The correlations between placental perfusion fraction and ultrasound estimates and plasma markers were highly significant (P = 0.002 and P = 0.0001, respectively). The highest coefficient of determination (R(2)  = 0.56) for placental perfusion fraction was found for a model that included pulsatility index in the ductus venosus, plasma level of soluble fms-like tyrosine kinase-1, estimated fetal weight and presence of PE.
  
  
  CONCLUSIONS
  The placental perfusion fraction has the potential to contribute to the clinical assessment of cases with placental insufficiency.
authors: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors: S
authors: S
authors: Sohlberg
authors: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors: A
authors: A
authors: Mulic-Lutvica
authors: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors: M
authors: M
authors: Olovsson
authors: Department of Surgical Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden.
authors: J
authors: J
authors: Weis
authors: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.|Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
authors: O
authors: O
authors: Axelsson
authors: Department of Surgical Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden.
authors: J
authors: J
authors: Wikström
authors: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors: A-K
authors: AK
authors: Wikström
mesh_terms: D000328:Adult; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D020567:Fetal Weight; D005865:Gestational Age; D006801:Humans; D010920:Placenta / Q000098:blood supply* / Q000000981:diagnostic imaging; D010927:Placental Insufficiency / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011225:Pre-Eclampsia / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood
chemical_list: D040281:Vascular Endothelial Growth Factor Receptor-1
keywords: intrauterine growth restriction; magnetic resonance imaging; perfusion; perfusion fraction; placenta; small-for-gestational age
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