Novel Detection of Placental Insufficiency by Magnetic Resonance Imaging in the Nonhuman Primate.
The placenta is a vital organ necessary for healthy fetal development. Placental insufficiency creates an in utero environment where the fetus is at risk of insufficient oxygen or nutrient exchange. This is primarily caused by impairment of either maternal or fetal circulation or vascular thrombosis such as placental infarction. As a result of placental dysfunction, affected fetuses may be growth restricted, neurologically impaired, and at risk of increased morbidity and mortality. In a cohort of 4 pregnant Rhesus macaques, we describe antenatal detection of naturally occurring intrauterine growth restriction (IUGR) and aberrant fetal neurodevelopment in 1 animal. Abnormal growth parameters were detected by Doppler ultrasound, and vascular insufficiency in the intervillous space was characterized by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Furthermore, placental oxygen reserve was shown to be reduced compared to control animals by measurements of placental water T2*. To characterize the effects of IUGR on fetal brain development, T2and diffusion anisotropy images of the fetal brain were acquired in utero. Reduced brain volume and cerebral cortical surface area were apparent macroscopically. Microstructural abnormalities within the developing white matter and cerebral cortex were also observed through analysis of water diffusion anisotropy. After delivery by cesarean section, pathological examination confirmed placental insufficiency with hypoxia. These findings exemplify how DCE-MRI and T2*-based measurements of blood oxygenation within the placenta can provide noninvasive imaging methods for assessing in vivo placental health to potentially identify pregnancies affected by placental insufficiency and abnormal fetal neurodevelopment prior to the onset of fetal and neonatal distress.
1 Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA.
Jamie O
JO
Lo
2 Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA.
Victoria H J
VHJ
Roberts
3 Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA.
Matthias C
MC
Schabel
4 Division of Neuroscience, Oregon National Primate Research Center, Portland, OR, USA.
Xiaojie
X
Wang
5 Department of Pathology, Oregon Health & Science University, Portland, OR, USA.
Terry K
TK
Morgan
4 Division of Neuroscience, Oregon National Primate Research Center, Portland, OR, USA.
Zheng
Z
Liu
6 Division of Neonatology, University of Washington, Seattle, WA, USA.
Colin
C
Studholme
3 Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA.|7 Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA.
Christopher D
CD
Kroenke
1 Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA.|2 Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA.
Antonio E
AE
Frias
D000818:Animals; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D008253:Macaca mulatta; D008279:Magnetic Resonance Imaging; D010920:Placenta / Q000000981:diagnostic imaging*; D021041:Placental Circulation / Q000502:physiology; D010927:Placental Insufficiency / Q000000981:diagnostic imaging*; D011247:Pregnancy
MRI; fetal brain development; intrauterine growth restriction; nonhuman primate; noninvasive imaging; placental insufficiency