Placental pathologies in fetal MRI with pathohistological correlation.

Abstract:

INTRODUCTION: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. PATIENTS AND 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. RESULTS AND DISCUSSION: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.

journal_name

Placenta

journal_title

Placenta

authors

Linduska N,Dekan S,Messerschmidt A,Kasprian G,Brugger PC,Chalubinski K,Weber M,Prayer D

doi

10.1016/j.placenta.2009.03.010

subject

Has Abstract

pub_date

2009-06-01 00:00:00

pages

555-9

issue

6

eissn

0143-4004

issn

1532-3102

pii

S0143-4004(09)00095-2

journal_volume

30

pub_type

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