T$_2$* and Susceptibility Mapping as Indicators of Placental Health

TL;DR

This study demonstrates that simultaneous T2* and susceptibility MRI mapping can assess placental oxygenation and health, revealing regional variations and differences between healthy and compromised pregnancies.

Contribution

It introduces a method to acquire T2* and susceptibility maps simultaneously, providing new insights into placental function and pathology during pregnancy.

Findings

T2* correlates with local inhomogeneities rather than bulk oxygenation.

Compromised placentas show lower T2* and higher susceptibility variability.

Regional differences indicate better blood mixing centrally and less perfusion at the fetal side.

Abstract

Objective(s): T$_2$* and susceptibility ($\chi$) MRI mapping provide complimentary measures of the haemodynamic environment in the placenta. The aims of this work were to use these simultaneously obtained measures to investigate the role of oxygen distribution on the well-established reduction of T$_2$* with gestational age found in healthy pregnancies and explore differences in both measures in compromised placentas. Methods: T$_2$* and $\chi$ were measured simultaneously from a double echo, echo planar scan of the whole placenta, across a range of gestational ages and pregnancy complications. Regional variations across the placenta were investigated. Results: Whole placental mean T$_2$* was more correlated with standard deviation of $\chi$ than mean $\chi$ indicating it is more driven by increasing local inhomogeneities rather than bulk deoxygenation with healthy gestation. Compromised placentas also showed increased standard deviation of $\chi$ as well as lower mean T$_2$* suggesting flow/uptake mismatch and reduced oxygenation. Regionally, the susceptibility was lowest (most oxygenated) and least variable in the central region of the placenta indicating good mixing and refreshment of blood in this area. The susceptibility was highest (most deoxygenated) and most variable at the fetal side, suggesting less effective perfusion in this region. Compromised cases showed the greatest difference on the fetal side for both mean and standard deviation of $\chi$. T$_2$* was lowest at the fetal side for healthy and compromised cases but the maternal and central regions better distinguished between the two groups. Conclusion(s): T$_2$* and susceptibility can be mapped simultaneously from a single MRI scan and provide complimentary information about the function of the placenta across healthy gestational development, and as a potential indicator of placental compromise.