Detecting abnormal placental microvascular flow in maternal and fetal diseases based on flow-compensated and non-compensated intravoxel incoherent motion imaging

Yuhao Liao; Taotao Sun; Ling Jiang; Zhiyong Zhao; Tingting Liu; Zhaoxia Qian; Yi Sun; Yi Zhang; Dan Wu

doi:10.1016/j.placenta.2022.01.010

Detecting abnormal placental microvascular flow in maternal and fetal diseases based on flow-compensated and non-compensated intravoxel incoherent motion imaging

Placenta. 2022 Mar 4:119:17-23. doi: 10.1016/j.placenta.2022.01.010. Epub 2022 Jan 18.

Authors

Yuhao Liao¹, Taotao Sun², Ling Jiang², Zhiyong Zhao¹, Tingting Liu¹, Zhaoxia Qian², Yi Sun³, Yi Zhang¹, Dan Wu⁴

Affiliations

¹ Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China.
² Department of Radiology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
³ MR Collaboration, Siemens Healthcare Ltd, Shanghai, China.
⁴ Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China. Electronic address: danwu.bme@zju.edu.cn.

PMID: 35066307
DOI: 10.1016/j.placenta.2022.01.010

Abstract

Introduction: Intravoxel Incoherent Motion (IVIM) imaging has been used to assess placental microcirculatory flows. We proposed a joint analysis of flow-compensated (FC) and non-compensated (NC) diffusion MRI to estimate the fraction and velocity of ballistic microcirculatory flow (f_b and v_b), and evaluated the diagnostic performance of the new markers in maternal and fetal disorders.

Methods: Gestational diabetes mellitus (GDM, n = 15) pregnancies and fetal growth restriction (FGR, n = 12), along with gestational age matched normal controls (n = 19 for GDM and 15 for FGR) underwent FC and NC-encoded IVIM scans at 1.5 T. f_b and v_b obtained from a FC-NC joint model, along with the conventional IVIM indices, were compared between patient groups for whole-placenta and maternal/fetal sides of the placenta. A linear support vector machine (SVM) was used to classify the GDM, FGR and controls.

Results: v_b of whole-placenta were significantly lower in both GDM (p = 0.017) and FGR (p = 0.043), compared with their controls, and the differences were more evident in the fetal side (p = 0.010 for GDM and p = 0.042 for FGR). f_b and f_FC showed group differences in the fetal side and D_FC showed differences in whole-placenta for GDM patients. In the classification task, v_b showed the highest diagnostic accuracy of 70.6% for GDM and 63.0% for FGR, and the combination of f_b and v_b further improved the detection accuracy to 73.5% and 66.7% for GDM and FGR, respectively.

Discussion: v_b showed superior performance in the diagnosis of GDM and FGR, indicating the potential of the joint FC-NC IVIM method for placenta examinations.

Keywords: Ballistic flow; Fetal growth restriction; Flow-compensated; Gestational diabetes mellitus; Intravoxel incoherent motion.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Case-Control Studies
Diabetes, Gestational / diagnostic imaging*
Diabetes, Gestational / physiopathology
Diffusion Magnetic Resonance Imaging / methods*
Female
Fetal Growth Retardation / diagnostic imaging*
Fetal Growth Retardation / physiopathology
Humans
Image Processing, Computer-Assisted / methods*
Microcirculation
Placental Circulation*
Pregnancy