Diffusion-sensitized magnetic resonance imaging highlights placental microstructural damage in patients with previous SARS-CoV-2 pregnancy infection

Giada Ercolani; Silvia Capuani; Alessandra Maiuro; Veronica Celli; Robert Grimm; Daniele Di Mascio; Maria Grazia Porpora; Carlo Catalano; Roberto Brunelli; Antonella Giancotti; Lucia Manganaro

doi:10.1016/j.placenta.2023.11.017

Diffusion-sensitized magnetic resonance imaging highlights placental microstructural damage in patients with previous SARS-CoV-2 pregnancy infection

Placenta. 2024 Jan:145:38-44. doi: 10.1016/j.placenta.2023.11.017. Epub 2023 Dec 2.

Authors

Affiliations

¹ Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Italy.
² CNR ISC Roma Sapienza, Physics Department Rome, Italy. Electronic address: silvia.capuani@isc.cnr.it.
³ CNR ISC Roma Sapienza, Physics Department Rome, Italy; Sapienza University of Rome, Physics Department, Rome, Italy.
⁴ Siemens Healthcare GmbH, Erlangen, Germany.
⁵ Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Italy.
⁶ Department of Radiological, Oncological and Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Italy. Electronic address: lucia.manganaro@uniroma1.it.

PMID: 38052124
DOI: 10.1016/j.placenta.2023.11.017

Abstract

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been a major global health problem since December 2019. This work aimed to investigate whether pregnant women's mild and moderate SARS-CoV-2 infection was associated with microstructural and vascular changes in the placenta observable in vivo by Intravoxel Incoherent Motion (IVIM) at different gestational ages (GA).

Methods: This was a retrospective, nested case-control of pregnant women during the SARS-CoV-2 pandemic (COVID-19 group, n = 14) compared to pre-pandemic healthy controls (n = 19). MRI IVIM protocol at 1.5T was constituted of diffusion-weighted (DW) images with TR/TE = 3100/76 ms and 10 b-values (0,10,30,50,75,100,200,400,700,1000s/mm2). Differences between IVIM parameters D (diffusion), and f (fractional perfusion) quantified in the two groups were evaluated using the ANOVA test with Bonferroni correction and linear correlation between IVIM metrics and GA, COVID-19 duration, the delay time between a positive SARS-CoV-2 test and MRI examination (delay-time exam+) was studied by Pearson-test.

Results: D was significantly higher in the COVID-19 placentas compared to that of the age-matched healthy group (p < 0.04 in fetal and p < 0.007 in maternal site). No significant difference between f values was found in the two groups suggesting no-specific microstructural damage with no perfusion alteration (potentially quantified by f) in mild/moderate SARS-Cov-2 placentas. A significant negative correlation was found between D and GA in the COVID-19 placentas whereas no significant correlation was found in the control placentas reflecting a possible accelerated senescence process due to COVID-19.

Discussion: We report impaired microstructural placental development during pregnancy and the absence of perfusion-IVIM parameter changes that may indicate no perfusion changing through microvessels and microvilli in the placentas of pregnancies with mild/moderate SARS-Cov-2 after reaching negativity.

Keywords: Diffusion MRI; IVIM; Microstructural damage; Placenta; SARS-CoV-2.

MeSH terms

COVID-19* / diagnostic imaging
Female
Humans
Magnetic Resonance Imaging / methods
Placenta* / blood supply
Placenta* / diagnostic imaging
Placentation
Pregnancy
Retrospective Studies
SARS-CoV-2