Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.
Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
BJOG. 2021 Jan;128(2):337-345. doi: 10.1111/1471-0528.16387. Epub 2020 Aug 5.
We hypothesised that a multi-compartment magnetic resonance imaging (MRI) technique that is sensitive to fetal blood oxygenation would identify changes in placental blood volume and fetal blood oxygenation in pregnancies complicated by early-onset fetal growth restriction (FGR).
Case-control study.
London, UK.
Women with uncomplicated pregnancies (estimated fetal weight [EFW] >10th centile for gestational age [GA] and normal maternal and fetal Doppler ultrasound, n = 12) or early-onset FGR (EFW <3rd centile with or without abnormal Doppler ultrasound <32 weeks GA, n = 12) were studied.
All women underwent MRI examination. Using a multi-compartment MRI technique, we quantified fetal and maternal blood volume and feto-placental blood oxygenation.
Disease severity was stratified according to Doppler pulsatility index and the relationship to the MRI parameters was investigated, including the influence of GA at scan.
The FGR group (mean GA 27 weeks, range 24 to 33 weeks) had a significantly lower EFW compared with the control group (mean GA 29 weeks; -705 g, 95% CI -353 to -1057 g). MRI-derived feto-placental oxygen saturation was higher in controls compared with FGR (75 ± 9.6% versus 56 ± 16.2%, P = 0.02, 95% CI 7.8-30.3%). Feto-placental oxygen saturation estimation correlated strongly with GA at scan in controls (r = -0.83).
Using a novel multimodal MRI protocol we demonstrated reduced feto-placental blood oxygen saturation in pregnancies complicated by early-onset FGR. The degree of abnormality correlated with disease severity defined by ultrasound Doppler findings. Gestational age-dependent changes in oxygen saturation were also present in normal pregnancies.
MRI reveals differences in feto-placental oxygen saturation between normal and FGR pregnancy that is associated with disease severity.
我们假设，一种对胎儿血氧敏感的多腔磁共振成像（MRI）技术能够识别出早发性胎儿生长受限（FGR）妊娠中胎盘血容量和胎儿血氧的变化。
病例对照研究。
英国伦敦。
研究对象为无并发症妊娠的孕妇（估计胎儿体重[EFW]＞胎龄[GA]第 10 百分位数且母体和胎儿多普勒超声正常，n=12）或早发性 FGR 孕妇（EFW＜第 3 百分位数，伴或不伴 32 孕周前多普勒超声异常，n=12）。
所有孕妇均行 MRI 检查。使用多腔 MRI 技术，我们量化了胎儿和母体的血容量以及胎-胎盘血氧。
根据多普勒搏动指数对疾病严重程度进行分层，并研究其与 MRI 参数的关系，包括扫描时 GA 的影响。
FGR 组（平均 GA 为 27 周，范围为 24 周至 33 周）的 EFW 明显低于对照组（平均 GA 为 29 周；-705g，95%CI-353 至-1057g）。与 FGR 组相比，对照组的 MRI 衍生胎-胎盘氧饱和度更高（75±9.6%对 56±16.2%，P=0.02，95%CI7.8-30.3%）。在对照组中，胎-胎盘氧饱和度的估计值与扫描时的 GA 密切相关（r=-0.83）。
使用一种新的多模态 MRI 方案，我们发现早发性 FGR 妊娠中胎-胎盘血含氧饱和度降低。异常程度与超声多普勒发现的疾病严重程度相关。正常妊娠中也存在与 GA 相关的氧饱和度变化。
MRI 显示正常妊娠和 FGR 妊娠之间胎-胎盘氧饱和度存在差异，且与疾病严重程度相关。
