Link Daphna, Many Ariel, Ben Sira Liat, Tarrasch Ricardo, Bak Stella, Kidron Debora, Gordon Zoya, Yagel Simcha, Harel Shaul, Ben Bashat Dafna
Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Placenta. 2020 Nov;101:252-260. doi: 10.1016/j.placenta.2020.08.001. Epub 2020 Aug 31.
Understanding regarding the whole placental vascular network structure is limited. Our aim was to quantitatively characterize the human placental vascular tree ex-vivo using high-resolution MRI.
34 normal placentas were rinsed and injected with a solution of gelatin and contrast agent through the umbilical vessels. A sample of six placentas taken from pregnancies with intrauterine-growth-restriction (IUGR) was used to demonstrate the potential application to cases with placental insufficiency. Structural ex-vivo MR scans of the placenta were performed using high resolution T weighted images. A semi-automatic method was developed to segment and characterize the placental vascular architecture: placental volume and cord insertion location; number of bifurcations, generations and vessels diameters.
Different vascular patterns were found in placentas with central versus marginal cord-insertion. Based on the placental volume and number of bifurcations we were able to predict birth weight. Furthermore, preliminary results on IUGR sample demonstrated the potential of this method to differentiate between small newborns with suspected IUGR from small normal newborns who reached their full growth potential. Results obtained using the automatic method were validated against manual values demonstrating no significant differences or bias. Histopathology supported the imaging findings.
This is the first study to quantitatively characterize the human placental vascular architecture using high resolution ex-vivo MRI. Different patterns of vascular architecture may be related to different functioning of the placenta and affect fetal development. This method is simple, relatively fast, provides detailed information of the placental vascular architecture, and may have important clinical applications.
关于整个胎盘血管网络结构的了解有限。我们的目的是使用高分辨率磁共振成像（MRI）对离体的人胎盘血管树进行定量表征。
34个正常胎盘经冲洗后，通过脐血管注入明胶和造影剂溶液。从患有宫内生长受限（IUGR）的妊娠中获取的六个胎盘样本用于证明该方法在胎盘功能不全病例中的潜在应用。使用高分辨率T加权图像对胎盘进行离体结构磁共振扫描。开发了一种半自动方法来分割和表征胎盘血管结构：胎盘体积和脐带插入位置；分支数量、代数和血管直径。
在脐带中央插入与边缘插入的胎盘中发现了不同的血管模式。基于胎盘体积和分支数量，我们能够预测出生体重。此外，IUGR样本的初步结果表明该方法有潜力区分疑似IUGR的小新生儿与达到其全部生长潜力的正常小新生儿。使用自动方法获得的结果与手动测量值进行了验证，结果显示无显著差异或偏差。组织病理学支持了影像学发现。
这是第一项使用高分辨率离体MRI对人胎盘血管结构进行定量表征的研究。不同的血管结构模式可能与胎盘的不同功能相关，并影响胎儿发育。该方法简单、相对快速，提供了胎盘血管结构的详细信息，可能具有重要的临床应用价值。
