Department of Obstetrics and Gynaecology, Aalborg University Hospital, Aalborg, Denmark.
Department of Obstetrics and Gynaecology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Eur J Obstet Gynecol Reprod Biol. 2023 Mar;282:72-76. doi: 10.1016/j.ejogrb.2023.01.013. Epub 2023 Jan 13.
Placental magnetic resonance imaging (MRI) may be a valuable tool in the prediction of small for gestational age (SGA) at birth. MRI provides reliable estimates of placental volume and thickness. In addition, placental transverse relaxation time (T2*) may be directly related to placental function. This study aimed to explore and compare the predictive performance of three placental MRI parameters - volume, thickness and T2* - in relation to SGA at birth.
A mixed cohort of 85 pregnancies was retrieved from the placental MRI database at the study hospital. MRI was performed in a 1.5 T system at gestational weeks 15-41. In normal birthweight (BW) pregnancies [BW > -22 % of expected for gestational age (GA)], the correlation between each of the MRI parameters and GA was investigated by linear regression. The prediction of SGA was investigated by logistic regression analysis adjusted for GA at MRI.
In normal BW pregnancies, a significant linear correlation was found between GA and each of the MRI parameters. Univariate analysis demonstrated that placental volume [odds ratio (OR) 0.97, p = 0.001] and placental T2* (OR 0.79, p = 0.003), but not placental thickness (OR 0.92, p = 0.862) were significant predictors of SGA. A multi-variate model including all three MRI parameters found that placental T2* was the only independent predictor of SGA (OR 0.81, p = 0.04).
Among the MRI parameters investigated in this study, placental T2* was the only independent predictor of SGA in a multi-variate model. This finding underlines the strong position of T2*-weighted placental MRI in the prediction of SGA.
胎盘磁共振成像（MRI）可能是预测出生时小于胎龄儿（SGA）的有价值的工具。MRI 可提供胎盘体积和厚度的可靠估计。此外，胎盘横向弛豫时间（T2*）可能与胎盘功能直接相关。本研究旨在探讨和比较三种胎盘 MRI 参数（体积、厚度和 T2*）与出生时 SGA 的预测性能。
从研究医院的胎盘 MRI 数据库中检索到 85 例混合妊娠。在 1.5T 系统中于妊娠 15-41 周进行 MRI。在正常出生体重（BW）妊娠中（BW>预期胎龄（GA）的-22%），通过线性回归研究了每种 MRI 参数与 GA 的相关性。通过调整 MRI 时的 GA 进行逻辑回归分析来研究 SGA 的预测。
在正常 BW 妊娠中，发现 GA 与每种 MRI 参数之间存在显著的线性相关性。单变量分析表明，胎盘体积[比值比（OR）0.97，p=0.001]和胎盘 T2*（OR 0.79，p=0.003），而不是胎盘厚度（OR 0.92，p=0.862）是 SGA 的显著预测因子。包括所有三种 MRI 参数的多变量模型发现，胎盘 T2*是 SGA 的唯一独立预测因子（OR 0.81，p=0.04）。
在本研究中研究的 MRI 参数中，胎盘 T2是多变量模型中 SGA 的唯一独立预测因子。这一发现强调了 T2-加权胎盘 MRI 在预测 SGA 中的重要地位。
