Developing Brain Institute, Division of Diagnostic Imaging and Radiology, Children's National Hospital, Washington DC, USA.
Developing Brain Institute, Division of Diagnostic Imaging and Radiology, Children's National Hospital, Washington DC, USA; Department of Obstetrics & Gynecology, MedStar Washington Hospital Center, Washington, DC, USA.
Placenta. 2024 Oct;156:92-97. doi: 10.1016/j.placenta.2024.09.006. Epub 2024 Sep 10.
Placental health is vital for maternal and fetal well-being, and placental T2∗ has been suggested to identify in vivo placental dysfunction prior to delivery. However, ideal regions of interest to best inform functional assessments of the placenta remain unknown. The aim of this study is to compare global and slice-wise measures of in-vivo placental T2∗ assessments.
This prospective study recruited pregnant people with singleton pregnancies between December 2017 and February 2022.3D multi-echo RF-spoiled gradient echo sequences were acquired, and placental T2∗ values were derived from global and slice-wise approaches. Statistical analyses included Pearson correlation coefficients, concordance correlation coefficients (CCC), intraclass correlation coefficients (ICC), and Bland-Altman analyses.
Of 115 participants (mean gestational age, 29.25 ± 5.05 weeks), 68 were healthy controls, and 47 were high-risk pregnancies. Global and slice-wise placental T2∗ assessments for the entire cohort showed no significant difference nor for individual subgroups (healthy controls or high-risk). Pearson correlation values ranged between 0.88 and 0.99 for mean global and slice-wise placental T2∗. CCC analyses ranged from 0.88 to 0.99 for mean T2∗, and ICC analyses ranged between 0.88 and 0.99 for mean T2∗, showing a strong agreement between measurements. Bland-Altman analyses depicted T2∗ differences across coverage methods, and groups resided within the 95 % limits of agreement.
Single-slice placental assessments offer robust, comparable T2∗ values to global assessments, with the added benefit of reducing post-processing time and SAR exposure. This supports slice-wise approaches as valid alternatives for assessing placental health in various pregnancies.
胎盘健康对母婴健康至关重要，已有研究表明，T2∗ 可在分娩前识别胎盘的体内功能障碍。然而，目前仍不清楚最佳的感兴趣区域，以提供胎盘功能的全面评估。本研究旨在比较体内胎盘 T2∗评估的整体和切片评估方法。
这项前瞻性研究招募了 2017 年 12 月至 2022 年 2 月期间的单胎妊娠孕妇。采集 3D 多回波 RF 扰相梯度回波序列，从整体和切片方法得出胎盘 T2∗值。统计分析包括 Pearson 相关系数、一致性相关系数（CCC）、组内相关系数（ICC）和 Bland-Altman 分析。
在 115 名参与者（平均妊娠年龄为 29.25±5.05 周）中，68 名是健康对照组，47 名是高危妊娠组。整个队列的整体和切片胎盘 T2∗评估没有显著差异，无论是在健康对照组还是高危妊娠组。平均整体和切片胎盘 T2∗的 Pearson 相关值在 0.88 到 0.99 之间。平均 T2∗的 CCC 分析在 0.88 到 0.99 之间，平均 T2∗的 ICC 分析在 0.88 到 0.99 之间，这表明测量之间具有很强的一致性。Bland-Altman 分析描绘了不同覆盖方法的 T2∗差异，且组内差异在 95%一致性区间内。
单一切片的胎盘评估提供了与整体评估相当的可靠 T2∗值，且具有减少后处理时间和 SAR 暴露的额外优势。这支持了切片评估方法作为评估各种妊娠期间胎盘健康的有效替代方法。
