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A retrospective segmentation analysis of placental volume by magnetic resonance imaging from first trimester to term gestation

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Abstract

Background

Abnormalities of the placenta affect 5–7% of pregnancies. Because disturbances in fetal growth are often preceded by dysfunction of the placenta or attenuation of its normal expansion, placental health warrants careful surveillance. There are limited normative data available for placental volume by MRI.

Objective

To determine normative ranges of placental volume by MRI throughout gestation.

Materials and methods

In this cross-sectional retrospective analysis, we reviewed MRI examinations of pregnant females obtained between 2002 and 2017 at a single institution. We performed semi-automated segmentation of the placenta in images obtained in patients with no radiologic evidence of maternal or fetal pathology, using the Philips Intellispace Tumor Tracking Tool.

Results

Placental segmentation was performed in 112 women and had a high degree of interrater reliability (single-measure intraclass correlation coefficient =0.978 with 95% confidence interval [CI] 0.956, 0.989; P<0.001). Normative data on placental volume by MRI increased nonlinearly from 6 weeks to 39 weeks of gestation, with wider variability of placental volume at higher gestational age (GA). We fit placental volumetric data to a polynomial curve of third order described as placental volume = –0.02*GA3 + 1.6*GA2 – 13.3*GA + 8.3. Placental volume showed positive correlation with estimated fetal weight (P=0.03) and birth weight (P=0.05).

Conclusion

This study provides normative placental volume by MRI from early first trimester to term gestation. Deviations in placental volume from normal might prove to be an imaging biomarker of adverse fetal health and neonatal outcome, and further studies are needed to more fully understand this metric. Assessment of placental volume should be considered in all routine fetal MRI examinations.

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Acknowledgments

This publication was made possible in part with support from the Indiana Clinical and Translational Sciences Institute, funded in part by award number UL1TR001108 from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award. Additional support came from the Joyce Victoria McRobbie Pediatric Fellowship grant. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Correspondence to Rachel L. León.

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León, R.L., Li, K.T. & Brown, B.P. A retrospective segmentation analysis of placental volume by magnetic resonance imaging from first trimester to term gestation. Pediatr Radiol 48, 1936–1944 (2018). https://doi.org/10.1007/s00247-018-4213-x

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  • DOI: https://doi.org/10.1007/s00247-018-4213-x

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