학술논문
Reduced T2*-weighted placental MRI predicts foetal growth restriction in women with chronic rheumatic disease-a Danish explorative study.
Document Type
Academic Journal
Author
Vestergaard T; Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 99, Entrance C, Level 1, Fix-Point C117, 8200, Aarhus, Denmark. theakalender@gmail.dk.; Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark. theakalender@gmail.dk.; Julsgaard M; Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 99, Entrance C, Level 1, Fix-Point C117, 8200, Aarhus, Denmark.; Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Center for Molecular Prediction of Inflammatory Bowel Disease (PREDICT), Department of Clinical Medicine, Aalborg University, Aalborg, Copenhagen, Denmark.; Helmig RB; Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark.; Faunø E; Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 99, Entrance C, Level 1, Fix-Point C117, 8200, Aarhus, Denmark.; Vendelboe T; Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.; Kelsen J; Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 99, Entrance C, Level 1, Fix-Point C117, 8200, Aarhus, Denmark.; Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Laurberg TB; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.; Sørensen A; Department of Obstetrics and Gynaecology, Aalborg University Hospital, Aalborg, Denmark.; Pedersen BG; Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.
Source
Publisher: Springer Country of Publication: Germany NLM ID: 8211469 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1434-9949 (Electronic) Linking ISSN: 07703198 NLM ISO Abbreviation: Clin Rheumatol Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: Women with chronic rheumatic disease (CRD) are at greater risk of foetal growth restriction than their healthy peers. T2*-weighted magnetic resonance imaging of placenta (T2*P-MRI) is superior to conventional ultrasonography in predicting birth weight and works as a proxy metabolic mirror of the placental function. We aimed to compare T2*P-MRI in pregnant women with CRD and healthy controls. In addition, we aimed to investigate the correlation between T2*P-MRI and birth weight.
Methods: Using a General Electric (GE) 1.5 Tesla, we consecutively performed T2*-weighted placental MRI in 10 women with CRD and 18 healthy controls at gestational week (GW)24 and GW32. We prospectively collected clinical parameters during pregnancy including birth outcome and placental weight.
Results: Women with CRD had significantly lower T2*P-MRI values at GW24 than healthy controls (median T2*(IQR) 92.1 ms (81.6; 122.4) versus 118.6 ms (105.1; 129.1), p = 0.03). T2*P-MRI values at GW24 showed a significant correlation with birth weight, as the T2*P-MRI value was reduced in all four pregnancies complicated by SGA at birth. Three out of four pregnancies complicated by SGA at birth remained undetected by routine antenatal ultrasound.
Conclusion: This study demonstrates reduced T2*P-MRI values and a high proportion of SGA at birth in CRD pregnancies compared to controls, suggesting an increased risk of placental dysfunction in CRD pregnancies. T2*P-MRI may have the potential to focus clinical vigilance by identifying pregnancies at risk of SGA as early as GW24. Key Points • Placenta-related causes of foetal growth restriction in women with rheumatic disease remain to be investigated. • T2*P-MRI values at gestational week 24 predicted foetuses small for gestational age at birth. • T2*P-MRI may indicate pregnant women with chronic rheumatic disease (CRD) in need of treatment optimization.
(© 2024. The Author(s).)
Methods: Using a General Electric (GE) 1.5 Tesla, we consecutively performed T2*-weighted placental MRI in 10 women with CRD and 18 healthy controls at gestational week (GW)24 and GW32. We prospectively collected clinical parameters during pregnancy including birth outcome and placental weight.
Results: Women with CRD had significantly lower T2*P-MRI values at GW24 than healthy controls (median T2*(IQR) 92.1 ms (81.6; 122.4) versus 118.6 ms (105.1; 129.1), p = 0.03). T2*P-MRI values at GW24 showed a significant correlation with birth weight, as the T2*P-MRI value was reduced in all four pregnancies complicated by SGA at birth. Three out of four pregnancies complicated by SGA at birth remained undetected by routine antenatal ultrasound.
Conclusion: This study demonstrates reduced T2*P-MRI values and a high proportion of SGA at birth in CRD pregnancies compared to controls, suggesting an increased risk of placental dysfunction in CRD pregnancies. T2*P-MRI may have the potential to focus clinical vigilance by identifying pregnancies at risk of SGA as early as GW24. Key Points • Placenta-related causes of foetal growth restriction in women with rheumatic disease remain to be investigated. • T2*P-MRI values at gestational week 24 predicted foetuses small for gestational age at birth. • T2*P-MRI may indicate pregnant women with chronic rheumatic disease (CRD) in need of treatment optimization.
(© 2024. The Author(s).)