Magnetic resonance imaging of the placenta: a systematic approach to the description of normal placenta

Background. Currently, one of the topical issues of prenatal magnetic resonance imaging is accurate and timely diagnosis of pathological conditions of extrafetal structures of the fetus. In particular, the most acute problem is the need to improve the diagnostic accuracy of recognition and differentiation of placental adhesive-invasive pathology (PAIP). In the literature, there is no unified approach to the methodology and description of MRI examination of the placenta. Objective. To improve the diagnostic methods of the method of magnetic resonance imaging for the study of the placenta. Design and methods. A total of 293 MRI studies of the small pelvis of pregnant women aged 22 to 45 years (average — 35 years), in gestational age from 14 to 38 weeks (average 36 weeks) were performed and analyzed. Results. A clinical three-stage method of MRI of the placenta and an algorithm for systematized description of MRI of the placenta of pregnant women have been developed and implemented. Conclusion. The developed systematic approach to the study of the placenta will help improve the capabilities of the MRI method for examining the placenta in connection with the demand for accurate and correct interpretation of this organ in vivo.

1. Guttmacher AE, Maddox YT, Spong CY. The human placenta project: placental structure, development, and function in real time. Placenta. 2014; 35 (5): 303–304.

2. D’Antonio F, Iacovella C, Palacios-Jaraquemada J, et al. Prenatal identification of invasive placentation using magnetic resonance imaging: systematic review and metaanalysis. Ultrasound Obstet Gynecol. 2014; 44 (1): 8–16.

3. Morita S, Ueno E, Fujimura M, et al. Feasibility of diffusion-weighted MRI for defining placental invasion. J Magn Reson Imaging. 2009; 30 (3): 666–671.

4. Reddy UM, Abuhamad AZ, Levine D, et al. Fetal imaging: executive summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Institute of Ultrasound in Medicine, American College of Obstetricians and Gynecologists, American College of Radiology, Society for Pediatric Radiology, and Society of Radiologists in ultrasound fetal imaging workshop. Am J Obstet Gynecol. 2014; 210 (5): 387–397.

5. Varghese B, Singh N, George RAN, et al. Magnetic resonance imaging of placenta accreta. Indian J Radiol Imaging. 2013; 23 (4): 379–385.

6. Dashe JS, McIntire DD, Ramus RM, et al. Persistence of placenta previa according to gestational age at ultrasound detection. Obstet Gynecol. 2002; 99 (5 Pt 1): 692–697.

7. Elsayes KM, Trout AT, Friedkin AM, et al. Imaging of the placenta: a multimodality pictorial review. Radiographics. 2009; 29 (5): 1371–1391.

8. Allen BC, Leyendecker JR. Placental evaluation with magnetic resonance. Radiol Clin North Am. 2013; 51 (6): 955–966.

9. Lee AJ, Bethune M, Hiscock RJ. Placental thickness in the second trimester: a pilot study to determine the normal range. J Ultrasound Med. 2012; 31 (2): 213–218.

10. Bailey AA, Twickler DM, Leyendecker JR. MRI of the placenta. MRI of Fetal and Maternal Diseases in Pregnancy. 2016; 245–268.

11. Baughman WC, Corteville JE, Shah RR. Placenta accreta: spectrum of US and MR imaging findings. Radiographics. 2008; 28 (7): 1905– 1916.

12. Grannum PA, Berkowitz RL, Hobbins JC. The ultrasonic changes in the maturing placenta and their relation to fetal pulmonic maturity. Am J Obstet Gynecol.1979; 133 (8): 915–922.

13. Brown BP, Meyers ML. Placental magnetic resonance imaging Part II: placenta accreta spectrum. Pediatr Radiol. 2020; 50 (2): 275–284.

14. Fadl S, Moshiri M, Fligner CL, et al. Placental imaging: normal appearance with review of pathologic findings. Radiographics. 2017; 37 (3): 979–998.

15. Gagaev CHG. Human umbilical cord in normal and complicated pregnancy. Diss. … doctor of medicine sciences: 14.01.01. М., 2015. In Russian

16. Iams JD, Goldenberg RL, Meis PJ, et al. The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network. N Engl J Med. 1996; 334 (9): 567–572.

17. Berghella V, Kuhlman K, Weiner S, et al. Cervical funneling: sonographic criteria predictive of preterm delivery. Ultrasound Obstet Gynecol. 1997; 10 (3): 161–166.