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Society for Pediatric Radiology – Poster Archive

Showing 5 Abstracts.

Brown Brandon,  Shea Lindsey,  Marine Megan

Final Pr. ID: Poster #: EDU-017

MRI evaluation of the placenta, and particularly placental vascularity, is a critical yet challenging task for the radiologist. Failure to accurately diagnose ischemic changes or to detect signs of the abnormally invasive placenta can have devastating consequences for both maternal and fetal patients. The radiologist's task is further complicated by the inability to use intravenous contrast.

In this presentation, we outline a 7-point, systematic method for evaluation of the placenta, highlighting key changes in appearance and signal intensity between 1.5T and 3T MR field strength, and also incorporating a novel method for evaluating blood flow within placental parenchyma utilizing a hybrid image derived from (noncontrast) SSFP and SSFSE pulse sequences. Our systematic approach analyzes the following diagnostic criteria: location, presence of deep vessels, presence of enlarged/ectatic vessels, presence of fibrin/blood products, disruption of uterine myometrial signal, focal bulge, and signal irregularity of the bladder dome. Finally, we correlate this diagnostic method with a quantitative scoring system which can further aid with delivery planning and prognostication.
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Authors:  Brown Brandon , Shea Lindsey , Marine Megan

Keywords:  MRI, placenta, vasculature

Valdez Quintana Melissa,  Caro Dominguez Pablo,  Grynspan David,  Hurteau-miller Julie,  Davila Jorge,  Moretti Felipe,  Miller Elka

Final Pr. ID: Poster #: SCI-040

Diffusion weighted images (DWI) have the potential to provide valuable information on the diffusion and perfusion properties of the human placenta and therefore has the capability for detection of early developmental fetal anomalies. The purpose of this study was to determine if DWI of the placenta demonstrates differences between fetuses with and without central nervous system (CNS) abnormalities. Read More

Authors:  Valdez Quintana Melissa , Caro Dominguez Pablo , Grynspan David , Hurteau-miller Julie , Davila Jorge , Moretti Felipe , Miller Elka

Keywords:  Placenta, Fetal, DWI, ADC, CNS Abnormalities

Qu Feifei,  Qian Zhaoxia,  Yadav Brijesh,  Romero Roberto,  Haacke E.,  Sun Taotao,  Patwardhan Sanjay,  Patwardhan Manasi,  Jaiman Sunil,  Jellal Pavan,  Mody Swati,  Marin Concha Julio,  Jiang Ling

Final Pr. ID: Paper #: 106

Both placental vascular density and oxygenation can indicate placenta health. MRA is a powerful tool to evaluate tissue vasculature but with limited applications because of the use of contrast agents. T2* maps can be used to estimate the placental oxygen reserve. In this work, we acquired non-contrast enhanced MRA and T2* maps to evaluate placental vasculature and oxygenation. Read More

Authors:  Qu Feifei , Qian Zhaoxia , Yadav Brijesh , Romero Roberto , Haacke E. , Sun Taotao , Patwardhan Sanjay , Patwardhan Manasi , Jaiman Sunil , Jellal Pavan , Mody Swati , Marin Concha Julio , Jiang Ling

Keywords:  Placenta, MRA, T2* mapping

Sarrami Amir Hossein,  Rubesova Erika

Final Pr. ID: Poster #: EDU-031

Placenta, one of the least understood human organs, is external to fetal body with genetic characteristics identical to the fetus. Placenta is made up of its parenchyma, membranes, and umbilical cord (UC). It involved in the transfer blood gases and nutrients, act as immune barrier, secrete hormones and other substances. Ultrasound, Doppler, and MRI are used to evaluate placental configuration and predict adverse outcomes. MR adds value to fetal and placental sonographic evaluation thanks to its wide field of view and high tissue contrast. Single shot fast spin echo (SSFSE), balanced steady state and T1-W, occasionally DWI, are the most used sequences. We present the spectrum of morphologies and pathologies of the placenta and UC on ultrasound and MRI.
Placental location and shape: Placental location is based on its relationship with the uterus and cervix. The placenta tends to migrate toward the fundus throughout pregnancy. Placental thickness ranges from 2-4 cm. It can be a single structure, bilobed or have an accessory lobe. Variations include circumvallate and placenta membranacea.
Placental signal: Normal parenchyma is intermediate to hyperintense on fluid sensitive images, more homogenous in the second trimester and progressively becoming lobulated and septated. Increased number and size of cotyledons make the placenta more heterogenous.
Placental hemorrhage: Blood pooling and hemorrhage are another cause of placental heterogeneity.
Placental-myometrial Interface: Best seen on steady state, displaying a trilaminar appearance.
Chorionicity: Chorionicity and amnionicity are determined on the first trimester ultrasound. MRI offers a larger field of view for evaluation of the membranes’ attachment and UC in the second and third trimesters.
UC insertion: UC inserted to the center of the placenta. Eccentric insertions, and velamentous insertions can be identified on MRI.
UC structure: The UC contains two umbilical arteries, a single umbilical vein, allantois duct and Wharton's jelly and is enclosed within the outer layer of amnion.
UC varix: This refers to the dilation of the fetal umbilical veins as it runs through the fetal abdomen.
UC cysts: Uncommon, differential diagnosis includes pseudocysts, omphalomesenteric duct cysts, vascular disorders, abdominal wall defects, bladder exstrophy and urachal anomalies.
Placental Tumors. Placental tumors are categorized in trophoblastic and non-trophoblastic. The latter include chorioangiomas, teratomas, and hemangiomas.
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Authors:  Sarrami Amir Hossein , Rubesova Erika

Keywords:  Placenta, Fetal MRI, Ultrasound