Novel MRI Assessment of Placental Structure and Function Throughout Pregnancy

妊娠期胎盘结构和功能的新型 MRI 评估

基本信息

批准号：
10004704
负责人：
ELFAR ADALSTEINSSON
金额：
$ 70.71万
依托单位：
BOSTON CHILDREN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-01 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10004704
关键词：
3-Dimensional Address Anatomy Blood Blood Pressure Blood Vessels Chorionic villi Clinical Clinical Trials Complex Computer Analysis Data Development Diagnosis Diagnostic Diffusion Disease Echo-Planar Imaging Electromagnetics Evaluation Excision Fetal Development Fetal Growth Fetal safety Fetus Financial compensation Fingerprint First Pregnancy Trimester Foundations Future Goals Health Heating Histopathology Human Hyperoxia Image Impairment Individual International Joints Magnetic Resonance Imaging Maps Measures Methodology Methods Modeling Monitor Morbidity - disease rate Mothers Motion Nutrient Organ Outcome Oxygen Pathologist Pattern Perfusion Periodicity Physiology Placenta Placenta Diseases Pre-Eclampsia Pregnancy Preparation Research Personnel Safety Scientist Second Pregnancy Trimester Spin Labels Spiral Artery of the Endometrium Structure Structure of placental cotyledon Structure of umbilical artery Technology Temperature Testing Third Pregnancy Trimester Time Tissues Uterine Contraction Villus Work body system clinically relevant experience fetal fetal blood image registration imaging modality in vivo innovation mortality multimodality new technology novel novel therapeutics oxygen transport pregnant radio frequency response simulation spatiotemporal tool treatment choice treatment response wasting

项目摘要

The placenta is a highly vascular organ, responsible for the interaction between mother and developing fetus. Close proximity of maternal blood, in intervillous spaces, and fetal blood, in chorionic villi, enables transport of nutrients, such as oxygen, from mother to fetus and removal of wastes. Perfusion of the intervillous spaces can be impaired by placental diseases, such as preeclampsia. Compromised placental perfusion impairs the exchange between maternal and fetal blood with potentially devastating impact on both mother and fetus. Today, no diagnostic tool can directly monitor regional placental perfusion, intervillous inflow, oxygen response and oxygen state. Clinicians still rely on indirect measures of placental health, such as fetal size and umbilical artery blood velocity. Induced delivery remains the treatment of choice for most placental disorders. New, effective technologies are desperately needed to monitor regional placental health in vivo. We assembled a team of technical MR experts, computational researchers, MR clinician scientists, experienced obstetricians and a internationally recognized placental biologist to address the need for clinically relevant technological advances in MRI for placental imaging. Here we will develop robust, quantitative measures of regional placental perfusion, intervillous inflow, oxygen response and oxygen state from late 2nd trimester to term, with safety analysis and feasibility testing that pave the way for extension to late 1st trimester. We will pilot and optimize our placental MRI measures in mothers with typical pregnancy (TP) and preeclampsia (PE) to determine if our novel MRI methods are tolerated by both groups and to evaluate their feasibility and potential as clinical tools to distinguish PE from TP placentas in individuals. Towards this end, we propose the following specific aims: 1. Map placental perfusion and estimate intervillous inflow: We will develop a new model for diffusion imaging intravoxel incoherent motion (IVIM) for placental perfusion and develop a velocity selective spin labeling (VSSL) approach to estimate intervillous inflow. 2. Map T1 and T2 to characterize changes in placental oxygen response and oxygen state: We will develop 2D MR Fingerprinting (MRF) to create rapid joint T1 and T2 maps of placental oxygen response during hyperoxia and 3D MRF or multi-inversion echo planar imaging (MIEPI) to create volumetric joint T1 and T2 maps to determine the placental oxygen state. For Aims 1 and 2, we will correlate multimodal placental patterns in TP and PE with regional placental histopathology using our placental flattening method for guidance. 3. Optimize imaging safety throughout pregnancy using temperature simulations: We will focus on the major safety concern of radiofrequency (RF) tissue heating in the first-through-third trimester of pregnancy. We will build on our anatomically realistic numerical pregnant body models and expertise with electromagnetic simulations and develop accurate and pregnancy-specific thermal models to determine and experimentally validate safe and efficient RF exposure throughout pregnancy.

胎盘是高度血管器官，负责母亲与发育中的胎儿之间的相互作用。在绒毛膜绒毛中，在间隔空间和胎儿血液中近距离接近孕产妇血液从母亲到胎儿的氧气，例如氧气，以及废物的去除。受到胎盘疾病的损害，例如先兆子痫。孕产妇和胎儿血液之间的交换对母亲和胎儿有潜在的毁灭性影响。如今，Noagnognostic工具可以直接监测区域胎盘灌注，间隔流入，氧气反应和氧气状态。动脉速度有效的技术迫切需要监测体内的区域胎盘健康技术MR专家，计算研究人员，临床科学家的团队，经验丰富的观察员以及国际公认的胎盘生物学家，以满足临床相关技术的需求胎盘成像的MRI进展。胎盘灌注，间隔流入，氧气反应和氧气，从妊娠晚期到学期安全分析和盛宴测试为延长到1级后期的铺平道路。优化我们典型首映（TP）和先兆子痫（PE）的母亲的胎盘MRI措施确定我们的新型MRI方法是否由两组耐受，并评估其可行性和潜力作为区分个体中的Pe Rom TP胎盘的临床工具。具体目的：1。地图放置灌注和估计助长流入：我们将开发一个新的模型扩散成像入内液不连贯运动（IVIM）进行胎盘灌注并发展速度选择性自旋标记（VSSL）估计间隔流入的方法。胎盘氧反应和氧气：我们将开发2D MR指纹（MRF）以创建快速关节在高氧和3D MRF或多对段回波平面期间的T1和T2图的T1和T2图成像（Miepi）创建体积关节T1和T2图以确定目标1的胎盘氧和2，我们将将TP和PE中的多模式胎盘模式与区域胎盘组织病理学相关联使用我们的胎盘扁平方法进行指导。温度模拟：我们将重点关注射频（RF）组织的主要安全关注怀孕的三个月，我们将建立在我们的解剖学上人体模型和电磁模拟的专业知识，并发展精确和特定于妊娠用于确定和实验的热模型验证整个整个安全有效的RF暴露怀孕。