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Kate F Walker

Publications and source records attributed to Kate F Walker.

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T$_2$* and Susceptibility Mapping as Indicators of Placental Health

Objective(s): T$_2$* and susceptibility ($\chi$) MRI mapping provide complimentary measures of the haemodynamic environment in the placenta. The aims of this work were to use these simultaneously obtained measures to investigate the role of oxygen distribution on the well-established reduction of T$_2$* with gestational age found in healthy pregnancies and explore differences in both measures in compromised placentas. Methods: T$_2$* and $\chi$ were measured simultaneously from a double echo, echo planar scan of the whole placenta, across a range of gestational ages and pregnancy complications. Regional variations across the placenta were investigated. Results: Whole placental mean T$_2$* was more correlated with standard deviation of $\chi$ than mean $\chi$ indicating it is more driven by increasing local inhomogeneities rather than bulk deoxygenation with healthy gestation. Compromised placentas also showed increased standard deviation of $\chi$ as well as lower mean T$_2$* suggesting flow/uptake mismatch and reduced oxygenation. Regionally, the susceptibility was lowest (most oxygenated) and least variable in the central region of the placenta indicating good mixing and refreshment of blood in this area. The susceptibility was highest (most deoxygenated) and most variable at the fetal side, suggesting less effective perfusion in this region. Compromised cases showed the greatest difference on the fetal side for both mean and standard deviation of $\chi$. T$_2$* was lowest at the fetal side for healthy and compromised cases but the maternal and central regions better distinguished between the two groups. Conclusion(s): T$_2$* and susceptibility can be mapped simultaneously from a single MRI scan and provide complimentary information about the function of the placenta across healthy gestational development, and as a potential indicator of placental compromise.

physics.med-ph

Placental contractions in uncomplicated pregnancies

In 2020 we first described placental contractions, and we have now undertaken a study to characterise them and seek features that might automatically separate them from uterine contractions. We recruited 36 healthy pregnant women to undergo magnetic resonance imaging (MRI) between 29 and 42 weeks of pregnancy in a single-centre, prospective, observational study. Participants had fetal ultrasound to confirm normal growth. Dynamic MRI was acquired for between 15 and 32 minutes using respiratory triggered, multi-slice, single shot, gradient echo, echo planar imaging covering the whole uterus. All participants had a live birth of a healthy baby weighing over the 10th centile for gestational age and none developed any associated conditions of placental dysfunction e.g. pre-eclampsia, or severe maternal or fetal villous malperfusion on placental histopathology. Any visible contractions were recorded for all participants who completed their MRI scan and placental contractions occurred in at least 60% of our healthy pregnant population with a median frequency of approximately 2 per hour, and a median duration of 2.4 minutes. Contractions involving a decrease in placental volume of >10% were classified as either placental or uterine by visual observation. Placental contractions occurred more frequently than uterine contractions (p=0.0061), were associated with a larger increase in the surface area of the uterine wall not covered by the placenta (p=0.0015), placental sphericity (p<0.0001) and longer duration (p=0.0151). All contractions led to an increase in the MRI parameter R2* in the placenta. There was large variation both between participants and between contractions from the same individual, in terms of time course and contractions features, with no apparent change across the gestational age range studied, although the largest fractional volume changes were detected at early gestation.

physics.med-ph