tetano
Editor, Senior Moderator
Placenta
. 2023 Dec 2:145:38-44.
doi: 10.1016/j.placenta.2023.11.017. Online ahead of print. Diffusion-sensitized magnetic resonance imaging highlights placental microstructural damage in patients with previous SARS-CoV-2 pregnancy infection
Giada Ercolani[SUP] 1 [/SUP], Silvia Capuani[SUP] 2 [/SUP], Alessandra Maiuro[SUP] 3 [/SUP], Veronica Celli[SUP] 1 [/SUP], Robert Grimm[SUP] 4 [/SUP], Daniele Di Mascio[SUP] 5 [/SUP], Maria Grazia Porpora[SUP] 5 [/SUP], Carlo Catalano[SUP] 1 [/SUP], Roberto Brunelli[SUP] 5 [/SUP], Antonella Giancotti[SUP] 5 [/SUP], Lucia Manganaro[SUP] 6 [/SUP]
Affiliations
Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been a major global health problem since December 2019. This work aimed to investigate whether pregnant women's mild and moderate SARS-CoV-2 infection was associated with microstructural and vascular changes in the placenta observable in vivo by Intravoxel Incoherent Motion (IVIM) at different gestational ages (GA).
Methods: This was a retrospective, nested case-control of pregnant women during the SARS-CoV-2 pandemic (COVID-19 group, n = 14) compared to pre-pandemic healthy controls (n = 19). MRI IVIM protocol at 1.5T was constituted of diffusion-weighted (DW) images with TR/TE = 3100/76 ms and 10 b-values (0,10,30,50,75,100,200,400,700,1000s/mm2). Differences between IVIM parameters D (diffusion), and f (fractional perfusion) quantified in the two groups were evaluated using the ANOVA test with Bonferroni correction and linear correlation between IVIM metrics and GA, COVID-19 duration, the delay time between a positive SARS-CoV-2 test and MRI examination (delay-time exam+) was studied by Pearson-test.
Results: D was significantly higher in the COVID-19 placentas compared to that of the age-matched healthy group (p < 0.04 in fetal and p < 0.007 in maternal site). No significant difference between f values was found in the two groups suggesting no-specific microstructural damage with no perfusion alteration (potentially quantified by f) in mild/moderate SARS-Cov-2 placentas. A significant negative correlation was found between D and GA in the COVID-19 placentas whereas no significant correlation was found in the control placentas reflecting a possible accelerated senescence process due to COVID-19.
Discussion: We report impaired microstructural placental development during pregnancy and the absence of perfusion-IVIM parameter changes that may indicate no perfusion changing through microvessels and microvilli in the placentas of pregnancies with mild/moderate SARS-Cov-2 after reaching negativity.
Keywords: Diffusion MRI; IVIM; Microstructural damage; Placenta; SARS-CoV-2.
. 2023 Dec 2:145:38-44.
doi: 10.1016/j.placenta.2023.11.017. Online ahead of print. Diffusion-sensitized magnetic resonance imaging highlights placental microstructural damage in patients with previous SARS-CoV-2 pregnancy infection
Giada Ercolani[SUP] 1 [/SUP], Silvia Capuani[SUP] 2 [/SUP], Alessandra Maiuro[SUP] 3 [/SUP], Veronica Celli[SUP] 1 [/SUP], Robert Grimm[SUP] 4 [/SUP], Daniele Di Mascio[SUP] 5 [/SUP], Maria Grazia Porpora[SUP] 5 [/SUP], Carlo Catalano[SUP] 1 [/SUP], Roberto Brunelli[SUP] 5 [/SUP], Antonella Giancotti[SUP] 5 [/SUP], Lucia Manganaro[SUP] 6 [/SUP]
Affiliations
- PMID: 38052124
- DOI: 10.1016/j.placenta.2023.11.017
Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been a major global health problem since December 2019. This work aimed to investigate whether pregnant women's mild and moderate SARS-CoV-2 infection was associated with microstructural and vascular changes in the placenta observable in vivo by Intravoxel Incoherent Motion (IVIM) at different gestational ages (GA).
Methods: This was a retrospective, nested case-control of pregnant women during the SARS-CoV-2 pandemic (COVID-19 group, n = 14) compared to pre-pandemic healthy controls (n = 19). MRI IVIM protocol at 1.5T was constituted of diffusion-weighted (DW) images with TR/TE = 3100/76 ms and 10 b-values (0,10,30,50,75,100,200,400,700,1000s/mm2). Differences between IVIM parameters D (diffusion), and f (fractional perfusion) quantified in the two groups were evaluated using the ANOVA test with Bonferroni correction and linear correlation between IVIM metrics and GA, COVID-19 duration, the delay time between a positive SARS-CoV-2 test and MRI examination (delay-time exam+) was studied by Pearson-test.
Results: D was significantly higher in the COVID-19 placentas compared to that of the age-matched healthy group (p < 0.04 in fetal and p < 0.007 in maternal site). No significant difference between f values was found in the two groups suggesting no-specific microstructural damage with no perfusion alteration (potentially quantified by f) in mild/moderate SARS-Cov-2 placentas. A significant negative correlation was found between D and GA in the COVID-19 placentas whereas no significant correlation was found in the control placentas reflecting a possible accelerated senescence process due to COVID-19.
Discussion: We report impaired microstructural placental development during pregnancy and the absence of perfusion-IVIM parameter changes that may indicate no perfusion changing through microvessels and microvilli in the placentas of pregnancies with mild/moderate SARS-Cov-2 after reaching negativity.
Keywords: Diffusion MRI; IVIM; Microstructural damage; Placenta; SARS-CoV-2.