A. S. Kierans¹, G. L. Bennett¹, T. C. Mussi¹, J. S. Babb¹, H. Rusinek¹, J. Melamed², and A. B. Rosenkrantz^1
1Radiology, NYU Langone Medical Center, New York, NY, United States, ²Pathology, NYU Langone Medical Center, New York, NY, United States

37 patients with an adnexal mass underwent pelvic MRI including DWI before resection. We evaluated performance of mean ADC, ADC entropy, and subjective interpretation of two radiologists using DWI in discriminating benign and malignant adnexal lesions. Malignant lesions demonstrated significantly higher ADC entropy than benign lesions but no significant difference in mean ADC. Accuracy of ADC entropy was similar to that of the less experienced reader. However, the more experienced reader’s accuracy was greater than that of all other assessments. We conclude ADC entropy may serve as a useful quantitative metric for ovarian lesion evaluation, particularly for less experienced readers.

Jennifer W Chong¹, Natalie Yang², Sarah J Jenkins³, Errol Colak¹, Shalini Anthwal¹, Andrew A Common¹, Vikram Prabhudesai¹, and Anish Kirpalani^1
1Department of Medical Imaging, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada, ²Department of Radiology, Austin Health, Heidelberg, Australia, ³Department of Diagnostic Imaging, Memorial University, St. John's, NL, Canada

A decrease in uterine fibroid enhancement on pelvic MRI is routinely used to monitor patients' response to uterine fibroid embolization (UFE). In this prospective cohort study of 50 patients (88 uterine fibroids), we examined whether the ADC from diffusion-weighted MRI also changed post-UFE. We found a statistically significant rise in the mean ADC of fibroids post-UFE. We also found that fibroids which have more residual contrast enhancement post-UFE had a higher pre-UFE ADC. ADC may therefore have a clinically important role in predicting treatment response.

Xiaoduo Yu¹, Yan Chen¹, Meng Lin¹, Han Ouyang¹, and Chunwu Zhou^1
1Department of Diagnostic Radiology, Cancer Hospital & Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, beijing, beijing, China

DWI could measure microscopic diffusion of water molecules and has the utility to evaluate the state of endometrium in physiology and pathology quantitatively. Difference among ADC value of endometrial carcinoma and normal endometrium of childbearing women in different menstrual cycle would be helpful in the diagnosis of endometrial carcinoma.

Ye Li¹, Yong Pang¹, Daniel Vigneron^1,2, Orit Glenn¹, Duan Xu¹, and Xiaoliang Zhang^1,2
1Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States, ²UCSF/UC Berkeley Joint Graduate Group in Bioengineering, San Francisco, CA, United States

In this work, we aim to evaluate parallel imaging performance of a 32 channel fetal array for fetal MRI at 1.5T. The gradient-echo image intensity of each coil element was calculated based on electromagnetic field distribution of each element. GRAPPA reconstructed images with different acceleration factors were carried out by using PULSAR toolbox. We studied the proposed flexible 32-channel array and compared with a commercial available 8-channel torso array that is routinely used in clinical fetal imaging. Our results show that the proposed fetal array improves parallel imaging performance for fetal MRI in terms of Artifact Power (AP) and image intensity.

Isaac Huen^1,2, David M. Morris^1,2, Caroline Wright³, Colin P. Sibley³, Edward Johnstone³, and Josephine H. Naish^1,2
1Imaging Sciences and Biomedical Engineering, University of Manchester, Manchester, United Kingdom, ²The University of Manchester Biomedical Imaging Institute, University of Manchester, Manchester, United Kingdom, ³Maternal & Fetal Health Research Centre, University of Manchester, Manchester, United Kingdom

Preeclampsia and Fetal Growth Restriction are common pregnancy complications thought to be caused by a compromised placental phenotype. This may affect placental oxygen delivery, for which there is little previously obtained data. Oxygen-Enhanced MRI (OE-MRI) measures ΔR₁ (R₁ = 1/T₁) which increases when dissolved molecular oxygen concentration rises. Blood Oxygen Level Dependent (BOLD) MRI measures ΔR₂* (R₂*= 1/T₂*) which decreases when deoxyhemoglobin concentration falls. OE-MRI and BOLD results are obtained in 10 pregnant subjects between breathing of medical air and 100% oxygen. Significant R₁ increases and R₂* decreases suggest oxygen delivery to the placenta has been observed in normal pregnancy.

David M Morris^1,2, Caroline Wright³, Mark S Dobbs^1,2, Philip N Baker⁴, Ian P Crocker³, Penny A Gowland⁵, Sue T Francis⁵, Colin P Sibley³, and Geoff JM Parker^1,2
1Imaging Sciences, University of Manchester, Manchester, United Kingdom, ²Biomedical Imaging Institute, University of Manchester, Manchester, United Kingdom, ³Maternal and Fetal Health Research Group, University of Manchester, Manchester, United Kingdom, ⁴Department of Physiology, University of Alberta, Edmonton, Alberta, Canada, ⁵Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, Nottingham, United Kingdom

Disruptions in placental morphology lead to impaired function that increases the risk of perinatal mortality and morbidity. Flow-sensitive Alternating Inversion Recovery Arterial Spin Labelling has been applied to investigate the flow characteristic of the placenta. Analysis was carried out to determine the robustness of results generated and clinical applicability. Nine human placentas in normal pregnancies were scanned in the third trimester. These results show the applicability of the technique, its potential to categorize the inhomogeneity of flow in the placenta on a voxel by voxel level, and good agreement with perfusion values using other methodologies.

Devasuda Anblagan¹, Nia W Jones², Alexander J Parker³, George Bugg², Carolyn Costigan¹, Ruta Deshpande², Lucy Coyne⁴, Rosanne Aleong⁵, Neil Roberts⁶, Zdenka Pausova^7,8, Nick Raine Fenning⁹, Tomas Paus^5,10, and Penny A Gowland^1
1Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, Nottingham, Nottinghamshire, United Kingdom, ²Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire, United Kingdom, ³University of Aberdeen, Aberdeen, United Kingdom, ⁴Liverpool Women's Hospital, Liverpool, United Kingdom, ⁵Rotman Research Institute, University of Toronto, Toronto, Ontario, Canada, ⁶Clinical Research and Imaging Centre, Queens Medical Research Institute, Edinburgh, United Kingdom, ⁷Research Institute of the Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada, ⁸Universite de Montreal, Montreal, Quebec, Canada, ⁹School of Clinical Sciences, University of Nottingham, United Kingdom, ¹⁰School of Psychology, University of Nottingham, United Kingdom

Cigarette smoke contains two main compounds: carbon monoxide and nicotine; both cross the placenta into the fetus where they reach levels exceeding those found in the maternal circulation. This has been associated with miscarriage, placenta abruption, placenta praevia, low birth weight and perinatal mortality. In the long-term, maternal smoking during pregnancy appears to increase the probability of respiratory disorders, obesity and behavioral problems. This work studies the effect of maternal smoking on the growth of fetal organs and shows that fetal lungs, kidneys and brain volumes are reduced by maternal smoking during pregnancy.

Reut Avni¹, Tal Raz¹, Joel Garbow², and Michal Neeman^1
1Biological Regulation, Weizmann Institute of Sceince, Rehovot, Israel, ²Biomedical MR Laboratory, Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, United States

The study presented here examines whether natural occurring deaths, as well as genetic manipulation to create targeted defects in placental function (PKBá/ Akt1-/- fetuses), affect placental perfusion and maternal blood volume in adjacent (normal) fetuses at late-gestation, as measured by in vivo Bi-Directional Arterial Spin Labeling (BD-ASL) MRI and ex vivo fluorescence microscopy, respectively. The ability to noninvasively determine fetal location along the uterine horn using BD-ASL method opens possibilities for determining and pursuing phenotypic alterations in genetic, as well as developmental, longitudinal studies. These data suggest in systems of multiple fetuses within one uterus there may exist communication mechanisms (e.g. hydrodynamic)

Felix Victor Guettler¹, Andreas Heinrich¹, Christian Bamberg², Jens Rump¹, Bernhard Schnackenburg³, Maximilian de Bucourt¹, Andreas Thomas¹, Bernd Hamm¹, and Ulf Teichgraeber^1
1Department of Radiology, Charité - University Hospital Berlin, Berlin, Berlin, Germany, ²Department of Obstetrics, Charité - University Hospital Berlin, Berlin, Berlin, Germany, ³Philips Medical Systems, Hamburg, Germany

The aim of this study was the visualization of the active second stage of vaginal delivery in real-time through an open magnetic resonance imager complying with modern safety standards in obstetrics. For this purpose an MR-compatible cardiotocograph (CTG) was developed. With some pregnant probands, a suitable birth position and a dynamic MR-sequence was designed. The demonstration of the fetal and maternal organs occurred with an interactive single-shot TSE sequence, which was also able to compensate eventual image artifacts of mother and child. The real-time representation of the human expulsive phase via open MRI allows further research of birth complication and birth defects, but is also suitable for birth simulations.