Standard diffusion-weighted, diffusion kurtosis and intravoxel incoherent motion MR imaging of the whole placenta: a pilot study of volumetric analysis

Background: Using magnetic resonance imaging (MRI) to explore the changes in microvascular perfusion fraction and the heterogeneity of the placenta during pregnancy. Methods: We retrospectively reviewed 24 patients with normal pregnancies who underwent standard diffusion-weighted, diffusion kurtosis, and intravoxel incoherent motion MRI. The mean, minimum and maximum parameters including the apparent diffusion coefficient (ADC) and exponential ADC (eADC) from standard diffusion-weighted imaging (DWI), the diffusion coefficient (MD) and diffusion kurtosis (MK) from diffusion kurtosis imaging (DKI), and the pure diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f) from intravoxel incoherent motion MR imaging (IVIM) were calculated from the whole placenta volumetric analysis and correlated with gestational age (GA) and volume of the placenta. Results: A significant positive correlation was found between eADC mean, eADC max, MK mean, MK max, the volume of the whole placenta, and GA, and a negative correlation was found between ADC mean, ADC min, MD min, D mean, D min, D* min and GA. The f mean and MK max values positively correlated with the volume of the whole placenta. Conclusions: eADC mean, eADC max, MK mean, MK max values increased with GA, while ADC mean, ADC min, MD min, D mean, D min, D* min decreased with GA. Secondly, the f mean and MK max also increased with placental volume. These results suggest the potential of diffusion and perfusion parameters to evaluate the placenta during its development using different DWI models.