Perfusion and apparent oxygenation in the human placenta (PERFOX)

Jana Hutter, Anita A Harteveld, Laurence H Jackson, Suzanne Franklin, Clemens Bos, Matthias J P van Osch, Jonathan O'Muircheartaigh, Alison Ho, Lucy Chappell, Joseph V Hajnal, Mary Rutherford, Enrico De Vita

Research output: Contribution to journalArticleAcademicpeer-review


PURPOSE: To study placental function-both perfusion and an oxygenation surrogate ( T 2 * )-simultaneously and quantitatively in-vivo.

METHODS: Fifteen pregnant women were scanned on a 3T MR scanner. For perfusion measurements, a velocity selective arterial spin labeling preparation module was placed before a multi-echo gradient echo EPI readout to integrate T 2 * and perfusion measurements in 1 joint perfusion-oxygenation (PERFOX) acquisition. Joint motion correction and quantification were performed to evaluate changes in T 2 * and perfusion over GA.

RESULTS: The optimized integrated PERFOX protocol and post-processing allowed successful visualization and quantification of perfusion and T 2 * in all subjects. Areas of high T 2 * and high perfusion appear to correspond to placental sub-units and show a systematic offset in location along the maternal-fetal axis. The areas of highest perfusion are consistently closer to the maternal basal plate and the areas of highest T 2 * closer to the fetal chorionic plate. Quantitative results show a strong negative correlation of gestational age with T 2 * and weak negative correlation with perfusion.

CONCLUSIONS: A strength of the joint sequence is that it provides truly simultaneous and co-registered estimates of local T 2 * and perfusion, however, to achieve this, the time per slice is prolonged compared to a perfusion only scan which can potentially limit coverage. The achieved interlocking can be particularly useful when quantifying transient physiological effects such as uterine contractions. PERFOX opens a new avenue to elucidate the relationship between maternal supply and oxygen uptake, both of which are central to placental function and dysfunction.

Original languageEnglish
Pages (from-to)549-560
Number of pages12
JournalMagnetic Resonance in Medicine
Issue number2
Publication statusPublished - Feb 2020


  • Arterial Spin Labeling (ASL)
  • perfusion
  • placenta
  • pre‐eclampsia
  • relaxometry
  • velocity‐selective ASL
  • velocity-selective ASL
  • pre-eclampsia


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