Quantitative MRI in twin-to-twin transfusion syndrome reveals heterogeneity of placental perfusion

Motivation: Twin-to-twin transfusion syndrome (TTTS) is a potential complication in monochorionic twin pregnancies due to uneven blood flow between the twins. Goal(s): To evaluate the placenta in TTTS and to compare blood flow (via IVIM) and relative oxygenation (via T2* mapping) between donor and recipient placental regions. Approach: Anatomical and functional placental imaging was performed at 1.5T. A radiologist evaluated the presence of anatomical abnormalities , and quantitative comparisons of IVIM and T2* in periumbilical donor and recipient placental regions were performed. Results: IVIM showed differences in D* between the donor and recipient placental regions, implying heterogeneous blood flow. Impact: Qualitative and quantitative MRI of the placenta may provide insight into pathologic changes secondary to twin-to-twin transfusion syndrome. Differences in D* may imply variations in microvascular flow in the donor versus recipient placental regions.