Magnetic resonance imaging of the placenta in intrauterine fetal growth restriction

S. Kalpana, H. Iyengeran, Ravi ., Malathy ., R. Karthick


Intrauterine growth restriction occurs when the foetus fails to attain its genetically determined potential size. The present study was carried out to test the hypothesis that placental MR morphology and signal intensity measurements could differentiate between normal placentas and placentas in early or late intrauterine growth restriction. Normal and growth restricted foetuses were studied by Ultrasound and MRI at varying weeks of gestation. 98 growth restricted foetuses and 61 normal foetuses were included in the study. Ultrasound was done on a Siemens Antares ultrasound machine and MRI on a Siemens 1.5 Tesla system. Data was collected pertaining to gestational age, foetal weight and placental appearance by Ultrasound and MRI. Post processing signal intensity measurements of placenta were obtained. Echogenic cysts and echogenic cotyledons were seen more frequently in the placenta of IUGR foetuses by ultrasound. Globoid appearance of placenta in MRI denoted IUGR (p< .005).Placental signal intensity calculated by Region of Interest (ROI) showed a decline in normal pregnancies with advancing gestational age and significant difference between normal and IUGR placentas. Significant difference was found in T2 weighted Amniotic Fluid/Placental signal intensity ratios between normal and growth restricted pregnancies. MR evaluation of the placenta provides significant contribution towards assessment of IUGR placentas. Evaluation of the placenta should be done in any antenatal MRI study and MRI may play a role in future in management of Placental insufficiency.


Keywords: Placenta, Intrauterine growth restriction, Placental MRI, Placental signal intensity

Full Text:



Krishna Usha, Bhalerao Sarita. Placental insufficiency and foetal growth restriction. The Journal of Obstetrics and Gynecology of India September–October 2011;61(5):505–511.

Kady S, Gardosi J. Perinatal mortality and foetal growth restriction. Best Pract Res Clin Obstet Gynaecol 2004;18:397-410.

Chatelain P. Children born with intra-uterine growth retardation (iugr) or small for gestational age (sga): Long term Growth and metabolic consequences. Endocrine regulations 2000;33:36.

Grannum Pat, Berkowitz RL, Hobbins JC. The ultrasonic changes in the maturing placenta and their relation to foetal pulmonic maturity. Am J ObstetGynecol 1979;133:915.

Turan OM, Turan S, Gungor S, et al. Progression of Doppler abnormalities in intrauterine growth restriction. Ultrasound ObstetGynecol 2008;32:160-7.

Crispi F, Dominguez C, Llurba E, Martin- Gallan P, Cabero L, Gratacos E. Placental angiogenic growth factors and uterine artery Do ppler findings for characterization of different subsets in preeclampsia and in isolated intrauterine growth restriction. Am J ObstetGynecol 2006;195:201-7.

Romo A, Carceller R, Tobajas J. Intrauterine growth retardation (IUGR): epidemiology and etiology. PediatrEndocrinolRev 2009; 6Suppl 3:332-336.

MeghanaToal,Vandana Chadda, Rory Windrim et al.Ulrasound detection of Placental Insufficiency in Women with Elevated Second Trimester Serum Alpha Protein or Human Chorionic Gonadotropin. JOGC March 2008, 198206.

Damodaram M, Story L, Eixarch E. Placental MRI in foetal growth restriction. Placenta. 2010;31(6):491–8.

LinduskaN,DekanS,MesserschmidtA,KasprianG,BruggerPC,ChalubinskiK, et al.PlacentalpathologiesinfoetalMRIwithpathohistologicalcorrelation. Placenta 2009;30:555e9.

Blaicher W, Brugger PC, Mittermayer C, Schwindt J, Deutinger J, Bernaschek G, et al. Magnetic resonance imaging of the normal placenta. Eur J Radiol 2006;57:256–260.