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Factors affecting performance of fetal blood T2 measurements for noninvasive estimation of oxygen saturation

Hedström, Erik LU orcid ; Piek, Marjolein LU ; Bidhult-Johansson, Sebastian ; Ryd, Daniel LU ; Testud, Fredrik ; Toger, Johannes LU and Aletras, Anthony LU orcid (2023) In Magnetic Resonance in Medicine 90(6). p.2472-2485
Abstract
Purpose
To ultimately make accurate and precise fetal noninvasive oxygen saturation (sO2) measurements by T2-prepared bSSFP more widely available by systematically assessing error sources in order to potentially reduce perinatal mortality in cardiovascular malformations and fetal growth restriction.

Methods
T2-prepared bSSFP data were acquired in phantoms; in flowing blood in adults in the superior sagittal sinus, ascending and descending aorta, and main pulmonary artery; and in the fetal descending aorta and umbilical vein. T2 was assessed in relation to T2 two- or three-parameter curve-fitting techniques, SSFP readout, refocusing time delay (τ), constant and pulsatile blood flow, and impact of T1 recovery. Further, fetal... (More)
Purpose
To ultimately make accurate and precise fetal noninvasive oxygen saturation (sO2) measurements by T2-prepared bSSFP more widely available by systematically assessing error sources in order to potentially reduce perinatal mortality in cardiovascular malformations and fetal growth restriction.

Methods
T2-prepared bSSFP data were acquired in phantoms; in flowing blood in adults in the superior sagittal sinus, ascending and descending aorta, and main pulmonary artery; and in the fetal descending aorta and umbilical vein. T2 was assessed in relation to T2 two- or three-parameter curve-fitting techniques, SSFP readout, refocusing time delay (τ), constant and pulsatile blood flow, and impact of T1 recovery. Further, fetal T2 and sO2 variability were quantified in the descending aorta and umbilical vein in healthy fetuses and fetuses with cardiovascular malformation (gestational weeks 32–38).

Results
In phantoms, three-parameter fitting was accurate irrespective of phase FOV (
Conclusions
Errors due to T2-fitting techniques, off-resonance, flow velocity, and insufficient T1 recovery between image acquisitions could be mitigated by using three-parameter fitting with included saturation-prepared images approximating infinite T2-preparation time, adequate shimming covering the fetus and placenta, and by modifying acquisition parameters. Variability in fetal blood T2 and sO2, however, indicate that it is currently not feasible to use these methods for prediction of disease. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Magnetic Resonance in Medicine
volume
90
issue
6
pages
2472 - 2485
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:37582228
  • scopus:85168116514
ISSN
1522-2594
DOI
10.1002/mrm.29821
language
English
LU publication?
yes
id
71040fee-6fdb-4e89-9761-70232d195bf8
date added to LUP
2023-10-02 07:55:50
date last changed
2023-10-26 14:45:49
@article{71040fee-6fdb-4e89-9761-70232d195bf8,
  abstract     = {{Purpose<br/>To ultimately make accurate and precise fetal noninvasive oxygen saturation (sO2) measurements by T2-prepared bSSFP more widely available by systematically assessing error sources in order to potentially reduce perinatal mortality in cardiovascular malformations and fetal growth restriction.<br/><br/>Methods<br/>T2-prepared bSSFP data were acquired in phantoms; in flowing blood in adults in the superior sagittal sinus, ascending and descending aorta, and main pulmonary artery; and in the fetal descending aorta and umbilical vein. T2 was assessed in relation to T2 two- or three-parameter curve-fitting techniques, SSFP readout, refocusing time delay (τ), constant and pulsatile blood flow, and impact of T1 recovery. Further, fetal T2 and sO2 variability were quantified in the descending aorta and umbilical vein in healthy fetuses and fetuses with cardiovascular malformation (gestational weeks 32–38).<br/><br/>Results<br/>In phantoms, three-parameter fitting was accurate irrespective of phase FOV (<br/>Conclusions<br/>Errors due to T2-fitting techniques, off-resonance, flow velocity, and insufficient T1 recovery between image acquisitions could be mitigated by using three-parameter fitting with included saturation-prepared images approximating infinite T2-preparation time, adequate shimming covering the fetus and placenta, and by modifying acquisition parameters. Variability in fetal blood T2 and sO2, however, indicate that it is currently not feasible to use these methods for prediction of disease.}},
  author       = {{Hedström, Erik and Piek, Marjolein and Bidhult-Johansson, Sebastian and Ryd, Daniel and Testud, Fredrik and Toger, Johannes and Aletras, Anthony}},
  issn         = {{1522-2594}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{2472--2485}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Magnetic Resonance in Medicine}},
  title        = {{Factors affecting performance of fetal blood T2 measurements for noninvasive estimation of oxygen saturation}},
  url          = {{http://dx.doi.org/10.1002/mrm.29821}},
  doi          = {{10.1002/mrm.29821}},
  volume       = {{90}},
  year         = {{2023}},
}