摘要
目的通过超声微血管成像技术(microvascular flow imaging,MVFI)评估胎盘微循环情况,并探究胎盘微血管指数(microvascular index,MVI)与胎儿生长发育的关系。方法连续入组2019年10-11月在北京协和医院常规就诊或自外院转诊的孕24-34周生长受限(fetal growth restriction,FGR)胎儿7例,按照1∶2孕周配比相同时期内正常胎儿14例作为对照组,共计21例纳入研究。应用二维超声测量胎儿生长参数及预估胎儿体重,观察胎盘回声并测量厚度;应用彩色多普勒血流显像评估子宫动脉搏动指数(uterine artery pulse index,UtA-PI)、大脑中动脉搏动指数(middle cerebral artery pulse index,MCA-PI)和脐动脉S/D。采用MVFI显示胎盘血流,并测量微血管指数。结果采用MVFI观察对照组(14例)和FGR组(7例)胎盘,与对照组相比,FGR组胎盘常表现为增厚、回声不均,MVI下降,UtA-PI可出现增高。两组胎儿胎盘平均MVI差异有统计学意义(P=0.044)。此外,随着胎盘厚度的增加,该处MVI数值整体呈下降趋势,但相关性差异无统计学意义(rs=-0.35,P=0.065)。MVI对于FGR的诊断具有更高的特异性(100%)。结论MVFI可以敏感地显示胎盘微循环情况,为胎盘灌注的定量评估提供了一种直接、简便的检查手段。
Objective To evaluate the placental micro-vascular circulation by microvascular flowing imaging(MVFI)method,and to explore the clinical value of microvascular index(MVI)for the diagnosis of fetal growth restriction(FGR).Methods A total of 21 fetuses at 24-34 weeks of gestation at the Peking Union Medical College Hospital from October to November 2019 were enrolled in this study,including 7 fetal growth restriction(FGR)fetuses,and 14 normal fetuses as control group.The fetuses of the two groups were matched according to the gestational weeks at the ratio of 1∶2.Fetal biometry parameters were measured and the placenta was observed by two-dimensional ultrasound.Uterine artery pulse index(UtA-PI),middle cerebral artery pulse index(MCA-PI),and umbilical artery S/D ratio were evaluated by color and pulse-wave Doppler.The placenta mico-circulation was displayed by the MVFI method and MVI was measured.Results The study included 14 normal fetuses and 7 FGR fetuses.Compared with the control group,more placenta in the FGR group manifested as thickened and heterogeneous with decreased MVI and increased UtA-PI.There was statistically significant difference in placental mean MVI between two groups(P=0.044).Besides,a trend towards significant negative correlation was observed between MVI and placenta thickness,although this was not statistically significant(rs=-0.35,P=0.065).MVI had a higher specificity(100%)in the prediction of FGR.Conclusions MVFI can display the micro-circulation of the placenta,and provide a direct and quantitative assessment method for placental perfusion.
作者
牛梓涵
张培培
武玺宁
姜玉新
欧阳云淑
孟华
Niu Zihan;Zhang Peipei;Wu Xining;Jiang Yuxin;Ouyang Yunshu;Meng Hua(Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2021年第8期691-696,共6页
Chinese Journal of Ultrasonography
基金
北京协和医院青年基金(pumch201911591)。
关键词
超声检查
微血管成像
胎盘
胎儿生长受限
Ultrasonography
Microvascular flowing imaging
Placenta
Fetal growth restriction
