Denbow M L, Eckersley R, Welsh A W, Taylor M J, Carter R C, Cosgrove D O, Fisk N M
Centre for Fetal Care, Institute of Obstetrics and Gynaecology, Imperial College School of Medicine, Queen Charlotte's and Chelsea Hospital, London, United Kingdom.
Am J Obstet Gynecol. 2000 Apr;182(4):966-71. doi: 10.1016/s0002-9378(00)70355-3.
The aim of this study was to delineate placental vasculature with the microbubble contrast agent Levovist (99.9% galactose and 0.1% palmitic acid; Schering AG, Berlin, Germany), with the ultimate goal of delineating placental vascular anatomy in utero.
A placental lobule from each of 11 term human placentas was perfused on the fetal side of the circulation under physiologic conditions. Randomly assigned dose-concentration combinations of Levovist were administered through a chorionic artery into the corresponding placental lobule, and the resultant echoenhancement with power Doppler imaging was recorded for digital analysis. Interplacental variability was corrected for by averaging the results of three injections at each dose-concentration combination.
Echoenhancement was seen at all dose-concentration combinations in the injected lobule but not in adjacent control lobules. The three dose-concentration combinations that achieved optimal maximal integrated intensity and duration of action for both chorionic vessel and villus enhancement were 100 microL/kg of 400-mg/mL Levovist, 200 microL/kg of 400-mg/mL Levovist, and 400 microL/kg of 200-mg/mL Levovist.
Microbubble contrast injection into the fetal vasculature enabled power Doppler imaging echoenhancement both in chorionic vessels and within the villus tree. We speculate that fetal injection of contrast agent may be applied to the delineation of placental lesions or areas of interfetal transfusion, although its applicability will be hindered by the need for fetal blood sampling.
本研究旨在利用微泡造影剂Levovist（99.9%半乳糖和0.1%棕榈酸；德国柏林先灵公司）描绘胎盘血管系统，最终目标是在子宫内描绘胎盘血管解剖结构。
在生理条件下，对11个足月人胎盘的每个胎盘小叶进行胎儿侧循环灌注。将随机分配的Levovist剂量 - 浓度组合通过绒毛膜动脉注入相应的胎盘小叶，并记录功率多普勒成像产生的回声增强，以便进行数字分析。通过对每个剂量 - 浓度组合的三次注射结果进行平均来校正胎盘间的变异性。
在注入的小叶中，所有剂量 - 浓度组合均可见回声增强，而相邻的对照小叶中未见。对于绒毛膜血管和绒毛增强，实现最佳最大积分强度和作用持续时间的三个剂量 - 浓度组合分别为400 mg/mL Levovist 100 μL/kg、400 mg/mL Levovist 200 μL/kg和200 mg/mL Levovist 400 μL/kg。
向胎儿血管系统注射微泡造影剂可使绒毛膜血管和绒毛树内的功率多普勒成像回声增强。我们推测，向胎儿注射造影剂可用于描绘胎盘病变或胎儿间输血区域，尽管其适用性会因需要采集胎儿血样而受到阻碍。
