Division of Maternal-Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Placenta. 2010 Mar;31(3):192-6. doi: 10.1016/j.placenta.2009.12.018. Epub 2010 Jan 8.
Placental vascular sonobiopsy has been proposed for obtaining a representative sample of the placental vascular tree when evaluation of the whole placenta is not feasible. We tested the hypothesis that placental vascular indices from sonobiopsy correlate well with those from the entire placenta.
Three-dimensional power Doppler ultrasound examinations were performed in 120 singleton pregnancies at 11-14 weeks' gestation. The VOCAL program was used to calculate placental vascularization index (VI), flow index (FI) and vascularization flow index (VFI) from stored images of each placenta by whole placenta evaluation and placenta vascular sonobiopsy. The mean of each index from four spherical sonobiopsies were compared to those from evaluation of the entire placenta for their degree of correlation and agreement.
The mean VI and VFI from the two techniques were similar (13.9 [95% CI 12.3-15.8] versus 14.3 [95% CI 12.1-17.0], p = 0.62 and 6.1 [95% CI 5.2-7.1] versus 6.1 [95% CI 5.0-7.4], p = 0.93, respectively) and significantly correlated (Pearson's r = 0.70 [95% CI 0.60-0.78, p < 0.001] and r = 0.69 [95% CI 0.58-0.77, p < 0.001], respectively). The mean FI from the two techniques were significantly different (44.5 [95% CI 42.9-46.1] versus 41.3 [95% CI 39.6-43.0], p = 0.001), but correlated (r = 0.59 [95% CI 0.46-0.70, p < 0.001]).
Our findings suggest that placenta vascular indices from sonobiopsy have a good correlation with those from evaluation of the entire placenta. Sonobiopsy may be a valid alternative for evaluation of the placental vascular tree when visualization of the entire placenta is not feasible. Measurements of VI and VFI appear to be more reliable than FI in sonobiopsy specimen.
当评估整个胎盘不可行时，胎盘血管声活检已被提议用于获取胎盘血管树的代表性样本。我们检验了这样一个假设，即来自声活检的胎盘血管指数与来自整个胎盘的指数密切相关。
对 120 例单胎妊娠 11-14 周的患者进行三维能量多普勒超声检查。使用 VOCAL 程序，通过整个胎盘评估和胎盘血管声活检，计算每个胎盘的胎盘血管化指数（VI）、血流指数（FI）和血管化血流指数（VFI）的存储图像。将来自四个球形声活检的每个指数的平均值与来自整个胎盘评估的平均值进行比较，以评估其相关性和一致性。
两种技术的平均 VI 和 VFI 相似（13.9[95%CI 12.3-15.8]与 14.3[95%CI 12.1-17.0]，p=0.62 和 6.1[95%CI 5.2-7.1]与 6.1[95%CI 5.0-7.4]，p=0.93，分别），且具有显著相关性（Pearson's r=0.70[95%CI 0.60-0.78，p<0.001]和 r=0.69[95%CI 0.58-0.77，p<0.001]，分别）。两种技术的平均 FI 有显著差异（44.5[95%CI 42.9-46.1]与 41.3[95%CI 39.6-43.0]，p=0.001），但具有相关性（r=0.59[95%CI 0.46-0.70，p<0.001]）。
我们的研究结果表明，来自声活检的胎盘血管指数与来自整个胎盘评估的指数具有良好的相关性。当整个胎盘的可视化不可行时，声活检可能是评估胎盘血管树的有效替代方法。VI 和 VFI 的测量在声活检标本中似乎比 FI 更可靠。
