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[胎盘三维多普勒血管造影术:当前及未来应用]

[Placental 3D Doppler angiography: current and upcoming applications].

作者信息

Duan J, Perdriolle-Galet E, Chabot-Lecoanet A-C, Callec R, Beaumont M, Chavatte-Palmer P, Tsatsaris V, Morel O

机构信息

IADI, université de Lorraine, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France; Inserm U947, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France.

IADI, université de Lorraine, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France; Inserm U947, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France; Pôle de la femme, service d'obstétrique et médecine fœtale, centre hospitalier universitaire de Nancy, 10, rue Heydenreich, 54000 Nancy, France.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2015 Feb;44(2):107-18. doi: 10.1016/j.jgyn.2014.09.007. Epub 2014 Oct 11.

Abstract

The placental dysfunction, which seems to be caused by a defect of trophoblastic invasion and impaired uterine vascular remodeling since the first trimester, is responsible in a non-exclusive way for the chronic placental hypoxia, resulting secondarily in the intra-uterine growth restriction (IUGR) and/or pre-eclampsia (PE). The quality of utero-placental vasculature is essential for a proper fetal development and a successful progress of pregnancy. However, the in vivo assessment of placental vascularization with non-invasive methods is complicated by the small size of placental terminal vessel and its complex architecture. Moreover, imaging with contrast agent is not recommended to pregnant women. Until recently, the fetal and maternal vascularization could only be evaluated through pulse Doppler of uterine arteries during pregnancy, which has little clinical value for utero-placental vascularization defects assessment. Recently, a non-invasive study, without use of contrast agent for vasculature evaluation of an organ of interest has become possible by the development of 3D Doppler angiography technique. The objective of this review was to make an inventory of its current and future applications for utero-placental vasculature quantification. The main findings of the literature on the assessment of utero-placental vascularization in physiological situation and major placental vascular dysfunction pathologies such as PE and IUGR were widely discussed.

摘要

胎盘功能障碍似乎自孕早期起就由滋养层侵入缺陷和子宫血管重塑受损所致,它并非唯一导致慢性胎盘缺氧的原因,继而引发宫内生长受限(IUGR)和/或先兆子痫(PE)。子宫胎盘血管系统的质量对于胎儿的正常发育和妊娠的顺利进展至关重要。然而,由于胎盘末梢血管尺寸小且结构复杂,采用非侵入性方法对胎盘血管化进行体内评估很复杂。此外,不建议对孕妇使用造影剂成像。直到最近,孕期只能通过子宫动脉脉冲多普勒评估胎儿和母体的血管化情况,这对于子宫胎盘血管化缺陷评估的临床价值不大。近来,随着三维多普勒血管造影技术的发展,不使用造影剂对感兴趣器官的血管系统进行评估的非侵入性研究已成为可能。本综述的目的是梳理其在子宫胎盘血管系统定量方面的当前及未来应用。文中广泛讨论了关于生理状态下子宫胎盘血管化评估以及诸如PE和IUGR等主要胎盘血管功能障碍病理情况的文献主要发现。

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