Macnaught Gillian, Gray Calum, Walker Jane, Simpson Mary, Norman Jane, Semple Scott, Denison Fiona
Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK.
Simpson Centre for Reproductive Health, Royal Infirmary, Edinburgh, UK.
NMR Biomed. 2015 Oct;28(10):1275-82. doi: 10.1002/nbm.3370. Epub 2015 Aug 27.
The placenta is a temporary organ that is essential for a healthy pregnancy. It performs several important functions, including the transport of nutrients, the removal of waste products and the metabolism of certain substances. Placental disorders have been found to account for over 50% of stillbirths. Despite this, there are currently no methods available to directly and non-invasively assess placental function in utero. The primary aim of this pilot study was to investigate the use of (1)H MRS for this purpose. (1)H MRS offers the possibility to detect several placental metabolites, including choline, lipids and the amino acids glutamine and glutamate (Glx), which are vital to fetal development and placental function. Here, in utero placental spectra were acquired from nine small for gestational age (SGA) pregnancies, a cohort who are at increased risk of perinatal morbidity and mortality, and from nine healthy gestation-matched pregnancies. All subjects were between 26 and 39 weeks of gestation. Placenta Glx, choline and lipids at 1.3 and 0.9 ppm were quantified as amplitude ratios to that of intrinsic H2O. Wilcoxon signed rank tests indicated a significant difference in Glx/H2O (p = 0.024) between the two groups, but not in choline/H2O (p = 0.722) or in either lipid/H2O ratio (1.3 ppm, p = 0.813; 0.9 ppm, p = 0.058). This study has demonstrated that (1)H MRS has potential for the detection of placental metabolites in utero. This warrants further investigation as a tool for the monitoring of placental function.
胎盘是一个对健康妊娠至关重要的临时器官。它执行多种重要功能，包括营养物质的运输、废物的清除以及某些物质的代谢。已发现胎盘疾病占死产的50%以上。尽管如此，目前尚无直接且无创地评估子宫内胎盘功能的方法。这项初步研究的主要目的是调查利用氢质子磁共振波谱（¹H MRS）来实现这一目的的可行性。¹H MRS能够检测多种胎盘代谢物，包括胆碱、脂质以及对胎儿发育和胎盘功能至关重要的氨基酸谷氨酰胺和谷氨酸（Glx）。在此，从9例小于胎龄（SGA）妊娠（这一组围产期发病率和死亡率风险增加）以及9例与之孕周匹配的健康妊娠中获取子宫内胎盘波谱。所有受试者的孕周均在26至39周之间。将胎盘在1.3和0.9 ppm处的Glx、胆碱和脂质定量为与内源性H₂O的幅度比。Wilcoxon符号秩检验表明两组之间Glx/H₂O存在显著差异（p = 0.024），但胆碱/H₂O无显著差异（p = 0.722），两种脂质/H₂O比值（1.3 ppm，p = 0.813；0.9 ppm，p = 0.058）也无显著差异。这项研究表明¹H MRS在子宫内检测胎盘代谢物方面具有潜力。作为监测胎盘功能的工具，这值得进一步研究。
