Werner Heron, Dos Santos Jorge Lopes, Sá Renato Augusto, Daltro Pedro, Gasparetto Emerson, Marchiori Edson, Campbell Stuart, Araujo Júnior Edward
Department of Radiology, Clínica de Diagnóstico por Imagem (CPDI), Rio de Janeiro, RJ, Brazil.
Instituto Nacional de Tecnologia, Desenho Industrial, Rio de Janeiro, RJ, Brazil.
Arch Gynecol Obstet. 2015 Dec;292(6):1183-4. doi: 10.1007/s00404-015-3891-y. Epub 2015 Sep 28.
Twin-to-twin transfusion syndrome (TTTS) is a serious complication of monochorionic twin gestation, which has a high risk of perinatal morbidity and mortality. Fetoscopic laser photocoagulation of the vascular anastomoses is the preferred treatment. Nowadays, Solomon technique which consists the vascular coagulation of all anastomoses in the placental equator is the preferable method.
To develop a method of virtual fetoscopy by means of ultrasound and resonance magnetic imaging (MRI) scan data to allow the identification of placental equator.
MRI was performed in a twin monochorionic twin pregnancy with 28 weeks previously treated for TTTS with fetoscopic laser photocoagulation. A three-dimensional (3D) file of the placenta was created from overlapping image layers generated by MRI using Mimics software. Virtual fetoscopy allowed adequate visualization of fetuses, umbilical cord insertion and placental equator.
Virtual fetoscopy is a non-invasive technique which allowed adequate identification of placental equator, and it may be an important learning method to novice fetal endoscopic surgeons in TTTS cases.
双胎输血综合征（TTTS）是单绒毛膜双胎妊娠的一种严重并发症，围产期发病率和死亡率风险很高。胎儿镜激光凝固血管吻合术是首选治疗方法。如今，所罗门技术（即对胎盘赤道部所有吻合血管进行凝固）是更可取的方法。
通过超声和磁共振成像（MRI）扫描数据开发一种虚拟胎儿镜检查方法，以识别胎盘赤道部。
对一例28周的单绒毛膜双胎妊娠进行了MRI检查，该孕妇此前接受过胎儿镜激光凝固术治疗TTTS。使用Mimics软件从MRI生成的重叠图像层创建了胎盘的三维（3D）文件。虚拟胎儿镜检查能够充分显示胎儿、脐带插入部位和胎盘赤道部。
虚拟胎儿镜检查是一种无创技术，能够充分识别胎盘赤道部，对于TTTS病例的新手胎儿内镜外科医生来说，它可能是一种重要的学习方法。
