Kanahashi Tohoru, Yamada Shigehito, Tanaka Mire, Hirose Ayumi, Uwabe Chigako, Kose Katsumi, Yoneyama Akio, Takeda Tohoru, Takakuwa Tetsuya
Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, 2606-8501, Japan.
Congenital Anomaly Research Center, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, 606-8501, Japan.
Anat Rec (Hoboken). 2016 Jan;299(1):8-24. doi: 10.1002/ar.23281. Epub 2015 Nov 5.
The cause of spontaneous abortion of normal conceptuses remains unknown in most cases. The study was aimed to reveal the latent abnormalities by using a large collection of embryo images from a magnetic resonance imaging (MRI) database and novel phase-contrast radiographic computed tomography (PXCT). MRI from 1,156 embryos between Carnegie stage (CS) 14 and CS23 from the Kyoto Collection were screened by using the volume of the liver as the target organ. Embryos with liver volumes ≥2 SD above or below the mean for the stage of development were screened and examined precisely on MRI. Embryos with potentially abnormal livers were further analyzed by using PXCT. Liver abnormality was detected in all 7 embryos in the extra-small liver group and in 2 of 8 embryos in the extra-large liver group. The abnormalities in the extra-small liver group consisted of hepatic agenesis (2 embryos), hepatic hypogenesis (4), and liver lobe defect (1). Among the 7 extra-small liver group, 2 had only liver abnormalities and 5 exhibited complications in other organs. Of the 2 embryos in the extra-large liver group, one had only a single liver abnormality and the other had a morphologically abnormal liver with complications in other organs. Most of such liver abnormality cases are not survive, as liver function becomes essential. The prevalence of liver malformations in CS18 and CS21 in the intrauterine population of externally normal embryos is approximately 1.7%. The present study is the first step toward the elucidation of the latent abnormalities resulting in spontaneous abortion in externally normal embryos.
在大多数情况下,正常胚胎自然流产的原因尚不清楚。本研究旨在通过使用来自磁共振成像(MRI)数据库的大量胚胎图像和新型相衬射线计算机断层扫描(PXCT)来揭示潜在的异常情况。以肝脏体积作为目标器官,对京都胚胎库中卡内基阶段(CS)14至CS23的1156个胚胎的MRI图像进行筛选。筛选出发育阶段肝脏体积高于或低于平均水平≥2个标准差的胚胎,并对其进行精确的MRI检查。对肝脏可能存在异常的胚胎进一步使用PXCT进行分析。在肝脏体积过小的7个胚胎中均检测到肝脏异常,在肝脏体积过大的8个胚胎中有2个检测到肝脏异常。肝脏体积过小组的异常包括肝缺如(2个胚胎)、肝发育不全(4个)和肝叶缺损(1个)。在肝脏体积过小的7个胚胎中,2个仅存在肝脏异常,5个在其他器官出现并发症。在肝脏体积过大的2个胚胎中,1个仅有单一的肝脏异常,另1个肝脏形态异常且伴有其他器官并发症。由于肝功能至关重要,大多数此类肝脏异常病例无法存活。在外观正常的胚胎子宫内群体中,CS18和CS21阶段肝脏畸形的发生率约为1.7%。本研究是朝着阐明外观正常胚胎自然流产潜在异常迈出的第一步。