Hawkes R A, Patterson A J, Priest A N, Harrison G, Hunter S, Pinney J, Set P, Hilliard N, Graves M J, Smith G C S, Lomas D J
Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, United Kingdom.
Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, United Kingdom.
Placenta. 2016 Jul;43:35-40. doi: 10.1016/j.placenta.2016.04.002. Epub 2016 Apr 6.
The aim of this work was to evaluate whether the uterine arteries (UtA) could be identified and their flow profiles measured during a fetal MRI examination. A comparison was performed against same day sonographic Doppler assessment.
35 normal, healthy, singleton pregnancies at 28-32 weeks gestation underwent routine Doppler examination, followed by MRI examination. The resistivity index (RI) and pulsatility index (PI) of the left and right UtA were measured using phase contrast MRI. Bland Altman statistics were used to compare MRI and ultrasound results.
Sixty-nine comparable vessels were analysed. Six vessels were excluded due to artefact or technical error. Bland-Altman analysis demonstrated the ultrasound indices were comparable, although systematically lower than the MRI indices; Right UtA RI bias -0.03 (95% limits of agreement (LOA) -0.27 to +0.20), and left UtA RI bias -0.06 (95% LOA -0.26 to +0.14); Right UtA PI bias -0.06 (95% LOA -0.50 to +0.38), Left UtA PI bias -0.11 (95% LOA -0.54 to +0.32). The inter-rater agreement for the MRI derived PI and RI analysis was good.
This study demonstrates that in the majority of early third trimester pregnancies, the uterine arteries can be identified, and their flow profiles measured using MRI, and that the derived PI and RI values are comparable with Doppler ultrasound values.
本研究旨在评估在胎儿MRI检查期间能否识别子宫动脉（UtA）并测量其血流情况。同时与同日超声多普勒评估结果进行比较。
35例妊娠28 - 32周的正常、健康单胎妊娠孕妇接受了常规多普勒检查，随后进行MRI检查。使用相位对比MRI测量左右子宫动脉的阻力指数（RI）和搏动指数（PI）。采用Bland Altman统计方法比较MRI和超声检查结果。
共分析了69条可比较的血管。6条血管因伪影或技术误差被排除。Bland - Altman分析表明，超声指数具有可比性，尽管系统性地低于MRI指数；右侧子宫动脉RI偏差为-0.03（95%一致性界限（LOA）为-0.27至+0.20），左侧子宫动脉RI偏差为-0.06（95% LOA为-0.26至+0.14）；右侧子宫动脉PI偏差为-0.06（95% LOA为-0.50至+0.38），左侧子宫动脉PI偏差为-0.11（95% LOA为-0.54至+0.32）。MRI得出的PI和RI分析的评分者间一致性良好。
本研究表明，在大多数孕晚期早期妊娠中，可以识别子宫动脉，并使用MRI测量其血流情况，且得出的PI和RI值与多普勒超声值具有可比性。
