Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Ultrasound Obstet Gynecol. 2018 Sep;52(3):373-377. doi: 10.1002/uog.17535. Epub 2018 Jul 23.
To quantify sonographic placental echogenicity in twin anemia-polycythemia sequence (TAPS) and to correlate it with middle cerebral artery peak systolic velocity (MCA-PSV) measurements.
We performed a retrospective search for consecutive TAPS cases between 16 and 36 weeks of gestation (MCA-PSV > 1.5 multiples of the median (MoM) in the anemic donor and < 1.0 MoM in the polycythemic recipient) in our database of monochorionic twin gestations from January 2007 until December 2016. In cases for which ultrasound images showing the donor's and the recipient's part of the placenta were available, echogenicity for both twins was quantified by image processing. MCA-PSV Doppler values of both fetuses were correlated to their respective placental echogenicity. Placental thickness of both twins was also measured.
Of 756 cases with MCA-PSV measurements identified from the database, 36 (4.8%) had TAPS; of these, 23 had TAPS combined with twin-twin transfusion syndrome and 13 showed isolated TAPS. Placental echogenicity could be quantified in 28 pregnancies. Mean ± SD placental echogenicity of donor twins was significantly higher than that of recipients (138.7 ± 22.8 vs 77.9 ± 37.0; P < 0.0001). Furthermore, a significant positive correlation was found between placental echogenicity and MCA-PSV MoM (R = 0.67, P < 0.0001). Mean placental thickness of donor twins (n = 20) was significantly higher than that of recipients (49.3 mm ± 13.4 vs 25.4 mm ± 10.1; P < 0.0001).
Echogenicity of the placental share in recipient and donor twins with TAPS correlates with MCA-PSV values. Quantification of sonographic placental echogenicity may help to determine the severity of TAPS in monochorionic twins. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
定量分析双胎贫血-多血序列征（TAPS）中胎盘的超声回声强度，并将其与大脑中动脉收缩期峰值速度（MCA-PSV）的测量值相关联。
我们对 2007 年 1 月至 2016 年 12 月期间数据库中单绒毛膜性双胎妊娠的连续 TAPS 病例进行了回顾性搜索，这些病例的 MCA-PSV 值在妊娠 16 至 36 周时大于贫血供体的中位数倍数（MoM）1.5，而小于多血症受体内的 MCA-PSV 值<1.0 MoM。对于可获得显示供体和受体胎盘部分的超声图像的病例，通过图像处理对两个双胞胎的回声强度进行了定量分析。对两个胎儿的 MCA-PSV 值与其各自的胎盘回声强度进行了相关性分析。还测量了两个双胞胎的胎盘厚度。
从数据库中确定了 756 个具有 MCA-PSV 测量值的病例，其中 36 个（4.8%）患有 TAPS；其中 23 个病例合并有双胎输血综合征，13 个病例表现为单纯 TAPS。在 28 例妊娠中可以定量分析胎盘回声强度。供体双胞胎的平均胎盘回声强度明显高于受体双胞胎（138.7 ± 22.8 与 77.9 ± 37.0；P<0.0001）。此外，还发现胎盘回声强度与 MCA-PSV MoM 之间存在显著的正相关关系（R=0.67，P<0.0001）。供体双胞胎（n=20）的平均胎盘厚度明显高于受体双胞胎（49.3 ± 13.4 与 25.4 ± 10.1；P<0.0001）。
TAPS 中受体和供体双胞胎的胎盘回声强度与 MCA-PSV 值相关。定量超声胎盘回声强度可能有助于确定单绒毛膜性双胎妊娠 TAPS 的严重程度。版权所有 © 2017 ISUOG。由 John Wiley & Sons Ltd 出版。
