Li Meizhi, Wang Chaoyang, Yang Yanhong, Mao Lijuan, Chen Jiawen, He Shaofu, Gou Chenyu, Zhang Xiaoling
Department of Radiology, First Affiliated Hospital of Sun-yat Sen University, Guangzhou, People's Republic of China.
Department of Obstetrics, Sixth Affiliated Hospital of Sun-yat Sen University, Guangzhou, People's Republic of China.
Prenat Diagn. 2020 May;40(6):715-723. doi: 10.1002/pd.5672. Epub 2020 Mar 5.
To determine the characteristics of the choriovascular anatomy, especially the potential role of arteriovenous perfusion imbalance in the pathogenesis of selective intrauterine growth restriction (sIUGR) using three-dimensional computed tomography angiography (3D-CTA).
Computed tomography angiography of the placental choriovascular tree from 15 twins with sIUGR and 15 twins without sIUGR were analyzed, and inter-twin vascular anastomoses were compared between the placentas from these two groups. The parameters evaluated were the presence and measures of artery-to-artery anastomoses (AAA), vein-to-vein anastomoses (VVA) or artery-to-vein anastomoses (AVA).
The frequency of AAA, VVA, and AVA did not differ significantly between sIUGR and without sIUGR-pairs. The area of the vein draining to the AVA in the larger twin's placenta was significantly greater in sIUGR compared to when no sIUGR was present. Based on the net cross-sectional area difference we speculate that in sIUGR there is net flow from the smaller to the larger twin.
We used 3D-CTA to display the vascular anastomoses in sIUGR twin pairs, demonstrating a difference in cross-sectional diameter of the vein draining to the AVA.
使用三维计算机断层血管造影（3D - CTA）确定绒毛膜血管解剖结构的特征，尤其是动静脉灌注失衡在选择性胎儿生长受限（sIUGR）发病机制中的潜在作用。
分析了15例患有sIUGR的双胎和15例未患sIUGR的双胎的胎盘绒毛膜血管树的计算机断层血管造影，并比较了这两组胎盘之间的双胎间血管吻合情况。评估的参数包括动脉 - 动脉吻合（AAA）、静脉 - 静脉吻合（VVA）或动脉 - 静脉吻合（AVA）的存在情况和测量值。
sIUGR双胎和未患sIUGR双胎中，AAA、VVA和AVA的发生率无显著差异。与未患sIUGR时相比，sIUGR时较大双胎胎盘中引流至AVA的静脉面积显著更大。基于净横截面积差异，我们推测在sIUGR中存在从较小双胎向较大双胎的净血流。
我们使用3D - CTA展示了sIUGR双胎对中的血管吻合情况，显示出引流至AVA的静脉横截面积存在差异。
