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应用离体应变弹性成像技术比较正常妊娠与胎儿宫内生长受限的胎盘弹性。

Comparison of placental elasticity in normal and intrauterine growth retardation pregnancies by ex vivo strain elastography.

机构信息

Perinatology Department, Training and Research Hospital, Etlik Zubeyde Hanim Women's Health Care, Ankara, Turkey.

出版信息

Arch Gynecol Obstet. 2020 Jul;302(1):109-115. doi: 10.1007/s00404-020-05596-1. Epub 2020 May 19.

Abstract

OBJECTIVE

To compare the placental elasticity in fetuses with or without intrauterine growth restriction (IUGR).

MATERIALS AND METHODS

One hundred pregnant women (50 IUGR and 50 healthy) with anteriorly located placenta were evaluated during the third trimester of pregnancy. Measurements were carried out by a machine that has a real-time elastographic ultrasonography feature. After obtaining the optimum image, three areas (subcutaneous tissue, center, and the edge of the placenta) were provided to identify the placental strain values. Then, the placental strain ratio (PSR) value was calculated automatically. Two groups compared in terms of their PSR values.

RESULTS

There was a significant difference in placental elasticity between the groups (P < 0.001). PSR value was 2.8 ± 1.2 in the IUGR group and 1.3 ± 0.6 in the control group. A PSR value of 1.78 had an 86% sensitivity (OR 4.3) and 80% specificity (OR 0.17) in IUGR cases. The positive predictive value was 81.1% and the negative predictive value was 85.1% for this cut-off value.

CONCLUSIONS

We have shown that placental strain ratio is increased during the third trimester of pregnancy in fetuses with IUGR. Increased stiffness and elasticity may be responsible for the onset of IUGR in some cases.

摘要

目的

比较胎儿有无宫内生长受限(IUGR)时的胎盘弹性。

材料与方法

在妊娠晚期,评估了 100 名前位胎盘的孕妇(50 例 IUGR 和 50 例健康)。使用具有实时弹性超声成像功能的机器进行测量。获得最佳图像后,提供三个区域(皮下组织、胎盘中心和边缘)来识别胎盘应变值。然后,自动计算胎盘应变比(PSR)值。比较两组的 PSR 值。

结果

两组胎盘弹性存在显著差异(P<0.001)。IUGR 组的 PSR 值为 2.8±1.2,对照组为 1.3±0.6。PSR 值为 1.78 时,对 IUGR 病例的敏感性为 86%(OR 4.3),特异性为 80%(OR 0.17)。该截断值的阳性预测值为 81.1%,阴性预测值为 85.1%。

结论

我们表明,在 IUGR 胎儿的妊娠晚期,胎盘应变比增加。在某些情况下,僵硬度和弹性的增加可能是 IUGR 发病的原因。

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