Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA.
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, Orange, CA, USA.
J Ultrasound Med. 2022 Jul;41(7):1623-1632. doi: 10.1002/jum.15841. Epub 2021 Sep 28.
Fetal 2D and 3D fractional limb volume (FLV) measurements by ultrasound can detect fetal lean and subcutaneous mass and possibly percent body fat. Our objectives were to 1) compare FLV measurements in fetuses with fetal growth restriction (FGR) versus small for gestational age (SGA) defined by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG)-supported international Delphi consensus and 2) correlate FLV findings with birth metrics. We hypothesize that FLV measurements will be significantly smaller in FGR versus SGA fetuses and will correlate closer with Ponderal index (PIx) in the neonate than abdominal circumference (AC).
Patients were categorized as FGR or SGA as defined by ISUOG. Total thigh volume (TTV), volumes of lean mass (LMV), and fat mass volume (FMV) were calculated from 3D acquisitions. Measurements were compared between groups and correlated with birthweight (BW) and PIx (BW/crown-heal length).
The FGR group (n = 37) delivered earlier (37/2 versus 38/0; P = .0847), were lighter (2.2 kg versus 2.6 kg; P = .0003) and had lower PIx (0.023 versus 0.025; P = .0013) than SGAs (n = 22). FGRs had reduced TTV (40.6 versus 48.4 cm ; P = .0164), FMV (20.8 versus 25.3 cm ; P = .0413), and LMV (19.8 versus 23.1 cm ; P = .0387). AC had the highest area under the curve (0.69) for FGR. FMV was more strongly associated with PIx than the AC (P = .0032).
The AC and FLV measurements were significantly reduced in FGR fetuses compared to SGAs. While the AC outperformed FLV in predicting FGR, the FLV correlated best with PIx, which holds investigative promise.
通过超声测量胎儿二维和三维肢体体积（FLV）可以检测胎儿瘦组织和皮下组织质量，可能还能检测体脂百分比。我们的目的是：1）比较胎儿生长受限（FGR）和胎龄小于正常（SGA）的胎儿的 FLV 测量值，这些胎儿是通过国际妇产科超声学会（ISUOG）支持的国际德尔菲共识定义的；2）将 FLV 结果与出生指标相关联。我们假设，与 SGA 胎儿相比，FGR 胎儿的 FLV 测量值明显更小，并且与新生儿的体质指数（PIx）比腹围（AC）相关性更好。
患者根据 ISUOG 定义分为 FGR 或 SGA。从 3D 采集数据中计算总大腿体积（TTV）、瘦组织体积（LMV）和脂肪组织体积（FMV）。比较两组间的测量值，并与出生体重（BW）和 Px（BW/头-臀长）相关联。
FGR 组（n=37）更早分娩（37/2 与 38/0；P=0.0847），体重更轻（2.2kg 与 2.6kg；P=0.0003），PIx 更低（0.023 与 0.025；P=0.0013），与 SGA 组（n=22）相比。FGR 组的 TTV（40.6 与 48.4cm；P=0.0164）、FMV（20.8 与 25.3cm；P=0.0413）和 LMV（19.8 与 23.1cm；P=0.0387）均减少。AC 对 FGR 的曲线下面积（AUC）最高（0.69）。FMV 与 PIx 的相关性强于 AC（P=0.0032）。
与 SGA 相比，FGR 胎儿的 AC 和 FLV 测量值显著降低。尽管 AC 在预测 FGR 方面优于 FLV，但 FLV 与 PIx 相关性最好，具有研究潜力。
