Nguyen Christopher D, Correia-Branco Ana, Adhikari Nimish, Mercan Ezgi, Mallidi Srivalleesha, Wallingford Mary C
Tufts University, Department of Biomedical Engineering, 4 Colby St, Medford, MA 02155.
Tufts Medical Center, Mother Infant Research Institute, 800 Washington Street Box #394, Boston, MA 02111.
EMJ Radiol. 2020 Sep;1(1):54-62. doi: 10.33590/emjradiol/19-00210.
The placenta is a highly vascularized organ with unique structural and metabolic complexities. As the primary conduit of fetal support, the placenta mediates transport of oxygen, nutrients, and waste between maternal and fetal blood. Thus, normal placenta anatomy and physiology is absolutely required for maintenance of maternal and fetal health during pregnancy. Moreover, impaired placental health can negatively impact offspring growth trajectories as well as increase the risk of maternal cardiovascular disease later in life. Despite these crucial roles for the placenta, placental disorders, such as preeclampsia, intrauterine growth restriction (IUGR), and preterm birth, remain incompletely understood. Effective noninvasive imaging and image analysis are needed to advance the obstetrician's clinical reasoning toolkit and improve the utility of the placenta in interpreting maternal and fetal health trajectories. Current paradigms in placental imaging and image analysis aim to improve the traditional imaging techniques that may be time-consuming, costly, or invasive. In concert with conventional clinical approaches such as ultrasound (US), advanced imaging modalities can provide insightful information on the structure of placental tissues. Herein we discuss such imaging modalities, their specific applications in structural, vascular, and metabolic analysis of placental health, and emerging frontiers in image analysis research in both preclinical and clinical contexts.
胎盘是一个高度血管化的器官,具有独特的结构和代谢复杂性。作为胎儿支持的主要通道,胎盘介导母体和胎儿血液之间氧气、营养物质和废物的运输。因此,正常的胎盘解剖结构和生理功能对于孕期维持母体和胎儿健康绝对必要。此外,胎盘健康受损会对后代的生长轨迹产生负面影响,并增加母体日后患心血管疾病的风险。尽管胎盘具有这些关键作用,但诸如子痫前期、宫内生长受限(IUGR)和早产等胎盘疾病仍未被完全理解。需要有效的非侵入性成像和图像分析来完善产科医生的临床推理工具,并提高胎盘在解读母体和胎儿健康轨迹方面的效用。胎盘成像和图像分析的当前范式旨在改进可能耗时、昂贵或具有侵入性的传统成像技术。与超声(US)等传统临床方法相结合,先进的成像方式可以提供有关胎盘组织结构的有见地的信息。在此,我们讨论此类成像方式、它们在胎盘健康的结构、血管和代谢分析中的具体应用,以及临床前和临床环境中图像分析研究的新兴前沿领域。