Placental oxygen transport estimated by the hyperoxic placental BOLD MRI response.
Placental oxygen transport estimated by the hyperoxic placental BOLD MRI response.
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DOI：
10.14814/phy2.12582
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发表时间：
2015-10
影响因子：
2.5
通讯作者：
Uldbjerg N
中科院分区：
文献类型：
--
作者：
Sørensen A;Sinding M;Peters DA;Petersen A;Frøkjær JB;Christiansen OB;Uldbjerg N
评估胎盘氧转运能力是非常可取的，因为受损的胎盘功能与胎儿生长受限（FGR）和不良的新生儿结局有关。在临床产科，无创方法来估计胎盘氧转运是不可用的，目前的方法集中在胎儿的福祉，而不是直接评估胎盘功能。在这篇文章中，我们的目的是估计胎盘氧转运使用高氧胎盘血氧水平依赖（BOLD）磁共振成像（MRI）的反应。在21例正常妊娠和4例严重早发性FGR中，在1.5特斯拉MRI系统中进行胎盘BOLD MRI（TR：8000 msec，TE：50 msec，翻转角：90）。对FGR病例进行胎盘组织学检查。在正常妊娠中，平均高氧胎盘BOLD反应为12.6 ± 5.4%（均值±标准差）。在FGR病例中，高氧BOLD反应仅在母体胎盘灌注不足的组织学体征病例中异常。高氧胎盘BOLD反应主要来源于母体静脉血饱和度的增加。在正常胎盘中，脐静脉的pO2与子宫静脉的pO2密切相关。因此，高氧胎盘BOLD反应可能反映了胎盘对胎儿的氧供应。在早发性FGR中，胎盘氧转运减少主要是因为母体灌注不足，在这些情况下，胎盘BOLD反应可能会改变。因此，胎盘BOLD MRI可能提供直接的无创评估胎盘氧转运。
Estimating placental oxygen transport capacity is highly desirable, as impaired placental function is associated with fetal growth restriction (FGR) and poor neonatal outcome. In clinical obstetrics, a noninvasive method to estimate the placental oxygen transport is not available, and the current methods focus on fetal well-being rather than on direct assessment of placental function. In this article, we aim to estimate the placental oxygen transport using the hyperoxic placental blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) response. In 21 normal pregnancies and in four cases of severe early onset FGR, placental BOLD MRI was performed in a 1.5 Tesla MRI system (TR:8000 msec, TE:50 msec, Flip angle:90). Placental histological examination was performed in the FGR cases. In normal pregnancies, the average hyperoxic placental BOLD response was 12.6 ± 5.4% (mean ± SD). In the FGR cases, the hyperoxic BOLD response was abnormal only in cases with histological signs of maternal hypoperfusion of the placenta. The hyperoxic placental BOLD response is mainly derived from an increase in the saturation of maternal venous blood. In the normal placenta, the pO2 of the umbilical vein is closely related to the pO2 of the uterine vein. Therefore, the hyperoxic placental BOLD response may reflect the placental oxygen supply to the fetus. In early onset FGR, the placental oxygen transport is reduced mainly because of the maternal hypoperfusion, and in these cases the placental BOLD response might be altered. Thus, the placental BOLD MRI might provide direct noninvasive assessment of placental oxygen transport.