Three-dimensional sonographic measurement of blood volume flow in the umbilical cord.
Three-dimensional sonographic measurement of blood volume flow in the umbilical cord.
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DOI：
10.7863/jum.2012.31.12.1927
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发表时间：
2012-12
期刊：
影响因子：
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通讯作者：
Fowlkes JB
中科院分区：
文献类型：
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作者：
Pinter SZ;Rubin JM;Kripfgans OD;Treadwell MC;Romero VC;Richards MS;Zhang M;Hall AL;Fowlkes JB
三维（3D）脐带血流量测量旨在提供一种简单、一致和准确的方法，克服与传统脉冲波多普勒流量测量相关的局限性，并提供一种识别和管理高危妊娠的方法。第一项研究涉及7只健康母羊的3D超声容积流量测量，这些母羊的妊娠期为18至19周（7只单胎）。将每个胎儿的超声脐动脉和静脉血流测量值与相应的平均动脉/静脉血流测量值进行比较，以评估在静态血管中测量的可行性。第二项补充研究涉及7名健康女性的3D超声容积流量测量，这些女性的妊娠期为17.9至36.3周（6例单胎，1例双胎）。脐静脉血流量测量值与文献中报道的类似流量测量值进行了比较。从招募患者的病历中提取妊娠结局。在胎羊模型中，9次测量中有8次的动脉/静脉血流比较误差小于或等于10%。在临床研究中，静脉血流量测量结果显示在一系列胎龄范围内与文献一致。在临床研究中，7例患者中有2例表现出低于预期胎龄的血流; 1例随后被诊断为宫内生长受限，另1例被诊断为先兆子痫。准确的测量脐带血流量可以相对容易地在绵羊模型和人类使用所提出的三维超声流量测量技术。结果鼓励进一步发展该方法作为诊断和识别高危妊娠的手段。
Three-dimensional (3D) umbilical cord blood volume flow measurement with the intention of providing a straightforward, consistent, and accurate method that overcomes the limitations associated with traditional pulsed-wave Doppler flow measurement and provides a means by which to recognize and manage at-risk pregnancies. The first study involved 3D ultrasound volume flow measurements in seven healthy ewes whose pregnancies ranged from 18 to 19 weeks’ gestation (7 singletons). Sonographic umbilical arterial and venous flow measurements from each fetus were compared to the corresponding average measured arterial/venous flow to assess feasibility of measurement in a static vessel. A second complementary study involved 3D ultrasound volume flow measurements in seven healthy women whose pregnancies ranged from 17.9 to 36.3 weeks’ gestation (6 singletons, 1 twin). Umbilical venous flow measurements were compared to similar flow measurements reported in the literature. Pregnancy outcomes were abstracted from the medical records of the recruited patients. In the fetal sheep model, arterial/venous flow comparisons yielded errors of 10% or less for eight out of the nine measurements. In the clinical study, venous flow measurements showed agreement with the literature over a range of gestational ages. Two of the seven patients in the clinical study demonstrated lower flow than anticipated for gestational age; one was subsequently diagnosed with intrauterine growth restriction and the other with preeclampsia. Accurate measurements of umbilical blood volume flow can be performed with relative ease in both the sheep model and in humans using the proposed 3D ultrasound flow measurement technique. Results encourage further development of the method as a means for diagnosis and identification of at-risk pregnancies.