Noninvasive high-resolution electromyometrial imaging of uterine contractions in a translational sheep model
Noninvasive high-resolution electromyometrial imaging of uterine contractions in a translational sheep model
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DOI：
10.1126/scitranslmed.aau1428
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发表时间：
2019-03-13
影响因子：
17.1
通讯作者：
Wang, Yong
中科院分区：
文献类型：
--
作者：
Wu, Wenjie;Wang, Hui;Wang, Yong
在目前的临床实践中，子宫收缩是通过产力计或宫内压力导管监测的，这两种方法都提供了关于宫缩的粗略信息。虽然宫电/肌电图可以测量子宫电活动，但这种方法缺乏空间特异性，因此不能准确地测量子宫收缩的电起始位置和特定位置的传播模式。为了全面评估三维子宫电激活模式，我们描述了子宫肌电成像(EMMI)的发展，以高空间和时间分辨率显示三维子宫收缩。EMMI将详细的体表电记录与从磁共振图像得出的身体-子宫几何形状相结合。我们用绵羊模型展示了Emmi可以从放置在腹部的电极重建子宫电激活模式。这些模式与直接放置在子宫表面的电极测量的结果非常吻合。此外，建模实验表明，EMMI重建受噪声和几何变形的影响最小。最后，我们展示了EMMI可以用来非侵入性地测量绵羊的子宫收缩，其设置与用于人类的相同。我们的结果表明，EMMI可以无创、安全、准确、健壮、可行地对绵羊宫缩期间的子宫电活动进行三维成像，并提示在临床上也可能获得类似的结果。
In current clinical practice, uterine contractions are monitored via a tocodynamometer or an intrauterine pressure catheter, both of which provide crude information about contractions. Although electrohysterography/electromyography can measure uterine electrical activity, this method lacks spatial specificity and thus cannot accurately measure the exact location of electrical initiation and location-specific propagation patterns of uterine contractions. To comprehensively evaluate three-dimensional uterine electrical activation patterns, we describe here the development of electromyometrial imaging (EMMI) to display the three-dimensional uterine contractions at high spatial and temporal resolution. EMMI combines detailed body surface electrical recording with body-uterus geometry derived from magnetic resonance images. We used a sheep model to show that EMMI can reconstruct uterine electrical activation patterns from electrodes placed on the abdomen. These patterns closely match those measured with electrodes placed directly on the uterine surface. In addition, modeling experiments showed that EMMI reconstructions are minimally affected by noise and geometrical deformation. Last, we show that EMMI can be used to noninvasively measure uterine contractions in sheep in the same setup as would be used in humans. Our results indicate that EMMI can noninvasively, safely, accurately, robustly, and feasibly image three-dimensional uterine electrical activation during contractions in sheep and suggest that similar results might be obtained in clinical setting.