Hemodynamic Responses of the Placenta and Brain to Maternal Hyperoxia in Fetuses with Congenital Heart Disease by Using Blood Oxygen-Level Dependent MRI.
Hemodynamic Responses of the Placenta and Brain to Maternal Hyperoxia in Fetuses with Congenital Heart Disease by Using Blood Oxygen-Level Dependent MRI.
复制标题
使用血氧水平依赖性 MRI 研究先天性心脏病胎儿胎盘和大脑对母体高氧的血流动力学反应。
DOI：
10.1148/radiol.2019190751
复制
发表时间：
2020
期刊：
影响因子：
19.7
通讯作者：
Limperopoulos,Catherine
中科院分区：
文献类型：
--
作者：
You,Wonsang;Andescavage,NickieN;Kapse,Kushal;Donofrio,MaryT;Jacobs,Marni;Limperopoulos,Catherine
先天性心脏病（CHD）胎儿脑发育受损 目的探讨母体妊娠是否能增加胎儿脑氧合， 给氧，母体高氧对血液的影响 用全血检测胎盘和胎脑的氧合情况 材料与方法对86例（56 健康胎儿和30例诊断为CHD的胎儿），年龄在22 - 39岁之间 从2015年5月至2017年12月， 以下研究设计：I期，基线时2分钟静息状态 (room第二阶段，母体在100%氧气条件下高氧6分钟; 第三阶段，5.6分钟恢复静息状态。在运动校正之后， 在胎盘和胎儿脑上对信号进行平均， 转换为R2* 的变化（ΔR2*）。CHD胎儿 分为单心室（SV）或双心室 心室（TV）和主动脉阻塞（AO）或非AO。数据 采用广义线性混合模型控制， 结果妊娠期高氧时胎盘ΔR2* 升高， 胎儿和胎儿CHD，但SV CHD（平均 ΔR2*，1.3 sec−1± 0.1 [标准误差;P< .01]，1.9 sec−1± 0.2[P< .01]，对照组分别为1.0 sec-1± 0.3 [P< .01] 胎儿、SV CHD胎儿和TV CHD胎儿）。胎盘 母体高氧时的ΔR2* 随GA的变化而变化 对照胎儿和SV或AO CHD胎儿（ΔR2*/周， 0.1 sec−1± 0 [P< .01]， 0.2 sec-1± 0 [P= .01]， 和0.2 sec−1± 0 [P= .01]，分别），但没有在胎儿CHD和TV或非AO。胎儿 健康对照组各时相的脑ΔR2* 均为常数 胎儿和胎儿与电视CHD，但增加了母亲高氧 在SV或AO CHD胎儿中（平均ΔR2*，0.7 sec−1± 0.2 [P= .01] 和0.5 sec−1± 0.2 [P= 结论母体高氧6分钟可增加胎盘氧合， 健康胎儿和患有先天性心脏病的胎儿， 选择性增加胎儿脑血氧饱和度 心室或主动脉阻塞。© RSNA，2019
BackgroundImpaired brain development in fetuses with congenital heart disease (CHD) may result from inadequate cerebral oxygen supply in utero.PurposeTo test whether fetal cerebral oxygenation can be increased by maternal oxygen administration, effects of maternal hyperoxia on blood oxygenation of the placenta and fetal brain were examined by using blood oxygenation level–dependent (BOLD) functional MRI.Materials and MethodsIn this prospective study, BOLD MRI was performed in 86 fetuses (56 healthy fetuses and 30 fetuses diagnosed with CHD) between 22 and 39 weeks gestational age (GA) from May 2015 to December 2017, with the following study design: phase I, 2-minute resting state at baseline (room air); phase II, 6-minute maternal hyperoxia with 100% oxygen; and phase III, 5.6-minute return to resting state. After motion correction, the signals were averaged over the placenta and fetal brain and converted to the change in R2* (ΔR2*). Fetuses with CHD were categorized into those with a single ventricle (SV) or two ventricles (TVs) and those with aortic obstruction (AO) or non-AO. Data were analyzed by using generalized linear mixed models controlling for GA and sex.ResultsPlacental ΔR2* increased during maternal hyperoxia in healthy fetuses and fetuses with CHD, but it was higher in SV CHD (mean ΔR2*, 1.3 sec−1± 0.1 [standard error;P< .01], 1.9 sec−1± 0.2 [P< .01], and 1.0 sec−1± 0.3 [P< .01], respectively, for control fetuses, fetuses with SV CHD, and fetuses with TV CHD). Placental ΔR2* during maternal hyperoxia changed with GA in healthy control fetuses and fetuses with SV or AO CHD (ΔR2* per week, 0.1 sec−1± 0 [P< .01], 0.2 sec–1± 0 [P= .01], and 0.2 sec−1± 0 [P= .01], respectively), but not in fetuses with CHD and TV or non-AO. Fetal brain ΔR2* was constant across all phases in healthy control fetuses and fetuses with TV CHD but increased during maternal hyperoxia in fetuses with SV or AO CHD (mean ΔR2*, 0.7 sec−1± 0.2 [P= .01] and 0.5 sec−1± 0.2 [P= .02], respectively).ConclusionSix minutes of maternal hyperoxia increased placental oxygenation in healthy fetuses and fetuses with congenital heart disease, and it selectively increased cerebral blood oxygenation in fetuses with single ventricle or aortic obstruction.© RSNA, 2019