Assessment of Placental Blood Volume Flow and Function in IUGR Using a Transfer Function Model

使用传递函数模型评估 IUGR 中的胎盘血流量和功能

• 批准号: 10001186
• 负责人: JONATHAN M RUBIN
• 金额: $ 1.91万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-02-14 至 2021-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10001186
• 关键词: 3-Dimensional; 3D ultrasound; Benign; Blood Circulation; Blood Volume; Blood flow; Clinical; Communication; Complex; Diagnostic Procedure; Doppler Echocardiography; Doppler Ultrasound; Drops; Exploratory/Developmental Grant; Fetal Development; Fetal Growth Retardation; Fetus; First Pregnancy Trimester; Hypertension; Lead; Measurement; Measures; Mechanics; Methods; Modeling; Mothers; Noise; Nutrient; Oxygen; Physiologic Monitoring; Placenta; Pre-Eclampsia; Pregnancy; Resistance; Sampling; Sheep; Structure of umbilical artery; Techniques; Testing; Testosterone; Time; Transducers; Translations; Ultrasonic Transducer; Ultrasonography; Umbilical cord structure; Umbilical vein; Vascular resistance; Venous; base; blood flow measurement; blood perfusion; electric impedance; fetal; fetal blood; functional status; high reward; high risk; human subject; in vivo; maternal diabetes; optimism; phantom model; placental transfer; predictive modeling; pregnant; pressure; time use

Abstract: The placenta is the conduit through which all fetal nourishment and oxygen delivery passes. Therefore, assessment of placental function is critical to understanding and monitoring the physiological state of the developing fetus. All nutrients and oxygen get to the fetus through placental communications between the maternal and fetal blood circulations. Hence, major factors for placental function are blood flow and perfusion. In this regard, we hypothesize that a new method for measuring umbilical arterial and venous flows can yield significant, new information about placental functional status. Since standard spectral Doppler studies can detect flow abnormalities related to IUGR, albeit generally late in gestation, we hypothesize that our new methods will be more sensitive to changes in placental function earlier than the present diagnostic techniques, including ultrasound Doppler measurements. We are expressing this optimism because we will use an angle-independent, flow profile independent volume flow measurement method, that we have validated in other settings, to make time-dependent blood flow measurements in the umbilical arteries and vein simultaneously. These will lead directly to a placental transfer function (PTF), which would be a totally benign method for analyzing placental function throughout gestation. If successful, our combined volume flow/transfer function methods can be quickly implemented on standard diagnostic ultrasound machines and moved into clinical use. Initially, we will use phantom studies to investigate how time-dependent umbilical cord flow is altered based on controlled changes in vascular resistance and compliance, and we will use this time-dependent flow information to create and validate a transfer function model of the phantom. In the phantom, we will have complete control of the flows, internal resistance/compliance, and pressure drops. We will be able to see how effectively the transfer function represents these parameters in the phantom. Once proven in phantoms, we will use a well-validated in-vivo pregnant sheep model of intrauterine growth restriction (IUGR), gestational testosterone treated sheep, to test how well flow and our transfer function model predict placental changes in IUGR.

抽象的： 胎盘是胎儿所有营养和氧气输送的管道。所以， 胎盘功能的评估对于了解和监测胎盘的生理状态至关重要 发育中的胎儿。所有营养物质和氧气都通过胎盘之间的通讯到达胎儿 母体和胎儿的血液循环。因此，胎盘功能的主要因素是血流量和灌注。 在这方面，我们假设一种测量脐动脉和静脉流量的新方法可以 产生有关胎盘功能状态的重要新信息。由于标准频谱多普勒研究可以 检测与 IUGR 相关的血流异常，尽管通常在妊娠晚期，我们假设我们的新方法 比目前的诊断技术更早对胎盘功能的变化更加敏感，包括 超声多普勒测量。我们表达这种乐观态度是因为我们将使用与角度无关的、 与流量剖面无关的体积流量测量方法，我们已在其他设置中进行了验证，以便 同时测量脐动脉和静脉中随时间变化的血流量。这些将导致 直接连接到胎盘传递函数（PTF），这将是一种完全良性的分析胎盘传递函数的方法 整个妊娠期的功能。如果成功，我们的组合体积流量/传递函数方法可以快速 在标准诊断超声机器上实施并进入临床使用。 最初，我们将使用模型研究来研究时间依赖性脐带血流如何改变 基于血管阻力和顺应性的受控变化，我们将使用这种随时间变化的流量 用于创建和验证体模传递函数模型的信息。在幻象中，我们将有 完全控制流量、内阻/合规性和压降。我们将能够看到如何 实际上，传递函数代表了模型中的这些参数。一旦在幻象中得到证实，我们将 使用经过充分验证的宫内生长受限 (IUGR) 体内怀孕羊模型 睾酮治疗的绵羊，以测试流量和我们的传递函数模型预测胎盘变化的效果 IUGR。