血管铸型结合CT三维模型评估先兆子痫胎盘血管结构  

Evaluation of placental vascular structure in preeclampsia by vascular casting combined with CT threedimensional model

作　　者：郭红志 王瑜 张加琪 梁海彬 马梓玮 冯伟 吴忧 司子燚 Guo Hongzhi;Wang Yu;Zhang Jiaqi;Liang Haibin;Ma Ziwei;Feng Wei;Wu You;Si Ziyi(Department of Ultrasond Imaging,Xiangyang No.1 People's Hospital Affiliated to Hubei University of Medicine,Jinzhou Medical University Union Training Base,Xiangyang 441000,Hubei Province,China;Department of Ultrasond Imaging,Xiangyang No.1 People's Hospital Affiliated to Hubei University of Medicine,Xiangyang 441000,Hubei Province,China;Hubei Clinical Research Center for Precise Diagnosis of Fetal complex malformations,Xiangyang 441000,Hubei Province,China;Department of Human Anatomy,National Virtual&Reality Experimental Education Center for Medical Morphology,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]锦州医科大学湖北医药学院附属襄阳市第一人民医院研究生联合培养基地超声影像科,湖北襄阳441000 [2]湖北医药学院附属襄阳市第一人民医院超声影像科,湖北襄阳441000 [3]湖北省胎儿复杂畸形精准诊断临床医学研究中心,湖北襄阳441000 [4]南方医科大学人体解剖学教研室,国家级医学形态学虚拟仿真实验教学中心,广州510515

出　　处：《中国临床解剖学杂志》2024年第1期5-10,共6页Chinese Journal of Clinical Anatomy

基　　金：湖北省胎儿复杂畸形精准诊断临床医学研究中心建设项目(2021LC002);襄阳市2021年度医疗卫生领域科技计划重点项目(2021YL19)。

摘　　要：目的通过子痫前期胎盘血管铸型及CT数字化三维结构模型分析子痫前期胎盘血管的解剖学特征,为子痫前期的临床预判提供数据支持。方法随机收集2018年11月至2020年6月的134例孕周≥34周胎盘,其中正常组68例,子痫前期66例(轻度组36例、重度组30例)。以自凝型牙托粉添加造影剂硫酸钡构建胎盘的血管铸型模型,对胎盘血管铸型模型进行CT扫描得到数字化的三维结构模型,测量铸型模型胎盘动静脉分级数、各级分支血管的直径及胎盘动静脉血管容积并比较3组差异。结果晚发型重度子痫前期胎盘与同期正常组、轻度子痫前期组相比,胎盘血管总容积及胎盘静脉容积变小(P<0.05),胎盘静脉分级数减少、静脉各级分支直径变细(P<0.05),动脉分级数减少及动脉第3、4级分支直径变细(P<0.05)。结论血管铸型结合CT三维模型有助于直观、全面地认识先兆子痫胎盘血管结构特点。Objective To study the vascular casting and CT digital three-dimensional structure model of placental vessels in preeclampsia,and statistically analyze the anatomical characteristics of placental vessels in preeclampsia,so as to provide technical data for clinical prediction of preeclampsia.Methods Totally 134 cases of placentas with gestational weeks≥34 weeks(68 normal placenta,among 66 preeclampsia,36 were mild and 30 were severe)were randomly collected from November 2018 to June 2020.The placental vascular cast models were constructed by adding barium sulfate as a contrast agent to the selfcoagulating denture powder.Then,the placental vascular cast models were scanned by CT and digital threedimensional structure models were obtained.The number of placental arteriovenous grades,the diameters of various branches and the volume of placental arteriovenous vessels in the cast models were measured and compared.Results The placental vascular volume and placental vein volume of late-onset severe preeclampsia were smaller than those of normal group and mild preeclampsia group(P<0.05).Compared with the placentas of normal group and mild preeclampsia in the same period,the placentas of late-onset severe preeclampsia had fewer grades of placental veins and narrower branches(P<0.05),the number of placental artery grades in late-onset severe preeclampsia group decreased and the diameter of the third and fourth branches of the artery became smaller(P<0.05).Conclusions Vascular casting combined with CT 3D model is helpful to understand the vascular structure of placenta in preeclampsia intuitively and comprehensively.

关 键 词：血管铸型 CT三维模型 胎盘 子痫前期 

分 类 号：R322-33[医药卫生—人体解剖和组织胚胎学] R322.12[医药卫生—基础医学]