超微血管成像技术在评估中晚期妊娠胎盘微血流灌注中的应用价值  

The application value of supermicrovascular imaging technology in evaluating microcirculation perfusion of the placenta in mid-to-late pregnancy

作　　者：孙红双 王一聪 王少春[1] 任芸芸 SUN Hongshuang;WANG Yicong;WANG Shaochun;REN Yunyun(Departmentof Ultrasound,Affiliated Hospital of Jining Medical University,Jining 272007,China;Departmentof Medical Imaging,Affiliated Hospital of Jining Medical University,Jining 272007,China;Department of Ultrasound,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200082,China)

机构地区：[1]济宁医学院附属医院超声科,山东济宁272007 [2]济宁医学院附属医院医学影像科,山东济宁272007 [3]复旦大学附属妇产科医院超声科,上海200082

出　　处：《医学影像学杂志》2024年第10期100-104,共5页Journal of Medical Imaging

基　　金：上海市卫生健康委员会科研项目(编号:202240083);山东省医药卫生科技项目(编号:202309020311);济宁医学院附属医院博士后科研项目(编号:JYFY362641)。

摘　　要：目的探讨胎盘超微血管成像技术(SMI)在评估中晚期妊娠胎盘微血流灌注中的价值,分析影响胎盘超声微血管指数(MFI)的相关因素。方法选取行常规产前检查的单胎孕妇343例,根据胎盘发育情况,将孕周分为四个孕周组:14~20周(中孕早期为A组),21~28周(中孕晚期为B组),29~35周(晚孕早期为C组),36~40周(晚孕晚期为D组)。分别测量相关多普勒超声参数,同时对胎盘行超微血管成像检测。分析其临床资料及超声检查表现与MFI的相关性,以及影响胎盘微血管灌注状态的独立因素。结果胎盘超声MFI随着孕周增长是增高的。而在29~35周发生不良妊娠结局的胎盘MFI显著低于妊娠结局良好胎盘的MFI,差异有统计学意义(P<0.05)。同时发现胎盘MFI与大脑中动脉血流灌注指数(PI)存在明显的正相关(P<0.05),与胎盘厚度、子宫动脉PI、脐动脉S/D值存在显著的负相关(P<0.05)。最终经过模型训练后得出大脑中动脉PI、脐动脉S/D值及孕周是胎盘MFI的独立影响因素。结论超声微血管成像技术在评估胎盘血流灌注中具有重要的应用价值。Objective To explore the value of placental microvascular imaging technology in evaluating microcirculation perfusion in mid to late pregnancy placenta,and to investigate the relevant factors affecting the placental ultrasound microflow index(MFI).Methods A total of 343 pregnant women with gestational age between 14-40 weeks were included in this study.Routine obstetric examinations were performed,and Doppler parameters of uterine artery,fetal middle cerebral artery and umbilical artery were measured.Placental microvascular imaging was used to detect and calculate the MFI of the placenta.The correlation between clinical data,ultrasound features and placental ultrasound MFI was analyzed,and independent factors affecting placental microvascular perfusion were explored.Results The study found that the placental ultrasound MFI increased with gestational age.In the late pregnancy early stage(29-35 weeks),the placental MFI was significantly lower in cases of adverse pregnancy outcomes compared to those with good pregnancy outcomes(P<0.05).Additionally,a significant positive correlation was found between the placental MFI and the cerebral middle artery(MCA-PIMoM)(P<0.05),and significant negative correlations were found with placental thickness,uterine artery(UtA-PIMoM),and umbilical artery(UA-S/DMoM)markers(P<0.05).Finally,after model training,it was determined that MCA-PI,UA-S/D,and ultrasound week were independent influencing factors for the placental MFI.Conclusion Ultrasound microvascular imaging technology can sensitively evaluate placental microvascular development,and the ultrasound microvascular index has important application value in evaluating placental blood flow perfusion.

关 键 词：妊娠高血压疾病 超声检查 胎盘 微循环 

分 类 号：R714.24[医药卫生—妇产科学] R445.1[医药卫生—临床医学]