使用MV-Flow成像定量评估胎盘血管化，以预测小于胎龄的新生儿

摘要(中文译文)

评估微血管血流（MV-flow）成像测量的妊娠晚期胎盘血管化与小于胎龄儿（SGA）风险之间的关联。在这项前瞻性队列研究中，妊娠30-32周的单胎妊娠妇女接受了MV-Flow超声检查，以量化胎盘血管指数（VI）。分析母体特征、胎儿胎盘多普勒参数和MV-Flow衍生的VI，并记录妊娠结局。在207例妊娠中，20例（9.7%）为SGA新生儿，187例为适合胎龄（AGA）新生儿。与AGA妊娠相比，SGA组的胎盘VI在胎盘的上部、中部和下部区域显著降低（上部：32.0 ± 13.4 vs 43.1 ± 13.8,中间：36.0 ± 15.3 vs 49.6 ± 15.0,下：30.3 ± 10.0 vs 42.5 ± 13.5; all < 0.001). SGA组还表现出较高的子宫动脉搏动指数（UtA PI）和较低的大脑中动脉PI（MCA-PI）和脑浆比率（CPR）（均 < 0.05). 在多变量逻辑回归中，UtA-PI、CPR和胎盘中期VI与SGA独立相关。与UtA-PI（AUC 0.626）和CPR（AUC 0.675）相比，中间胎盘VI对SGA（AUC 0.756）具有中度鉴别作用。结合UtA-PI、CPR和胎盘VI的联合模型的AUC为0.866，灵敏度为55%，假阳性率为10%。MV-Flow超声测量的胎盘血管化指数降低与SGA显著相关。MV Flow衍生的VI与常规多普勒参数的整合可以改善SGA的风险分层，并为MV Flow在评估胎盘微循环和胎儿生长方面的潜在临床价值提供支持性证据。

Abstract

To evaluate the association between third-trimester placental vascularization measured by microvascular flow (MV-Flow) imaging and the risk of small-for-gestational-age (SGA) neonates. In this prospective cohort study, women with singleton pregnancies at 30-32 weeks' gestation underwent MV-Flow ultrasound for quantification of placental vascular indices (VI). Maternal characteristics, fetoplacental Doppler parameters, and MV-Flow-derived VI were analyzed, and pregnancy outcomes were recorded. Of 207 pregnancies, 20 (9.7%) resulted in SGA neonates and 187 in appropriate-for-gestational-age (AGA) neonates. Compared with the AGA pregnancies, placental VI in the SGA group were significantly lower across the upper, middle, and lower regions of the placenta (upper: 32.0 ± 13.4 vs 43.1 ± 13.8, middle: 36.0 ± 15.3 vs 49.6 ± 15.0, lower: 30.3 ± 10.0 vs 42.5 ± 13.5; all < 0.001). The SGA group also exhibited higher uterine artery pulsatility index (UtA-PI) and lower middle cerebral artery PI (MCA-PI) and cerebroplacental ratio (CPR) (all < 0.05). In multivariable logistic regression, UtA-PI, CPR, and mid-placental VI were independently associated with SGA. The middle placental VI demonstrated moderate discriminative for SGA (AUC 0.756) compared with UtA-PI (AUC 0.626) and CPR (AUC 0.695). A combined model incorporating UtA-PI, CPR, and placental VI achieved an AUC of 0.866 with 55% sensitivity and a 10% false-positive rate. Reduced placental vascularization index measured by MV-Flow ultrasonography is significantly associated with SGA. Integration of MV-Flow-derived VI with conventional Doppler parameters may improve risk stratification for SGA and provides supportive evidence for the potential clinical value of MV-Flow in assessing placental microcirculation and fetal growth.

如何引用

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 的其他文献

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