Assessment of Placental Stiffness Using Acoustic Radiation Force Impulse Elastography in Pregnant Women with Fetal Anomalies

다국어 초록 (Multilingual Abstract)

Objective: We aimed to evaluate placental stiffness measured by acoustic radiation force impulse (ARFI) elastography in pregnant women in the second trimester with a normal fetus versus those with structural anomalies and non-structural findings.
Materials and Methods: Forty pregnant women carrying a fetus with structural anomalies diagnosed sonographically at 18–28 weeks of gestation comprised the study group. The control group consisted of 34 healthy pregnant women with a sonographically normal fetus at a similar gestational age. Placental shear wave velocity (SWV) was measured by ARFI elastography and compared between the two groups. Structural anomalies and non-structural findings were scored based on sonographic markers. Placental stiffness measurements were compared among fetus anomaly categories. Doppler parameters of umbilical and uterine arteries were compared with placental SWV measurements.
Results: All placental SWV measurements, including minimum SWV, maximum SWV, and mean SWV were significantly higher in the study group than the control group ([0.86 ± 0.2, 0.74 ± 0.1; p < 0.001], [1.89 ± 0.7, 1.59 ± 0.5; p = 0.04], and [1.26 ± 0.4, 1.09 ± 0.2; p = 0.01]), respectively.
Conclusion: Placental stiffness evaluated by ARFI elastography during the second trimester in pregnant women with fetuses with congenital structural anomalies is higher than that of pregnant women with normal fetuses.

참고문헌 (Reference)

1 Afrakhteh M, "Uterine Doppler velocimetry of the uterine arteries in the second and third trimesters for the prediction of gestational outcome" 36 : 35-39, 2014

2 Cnossen JS, "Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis" 178 : 701-711, 2008

3 Zhi H, "Ultrasound elastography of breast lesions in chinese women: a multicenter study in China" 13 : 392-400, 2013

4 Göya C, "The utility of acoustic radiation force impulse imaging in diagnosing acute appendicitis and staging its severity" 20 : 453-458, 2014

5 Papageorghiou AT, "The role of uterine artery Doppler in predicting adverse pregnancy outcome" 18 : 383-396, 2004

6 Bromley B, "The Genetic Sonogram Scoring Index" 27 : 124-129, 2003

7 Cimsit C, "Strain elastography in placental dysfunction: placental elasticity differences in normal and preeclamptic pregnancies in the second trimester" 291 : 811-817, 2015

8 Benacerraf BR, "Sonographic scoring index for prenatal detection of chromosomal abnormalities" 11 : 449-458, 1992

9 Bowman ZS, "Sonographic appearance of the placenta" 43 : 356-373, 2014

10 Cimsit C, "Shear wave elastography in placental dysfunction: comparison of elasticity values in normal and preeclamptic pregnancies in the second trimester" 34 : 151-159, 2015

11 Ohmaru T, "Placental elasticity evaluation using virtual touch tissue quantification during pregnancy" 36 : 915-920, 2015

12 Arizawa M, "Pathological analysis of the placenta in trisomies 21, 18 and 13" 44 : 9-13, 1992

13 Papageorghiou AT, "Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery Doppler at 23 weeks of gestation" 18 : 441-449, 2001

14 Kuroda H, "Liver stiffness measured by acoustic radiation force impulse elastography reflects the severity of liver damage and prognosis in patients with acute liver failure" 45 : 571-577, 2015

15 Bromley B, "Genetic sonogram scoring index: accuracy and clinical utility" 18 : 523-528, 1999

16 Li WJ, "Detection of placenta elasticity modulus by quantitative real-time shear wave imaging" 39 : 470-473, 2012

17 Goddi A, "Breast elastography: a literature review" 15 : 192-198, 2012

18 Calvete AC, "Acoustic radiation force impulse imaging for evaluation of the thyroid gland" 33 : 1031-1040, 2014

19 Sugitani M, "A new method for measurement of placental elasticity: acoustic radiation force impulse imaging" 34 : 1009-1013, 2013