CAJ | 학술논문

目的：探讨声脉冲辐射力成像(acoustic radiation forcs impulse,ARFI)技术定量分析胎盘弹性的临床应用价值。方法正常妊娠孕妇487例,测量胎盘组织剪切波速度(shear wave velocity,SWV)。根据不同孕周、胎盘位置及感兴趣区域取样深度分组,采用单因素方差分析,比较正常胎盘不同位置及感兴趣区域不同取样深度之间 SWV 的差异。采用 Pearson 相关分析评估正常胎盘 SWV 与不同孕周及胎盘分级之间的可能关系。重度子痫前期孕妇26例,重度子痫前期合并胎儿生长受限(fetal growth restriction,FGR)孕妇25例,分别测量胎盘 SWV,与正常胎盘 SWV 比较。取50例正常胎盘与异常组51例胎盘行病理检测。结果根据胎盘位置分前壁、侧壁及后壁3组。单因素方差分析显示,前壁或侧壁与后壁 SWV 比较差异有统计学意义(P <0.05),前壁与侧壁 SWV 比较差异无统计学意义。根据感兴趣区域取样深度不同,将取样深度距离探头(范围2.0~7.99 cm)每增加1 cm 为1组,共分成6组。距离探头范围2.0~5.99 cm 与6.0~7.99 cm 之间的两组 SWV 比较差异有统计学意义(P <0.05),其余各组 SWV 比较差异无统计学意义。正常胎盘组织 SWV 均值为(0.78±0.08)m/s,与孕周无相关性,与胎盘分级呈正相关(P <0.05)。正常组与异常组 SWV 比较差异有统计学意义(P <0.05)。重度子痫前期组与重度子痫前期合并 FGR 组 SWV 比较差异无统计学意义(P >0.05)。病理检查显示异常组胎盘有显著改变。结论ARFI 可便捷、无创地定量分析胎盘实质的弹性程度,并可有效区别正常与异常胎盘组织弹性差异。
목적：탐토성맥충복사력성상(acoustic radiation forcs impulse,ARFI)기술정량분석태반탄성적림상응용개치。방법정상임신잉부487례,측량태반조직전절파속도(shear wave velocity,SWV)。근거불동잉주、태반위치급감흥취구역취양심도분조,채용단인소방차분석,비교정상태반불동위치급감흥취구역불동취양심도지간 SWV 적차이。채용 Pearson 상관분석평고정상태반 SWV 여불동잉주급태반분급지간적가능관계。중도자간전기잉부26례,중도자간전기합병태인생장수한(fetal growth restriction,FGR)잉부25례,분별측량태반 SWV,여정상태반 SWV 비교。취50례정상태반여이상조51례태반행병리검측。결과근거태반위치분전벽、측벽급후벽3조。단인소방차분석현시,전벽혹측벽여후벽 SWV 비교차이유통계학의의(P <0.05),전벽여측벽 SWV 비교차이무통계학의의。근거감흥취구역취양심도불동,장취양심도거리탐두(범위2.0~7.99 cm)매증가1 cm 위1조,공분성6조。거리탐두범위2.0~5.99 cm 여6.0~7.99 cm 지간적량조 SWV 비교차이유통계학의의(P <0.05),기여각조 SWV 비교차이무통계학의의。정상태반조직 SWV 균치위(0.78±0.08)m/s,여잉주무상관성,여태반분급정정상관(P <0.05)。정상조여이상조 SWV 비교차이유통계학의의(P <0.05)。중도자간전기조여중도자간전기합병 FGR 조 SWV 비교차이무통계학의의(P >0.05)。병리검사현시이상조태반유현저개변。결론ARFI 가편첩、무창지정량분석태반실질적탄성정도,병가유효구별정상여이상태반조직탄성차이。
Objective To investigate the clinical value of acoustic radiation forcs impulse (ARFI)in quantitative evaluating placental elasticity.Methods The study population included 487 normal pregnant women,and ARFI generated shear wave velocity (SWV)was measured.On the basis of gestational ages, placental sites and sampling depths in region of interest (ROI),the normal population was divided into different groups.One-way analysis of variance was used to compare the discrepancy on the SWV values amomg the nomal placental sites or the sampling depths in ROI.Pearson correlation coefficient were used to assess the possible relationships between the normal placental SWV values and the different gestational ages or the placental grades.A total of 5 1 cases were diagnosed with severe preeclampsia,among them 25 cases were categorized as severe preeclampsia with fetal growth restriction (FGR).The placental SWV values were measured and compared with those of the normal population.The pathological examinations were performed on 50 normal and 5 1 abnormal placentas.Results Basing on the placental sites,the normal population were divided into three groups:anterior wall,lateral wall and posterior wall groups.Compared with the posterior wall group,the placental SWV values in the anterior wall or lateral wall group significantly decreased (P <0.05).No statistical significant difference was found between the anterior wall group and the lateral wall group.Basing on the distance from the sampling depths to the probe (range from 2 to 7.99 cm,and each additional 1 cm corresponding a group),the normal population were divided into six groups.There was statistical significant difference for the placental SWV values between the two groups of distance in the range of 2.0 to 5.99 cm and 6.0 to 7.99 cm (P <0.05).There was no statistical significant difference between the other two groups.The mean SWV value was (0.78±0.08 m/s)in the normal group. No significant relationships were found between the placental SWV values and the gestational ages of the normal population.However the placental SWV values were significantly related to the placental grades.For the placental SWV values,there was statistical significant difference between the normal group and the abnormal group (P <0.05).No statistical significant difference was found between the severe preeclampsia group and the severe preeclampsia with FGR group.The pathological examinations also showed significant changes in the abnormal group.Conclusions ARFI may quantitatively analyze the placental elasticity and make a difference between nomal and abnormal placenta.