Three-dimensional power doppler evaluation of cerebral vascular blood flow: A novel tool in the assessment of fetal growth restriction
JournalJournal of Ultrasound in Medicine
PublisherJohn Wiley and Sons Ltd.
MetadataShow full item record
AbstractObjectives To determine whether fetuses with fetal growth restriction (FGR) are more likely to have abnormal cerebral vascular flow patterns compared to fetuses who are appropriate for gestational age (AGA) when quantified by using 3-dimensional (3D) power Doppler ultrasound. Methods We conducted a prospective cohort study of singleton gestations presenting for growth ultrasound examination between 24 and 36 weeks' gestation. Patients with FGR (estimated fetal weight < 10th percentile) were enrolled and matched 1:1 for gestational age (±7 days) with AGA fetuses. A standardized 3D power Doppler image of the middle cerebral artery territory was obtained from each patient. The vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) were calculated by the Virtual Organ computer-aided analysis technique (GE Healthcare, Milwaukee, WI). These indices were compared between FGR and AGA fetuses and correlated with 2-dimensional Doppler parameters. Neonatal outcomes were also compared with respect to the 3D parameters. Results Of 306 patients, there were 151 cases of FGR. There was no difference in the VI (6.0 versus 5.7; P = .65) or VFI (2.0 versus 1.8; P = .31) between the groups; however, the FI was significantly higher in FGR fetuses compared to AGA controls (33.9 versus 32.3; P = .009). There was a weak, but significant, negative correlation between the FI and both the middle cerebral artery pulsatility index (r = -0.34; P < .001) and cerebroplacental ratio (r = -0.29; P < .001). Within the FGR group, there was no difference in any of the 3D vascular indices with regard to neonatal outcomes. Conclusions Three-dimensional power Doppler measurement of cerebral blood flow, but not the vascularization pattern, is significantly altered in FGR. This measurement may play a future role in distinguishing pathologic FGR from constitutionally small growth. Copyright 2017 by the American Institute of Ultrasound in Medicine.
SponsorsThis research was supported in part by the American College of Obstetricians and Gynecologists Kenneth Gottesfeld-Charles Hoh-ler Memorial Foundation Research Award in Ultrasound. This work was presented in part as an oral presentation at the American Institute of Ultrasound in Medicine 2014 Annual Convention; March 29-April 2, 2014; Las Vegas, Nevada.
Keyword3-dimensional power doppler
Fetal growth restriction
Middle cerebral artery
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85045726794&doi=10.1002%2fjum.14323&partnerID=40&md5=fbad140b8c62e6074cf1584337d4b865; http://hdl.handle.net/10713/9116
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