Korean J Radiol.  2016 Apr;17(2):218-223. 10.3348/kjr.2016.17.2.218.

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

• Alan B
• Goya C
• Tunc S
• Teke M
• Hattapoglu S

• KMID: 2360206
• DOI: http://doi.org/10.3348/kjr.2016.17.2.218

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.

Keyword

Acoustic radiation force impulse elastography; Ultrasonography; Fetal anomaly; Placenta stiffness

MeSH Terms

Adolescent
Adult
Area Under Curve
*Elasticity Imaging Techniques
Female
Fetus/*abnormalities
Gestational Age
Humans
Placenta/ultrasonography
Pregnancy
Prospective Studies
ROC Curve
Young Adult

Figure

• 

  Fig. 1 SWV measurement of placenta. A. ROI (box) was placed at center of anterior placenta in women with normal fetus. Placental elasticity value was 0.74 m/s. B. ROI (box) was placed at center of anterior placenta in women with fetal anomalies. Placental elasticity value was 1.38 m/s. ROI = region of interest

• 

  Fig. 2 Comparison of mean SWV values of study and control groups (1.26 ± 0.4, 1.09 ± 0.2; p = 0.01). SWV = shear wave velocity

• 

  Fig. 3 ROC curve analyses of prediction of fetal anomalies using minimum SWV (minSWV), maximum SWV (maxSWV), and mean SWV (meanSWV) values. ROC = receiver operating characteristic, SWV = shear wave velocity

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