Characterization of Placental Microvasculature Using Superb Microvascular Imaging

Abstract

uses clutter suppression to extract flow signals at rapid frame rates, which provides high-resolution vessel-branching details without the need for contrast agents. The potential diagnostic benefits of SMI, as described in other areas of medicine, requires further exploration during pregnancy. In this pictorial essay, we demonstrate the complementary use of SMI compared to conventional Doppler ultrasound and how it may improve our ability to characterize placental microvascular patterns without the need for ultrasound contrast agents.

Missing decidual Doppler signals as a new diagnostic criterion for placenta accreta spectrum: A case described using superb microvascular imaging

“…reported a direct finding of shed decidual blood flows, and Hasegawa et al . reported an indirect finding of the unique properties of intraplacental chorionic blood vessels 10,11 . In addition, in our case, these findings were detected using a conventional transabdominal probe as opposed to high‐resolution 18‐MHz SMI.…”

Peculiar blood flow profiles among placental chorionic villous vessels of an abnormally thick placenta in a case of systemic lupus erythematosus characterized using microvascular imaging

“…Mack et al reported a direct finding of missing decidual blood flows, and Hasegawa et al reported indirect findings of unique characteristics of intraplacental chorionic vessels. 5,6 We also diagnosed PAS by finding missing decidual tissues directly, using SMI. Spontaneous uterine rupture is rare in an undamaged uterus.…”

Update on Color Flow Imaging in Obstetrics

“…MVFI provides new opportunities for noninvasive characterization of the placental microvascular pattern during pregnancy without contrast [33]. MVFI shows the intraplacental small vessels more clearly than CDI or PDI [33] while maintaining relatively high frame rates (Figure 14A-C) [56]. A recent longitudinal study has shown that it is feasible to use MVFI to assess the development of the placental microvascularization throughout normal pregnancies [57].…”

“…In pregnancies affected by or at risk of fetal growth restriction or pre-eclampsia, MVFI provides new opportunities for noninvasive characterization of the placental microvascular pattern from the first to the third trimester [33,[56][57][58]. MVFI can also be used to confirm the absence of blood flow to, among others, a multicystic dysplastic kidney, an absent kidney [40], or placental lakes [50,51].…”