Diagnosis of pre‐eclampsia and assessment of severity through examination of the placenta with acoustic radiation force impulse elastography

Alan, Bircan; Tunç, Senem Yaman; Ağaçayak, Elif; Bilici, Aslan

doi:10.1016/j.ijgo.2016.03.037

Cited by 23 publications

(23 citation statements)

References 21 publications

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“…This is a credible hypothesis already suggested by studies ( Table 5 ). Among this literature, several ex vivo studies [ 20 , 26 , 36 ] and in vivo studies [ 19 , 22 , 27 , 32 – 35 ] compared normal and insufficient placentas in humans (either preeclampsia, IUGR or both).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, they have employed a diverse range of elastography techniques: strain elastography [ 19 , 26 , 30 ], ARFI [ 20 , 28 , 32 – 34 ], or SWE [ 21 , 22 , 25 , 27 , 29 ]. The orders of magnitude of the measurements sometimes differed from one study to another.…”

Section: Discussionmentioning

confidence: 99%

“…The orders of magnitude of the measurements sometimes differed from one study to another. For example, the mean YM in preeclampsia cases ranged from 7.01 kPa (range 3.79–13.3) [ 22 ] to 21 kPa (range 3–71) [ 27 ], and the mean SWS value ranged from 1.34 m/s (IQR 1.31–1.39) [ 32 ] to 1.93 m/s (+/- SD 0.62) [ 33 ]. In normal placentas in vivo , mean YMs have varied from 2.53 kPa (range 2.29–2.80) [ 22 ] to 7.84 kPa (+/- SD 1.68) [ 21 ] and mean SWS from 0.91 m/s (+/- SD 0.20) [ 33 ] to 1.59 m/s (+/- SD 0.5) [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

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Measurement of shear wave speed dispersion in the placenta by transient elastography: A preliminary ex vivo study

Simon¹,

Callé²,

Perrotin³

et al. 2018

PLoS ONE

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BackgroundPlacental elasticity may be modified in women with placental insufficiency. Shear wave elastography (SWE) can measure this, using acoustic radiation force, but the safety of its use in pregnant women has not yet been demonstrated. Transient elastography (TE) is a safer alternative, but has not yet been applied to the placenta. Moreover, the dispersion of shear wave speed (SWS) as a function of frequency has received relatively little study for placental tissue, although it might improve the accuracy of biomechanical assessment.ObjectiveTo explore the feasibility and reproducibility of TE for placental analysis, to compare the values of SWS and Young’s modulus (YM) from TE and SWE, and to analyze SWS dispersion as a function of frequency ex vivo in normal placentas.Materials and methodsTen normal placentas were analyzed ex vivo by an Aixplorer ultrasound system as shear waves were generated by a vibrating plate and by using an Aixplorer system.The frequency analysis provided the value of the exponent n from a fractional rheological model applied to the TE method. We calculated intra- and interobserver agreement for SWS and YM with 95% prediction intervals, created Bland-Altman plots with 95% limits of agreement, and estimated the intraclass correlation coefficient (ICC).Main resultsThe mean SWS was 1.80 m/s +/- 0.28 (standard deviation) with the TE method at 50 Hz and 1.82 m/s +/-0.13 with SWE (P = 0.912). No differences were observed between the central and peripheral regions of placentas with either TE or SWE. With TE, the intraobserver ICC for SWS was 0.68 (0.50–0.82), and the interobserver ICC for SWS 0.65 (0.37–0.85). The mean parameter n obtained from the fractional rheological model was 1.21 +/- 0.12, with variable values of n for any given SWS.ConclusionsTE is feasible and reproducible on placentas ex vivo. The frequency analysis of SWS provides additional information about placental elasticity and appears to be able to distinguish differences between placental structures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Measurement of shear wave speed dispersion in the placenta by transient elastography: A preliminary ex vivo study

Simon¹,

Callé²,

Perrotin³

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Regarding placentomes, it is known that although individual placentomes may continue to undergo morphologic transformations as gestation advances, major placental growth is complete by mid-gestation in sheep (Liu et al, 2018;Reynolds et al, 2005) justifying the constant SWV observed. Elastographic evaluation of placenta was validated by previous studies (Alan, Tunç, Agacayak, & Bilici, 2016;Rumball, Harding, Oliver, & Bloomfield, 2008;Yuksel et al, 2016), which detected lower and higher placental stiffness in women with pre-eclampsia and gestational diabetes mellitus, respectively. It allows the obstetrician-gynaecologist to perform not only an early diagnosis, but also a rapid and successful intervention to save the lives of mother and foetus.…”

Section: Variablesmentioning

confidence: 92%

Acoustic radiation force impulse (ARFI) elastography to asses maternal and foetal structures in pregnant ewes

Silva

Uscátegui

Santos

et al. 2018

Reprod Domestic Animals

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Contents The aim of this study was to evaluate the stiffness of foetal lungs, liver, kidneys and placentomes by acoustic radiation force impulse (ARFI) elastography in ovine and to correlate obtained findings with foetal development. Twenty‐four ewes were included, and tissue stiffness of foetal lung, liver, kidney and placentome was measured beginning with 10th gestational week by qualitative–quantitative ARFI elastography. A total of 33 healthy lambs were born. Qualitative elastographic analysis permitted to classify maternal and foetal tissues elasticity in decreasing order as follows: placentome, kidney, liver and lung. Regarding quantitative ARFI elastography data, shear wave velocity (SWV) of foetal lung and liver varied. The lung SWV decreased gradually from the 16th to the 21st gestational week (R2 = 0.80; p < 0.001), while liver SWV increased gradually from the 14th to 21st gestational week (R2 = 0.80; p < 0.001). In contrast, the kidneys and placentomes SWV's remained constant through gestation (p = 0.076; and 0.34). ARFI elastography was shown feasible for evaluation of maternal and foetal tissues stiffness in the ovine model. It can be used to demonstrate pulmonary and hepatic stiffness modifications during foetal development.

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“…Recent work has shown that the placenta and umbilical cord undergo biomechanical changes during disease, which could potentially be used as an evaluation parameter for disease detection. For example, the in vivo evaluation of the placenta stiffness via ultrasound elastography was suggested as a means to detect PE (Cimsit et al, 2015a , b ; Kiliç et al, 2015 ; Alan et al, 2016b ; Erbil et al, 2016 ) and IUGR (Quibel et al, 2015 ; Durhan et al, 2017 ; Habibi et al, 2017 ). Further, biofluid mechanics analysis of the placenta and evaluation of the umbilical-placenta vascular mechanical properties will improve our understanding about the placenta biotransport phenomenon and its vascular growth and remodeling process, respectively.…”

Section: Introductionmentioning

confidence: 99%

A Review of Biomechanics Analysis of the Umbilical–Placenta System With Regards to Diseases

2021

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Placenta is an important organ that is crucial for both fetal and maternal health. Abnormalities of the placenta, such as during intrauterine growth restriction (IUGR) and pre-eclampsia (PE) are common, and an improved understanding of these diseases is needed to improve medical care. Biomechanics analysis of the placenta is an under-explored area of investigation, which has demonstrated usefulness in contributing to our understanding of the placenta physiology. In this review, we introduce fundamental biomechanics concepts and discuss the findings of biomechanical analysis of the placenta and umbilical cord, including both tissue biomechanics and biofluid mechanics. The biomechanics of placenta ultrasound elastography and its potential in improving clinical detection of placenta diseases are also discussed. Finally, potential future work is listed.

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Diagnosis of pre‐eclampsia and assessment of severity through examination of the placenta with acoustic radiation force impulse elastography

Abstract: Measurement of the placental SWV with ARFI imaging is a useful additional method for the diagnosis of pre-eclampsia and for determination of the disease severity.

Cited by 23 publications

References 21 publications

Measurement of shear wave speed dispersion in the placenta by transient elastography: A preliminary ex vivo study

Measurement of shear wave speed dispersion in the placenta by transient elastography: A preliminary ex vivo study

Acoustic radiation force impulse (ARFI) elastography to asses maternal and foetal structures in pregnant ewes

A Review of Biomechanics Analysis of the Umbilical–Placenta System With Regards to Diseases

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