High-resolution imaging diagnosis of human fetal membrane by three-dimensional optical coherence tomography

Abstract

Abstract. Microscopic chorionic pseudocyst (MCP) arising in the chorion leave of the human fetal membrane (FM) is a clinical precursor for preeclampsia which may progress to fatal medical conditions (e.g., abortion) if left untreated. To examine the utility of three-dimensional (3D) optical coherence tomography (OCT) for noninvasive delineation of the morphology of human fetal membranes and early clinical detection of MCP, 60 human FM specimens were acquired from 10 different subjects undergoing term cesarean delivery for an ex vivo feasibility study. Our results showed that OCT was able to identify the four-layer architectures of human FMs consisting of high-scattering decidua vera (DV, average thickness d DV ≈ 92 ± 38 μm), low-scattering chorion and trophoblast (CT, d CT ≈ 150 ± 67 μm), high-scattering subepithelial amnion (A, d A ≈ 95 ± 36 μm), and low-scattering epithelium (E, d E ≈ 29 ± 8 μm). Importantly, 3D OCT was able to instantaneously detect MCPs (low scattering due to edema, fluid buildup, vasodilatation) and track (staging) their thicknesses d MCP ranging from 24 to 615 μm. It was also shown that high-frequency ultrasound was able to compliment OCT for detecting more advanced thicker MCPs (e.g., d MCP >615 μm) because of its increased imaging depth. C 2011 Society of Photo-Optical Instrumentation Engineers (SPIE).

Optical coherence tomography of human fetal membrane sub-layers during dynamic loading

“…Previously, static OCT images of fetal membranes were compared to histology sections and features like obliterated chorionic villi, pseudo-cysts, and calcifications were identified, and thicknesses were measured [28][29][30]. Separately, mechanical studies of fetal membranes loading response to inflation by pressurized saline or aspiration by vacuum have evaluated mechanical properties of these tissues using video camera measurements of membrane deflections (either side view of apex rise or top view of ink markings) [24].…”

“…Prior studies have defined the layers of the amniochorion with histology [28][29][30] and two-photon endogenous microscopy (2P microscopy) [6,7]. Therefore, histology and 2P microscopy were performed in paired samples with OCT volume imaging under mechanical loading to identify sources of contrast in the OCT volumes.…”

“…Optical coherence tomography (OCT) is an optical imaging technique akin to ultrasound imaging that uses low-coherence near-infrared or visible light to capture cross-sectional 2D or 3D images of the tissue with high (micrometer) resolution [26,27]. Previously, OCT was used to measure fetal membranes thickness [28,29] and identify features like atrophic chorionic ghost villi and chorionic pseudocysts [29,30]. However, these studies were limited to stationary samples without investigation of the effects of loading.…”

Fetal membrane imaging: current and future perspectives—a review

“…Magnetic resonance imaging (MRI) is also used to image the FMs, investigations in this domain remain relatively scarce ( Qi et al, 2020 ). In addition to the imaging of FMs in vivo, researchers also used the optical coherence tomography (OCT) method to image FMs in vitro to obtain a complete biological structure of FMs ( Ren et al, 2011 ; Micili et al, 2013 ; Avila et al, 2014 ).…”

“…FM imaging, such as ultrasound and MRI, uses noninvasive methods to visualize the structure of the FMs, which can predict the health of the fetus in the perinatal period with less danger to pregnant women and the fetus ( Nunes et al, 2016 ), while in vitro imaging of the FM is of great significance to the study morphological details of human FMs ( Ren et al, 2011 ). These imaging methods can provide meaningful information for the study of fetal membranes and the study of pPROM.…”