Postpartum computed tomography angiography of the fetoplacental macrovasculature in normal pregnancies and in those complicated by fetal growth restriction

Thunbo, Mette Østergaard; Sinding, Marianne; Korsager, Anne Sofie; Frøkjær, Jens Brøndum; Østergaard, Lasse Riis; Petersen, Astrid; Overgaard, Charlotte; Sørensen, Anne

doi:10.1111/aogs.13289

Cited by 10 publications

(10 citation statements)

References 31 publications

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“…Additionally, a more in-depth look at the structural differences between healthy and pathological placentae has been possible [14,18,23,26,28]. …”

Section: Discussionmentioning

confidence: 99%

“…Three-dimensional imaging has allowed the quantification of some intriguing geometrical parameters of the terminal villi [ 18 , 19 ]. Additionally, a more in-depth look at the structural differences between healthy and pathological placentae has been possible [ 14 , 18 , 23 , 26 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…(c)The complex vasculature of a terminal villi reconstructed from fluorescent CLSM and used for computational simulations [ 19 ]. (d)Reconstruction of the global feto-placental network from CT angiography [ 23 ]. (e)3D rendering from MRA [ 15 ].…”

Section: Human Placental Morphologymentioning

confidence: 99%

“…To allow an automatic reconstruction of placental images, Thunbo etal. [ 23 ] injected a contrasting mixture to the feto-placental vasculature and imaged the villous trees using computed tomography angiography (CTA). In this work, FGR placentae showed an increase in macrovascular density, calculated as the ratio of macrovascular parameters (vascular surface area and the number of vessel junctions) and placental volume.…”

Section: Human Placental Morphologymentioning

confidence: 99%

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Advances in Human Placental Biomechanics

Mayo

2018

Computational and Structural Biotechnology Journal

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Pregnancy complications are a major clinical concern due to the related maternal and fetal morbidity. Many are caused through defective placentation, but research into placental function is difficult, principally because of the ethical limitations associated with the in-vivo organ and the difficulty of extrapolating animal models. Perfused by two separate circulations, the maternal and fetal bloodstreams, the placenta has a unique structure and performs multiple complex functions. Three-dimensional imaging and computational modelling are becoming popular tools to investigate the morphology and physiology of this organ. These techniques bear the potential for better understanding the aetiology and development of placental pathologies, however, their full potential is yet to be exploited. This review aims to summarize the recent insights into placental structure and function by employing these novel techniques.

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“…Additionally, a more in-depth look at the structural differences between healthy and pathological placentae has been possible [14,18,23,26,28]. …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Human Placental Morphologymentioning

confidence: 99%

Section: Human Placental Morphologymentioning

confidence: 99%

See 2 more Smart Citations

Advances in Human Placental Biomechanics

Mayo

2018

Computational and Structural Biotechnology Journal

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“…These approaches generally require balancing resolution with sample volume. Structural analyses of placental vessels from whole organ or single villous branches have been conducted using multiple imaging modalities [1,2] including CT angiography [3], micro-CT [4,5], confocal laser scanning microscopy [6] and fluorescent CLSM [7]. Each of these methods has positives and negatives associated with it, however, none of them provide access to 3D micro-structures in situ, at high enough resolution to resolve the blood vessels, or functional units of the placenta, and still provide contextual information of the tissue.…”

Section: Introductionmentioning

confidence: 99%

A massively multi-scale approach to characterising tissue architecture by synchrotron micro-CT applied to the human placenta

Tun

Poologasundarampillai

Bischof

et al. 2020

Preprint

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Multi-scale structural assessment of biological soft tissue is challenging but essential to gain insight into structure-function relationships of tissue/organ. Using the human placenta as an example, this study brings together sophisticated sample preparation protocols, advanced imaging, and robust, validated machine-learning segmentation techniques to provide the first massively multi-scale and multi-domain information that enables detailed morphological and functional analyses of both maternal and fetal placental domains. Finally, we quantify the scale-dependent error in morphological metrics of heterogeneous placental tissue, estimating the minimal tissue scale needed in extracting meaningful biological data. The developed protocol is beneficial for high-throughput investigation of structure-function relationships in both normal and diseased placentas, allowing us to optimise therapeutic approaches for pathological pregnancies. In addition, the methodology presented is applicable in characterisation of tissue architecture and physiological behaviours of other complex organs with similarity to the placenta, where an exchange barrier possesses circulating vascular and avascular fluid spaces.SummaryUsing the human placenta as an example, this study brings together sophisticated sample preparation protocols, advanced 3D X-ray imaging, and robust, validated machine-learning segmentation techniques to provide massively multi-scale and multi-domain insights on vascular-rich organ morphology and function.

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Characterization of Placental Microvascular Architecture by MV‐Flow Imaging in Normal and Fetal Growth–Restricted Pregnancies

Chen

Xia

Zhao

et al. 2020

J of Ultrasound Medicine

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Objectives-To observe the microvascular architecture in the placental bed and explore the feasibility and clinical utility of MV-Flow imaging (Samsung Medison Co, Ltd, Seoul, Korea) during normal pregnancy and fetal growth restriction (FGR).Methods-Placental microvascular structure ultrasound imaging by MV-Flow was performed on 227 unaffected and 17 FGR fetuses between 11 and 41 weeks' gestation. A placental vascular index (VI MV ) was acquired by application of various MV-Flow regions of interest (ellipse, rectangle, and manual trace). Unaffected control and FGR groups were assessed for umbilical artery, middle cerebral artery, and uterine artery pulsatility indices and the cerebroplacental ratio calculated by ultrasound.Results-No significant difference in the VI MV by varying regions of interest or placental regions was observed in the control group. The VI MV in the first trimester was lower than that in the second and third trimesters, with 5th through 95th percentile normal VI MV reference values of 18.39 to 63.79 for 13.6 weeks and earlier, 28.53 to 66.64 for 14 weeks to 27 weeks 6 days, and 21.95 to 67.45 for 28 weeks and later. The VI MV values in the FGR group were lower than those in the control group in the upper, middle, and lower parts of the placenta (mean AE SD, 24.9 AE 13.9 versus 45.0 AE 13.4; P < .01; 30.5 AE 16.1 versus 44.7 AE 14.3; P < .01; and 29.9 AE 17.4 versus 47.6 AE 12.2; P < .01, respectively). Higher umbilical artery and uterine artery pulsatility indices and a lower cerebroplacental ratio were found in the FGR group compared with the control group (P < .01).Conclusions-MV-Flow technology can display and quantify placental microvascular architecture at the level of the stem villi and villous leaves, and the VI MV provides for quantification of tissue vascularity. MV-Flow is a potentially powerful and promising tool to explore placental microvascular perfusion and provide new information on a host of pregnancy-related conditions. Key Words-fetal growth restriction; MV-Flow; placental microvascular F etal growth restriction (FGR) is one of the most common pregnancy complications, accounting for approximately 3% to 9% of all pregnancies. It remains the leading cause of preventable stillbirth and neurodevelopmental complications in offspring. 1,2 There are many possible causes of FGR, including maternal, fetal, and placental factors, such as maternal alcohol and

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Postpartum computed tomography angiography of the fetoplacental macrovasculature in normal pregnancies and in those complicated by fetal growth restriction

Cited by 10 publications

References 31 publications

Advances in Human Placental Biomechanics

Advances in Human Placental Biomechanics

A massively multi-scale approach to characterising tissue architecture by synchrotron micro-CT applied to the human placenta

Characterization of Placental Microvascular Architecture by MV‐Flow Imaging in Normal and Fetal Growth–Restricted Pregnancies

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