Viscoelasticity quantification by ultrasound for placental assessment in healthy versus gestational diabetes mellitus pregnancies.

IF 2.5 2区医学 Q2 DEVELOPMENTAL BIOLOGY

Placenta Pub Date : 2025-10-10 DOI:10.1016/j.placenta.2025.10.010

Jing Zhang, Jiahao Han, Lu Chen, Danlei Song, Jia Li

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引用次数: 0

Abstract

Introduction: Viscosity is a novel parameter, recently introduced in the use of elastographic techniques. Ultrasound viscoelastic imaging quantifies tissue stiffness and viscosity. This study investigated its application for quantitatively assessing placental viscoelastic parameters and identifying functional alterations in healthy versus gestational diabetes mellitus (GDM) pregnancies.

Methods: Pregnant women undergoing mid-trimester checkups (Jan-Apr 2025) at Zhongda Hospital were prospectively enrolled. Based on Oral Glucose Tolerance Test (OGTT) results, participants were categorized into GDM and control groups. Vmean and Emean were measured in the middle of anterior placenta using Mindray Resona A20S. Inter- and intra-observer reproducibility was assessed on the initial 55 placentas. Variables influencing Vmean were analyzed using univariate and multivariate linear regression.

Results: Reproducibility was excellent for Vmean (intra-observer ICC = 0.95, 95 % CI:0.91-0.97; inter-observer ICC = 0.94, 95 % CI:0.89-0.96) and good for Emean (intra-observer ICC = 0.79, 95 %CI:0.64-0.88; inter-observer ICC = 0.75, 95 % CI:0.58-0.86). The GDM group had significantly higher BMI, abdominal subcutaneous adipose tissue thickness (ASAT-thickness), Vmean, and Emean than controls (all p < 0.05). Multivariate regression identified GDM (β = 0.346, p < 0.001), Emean (β = 0.136, p < 0.001), and ASAT-thickness (β = 0.222, p < 0.001) as independent positive correlates of Vmean. This association between GDM and elevated Vmean was consistent across different levels of maternal ASAT-thickness.

Conclusions: Ultrasound viscoelastic imaging has demonstrated good reproducibility for measurements of placental Vmean and Emean. Elevated Vmean in pregnancies with GDM, along with its independent associations with GDM status, placental stiffness (Emean), and ASAT-thickness, supports its utility as a diagnostic parameter for placental assessment in GDM. The consistent association between GDM and elevated Vmean across different levels of maternal ASAT-thickness further strengthens its potential clinical applicability.

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超声粘弹性定量评价健康妊娠与妊娠期糖尿病妊娠的胎盘。

简介：粘度是一个新的参数，最近引入了弹性技术的使用。超声粘弹性成像量化组织刚度和粘度。本研究探讨了其在定量评估健康妊娠与妊娠期糖尿病（GDM）妊娠胎盘粘弹性参数和识别功能改变方面的应用。方法：前瞻性纳入中大医院于2025年1 - 4月进行中期体检的孕妇。根据口服葡萄糖耐量试验（OGTT）结果，将参与者分为GDM组和对照组。采用迈瑞超声A20S仪测量前胎盘中部的Vmean和Emean。在最初的55个胎盘中评估了观察者之间和观察者内部的可重复性。采用单因素和多因素线性回归分析影响Vmean的变量。结果：Vmean的重现性极好（观察者内ICC = 0.95, 95% CI:0.91-0.97；观察者间ICC = 0.94, 95% CI:0.89-0.96）， Emean的重现性良好（观察者内ICC = 0.79, 95% CI:0.64-0.88；观察者间ICC = 0.75, 95% CI:0.58-0.86）。GDM组BMI、腹部皮下脂肪组织厚度（ASAT-thickness）、Vmean和Emean均显著高于对照组（均为p）。结论：超声粘弹性成像测量胎盘Vmean和Emean具有良好的再现性。妊娠期GDM患者Vmean升高，以及其与GDM状态、胎盘硬度（Emean）和asat厚度的独立关联，支持其作为GDM胎盘评估的诊断参数的实用性。GDM与Vmean升高在不同asat厚度之间的一致关联进一步增强了其潜在的临床适用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Placenta 医学-发育生物学

CiteScore

6.30

自引率

10.50%

发文量

391

审稿时长

78 days

期刊介绍： Placenta publishes high-quality original articles and invited topical reviews on all aspects of human and animal placentation, and the interactions between the mother, the placenta and fetal development. Topics covered include evolution, development, genetics and epigenetics, stem cells, metabolism, transport, immunology, pathology, pharmacology, cell and molecular biology, and developmental programming. The Editors welcome studies on implantation and the endometrium, comparative placentation, the uterine and umbilical circulations, the relationship between fetal and placental development, clinical aspects of altered placental development or function, the placental membranes, the influence of paternal factors on placental development or function, and the assessment of biomarkers of placental disorders.