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Evaluation of fetal regional cerebral blood perfusion using power Doppler ultrasound and the estimation of fractional moving blood volume

Hernandez-Andrade, E.; Jansson, Tomas LU ; Figueroa-Diesel, H.; Rangel-Nava, H.; Acosta-Rojas, R. and Gratacos, E. (2007) In Ultrasound in Obstetrics & Gynecology 29(5). p.556-561
Abstract
Objective To standardize the evaluation of regional fetal brain blood perfusion, using power Doppler ultrasound (PDU) to estimate the fractional moving blood volume (FMBV) and to evaluate the reproducibility of this estimation. Methods Brain blood perfusion was evaluated in 35 normally grown fetuses at 28-30 weeks of gestation, using PDU. The following cerebral regions were included in the PDU color box: anterior sagittal, complete sagittal, basal ganglia, and cerebellar. Ten consecutive good-quality images of each anatomical plane were recorded and the delimitation of the region of interest (ROI) was performed off-line. FMBV was quantified in the ROI of all images and the mean considered as the final value. Differences between regions,... (More)
Objective To standardize the evaluation of regional fetal brain blood perfusion, using power Doppler ultrasound (PDU) to estimate the fractional moving blood volume (FMBV) and to evaluate the reproducibility of this estimation. Methods Brain blood perfusion was evaluated in 35 normally grown fetuses at 28-30 weeks of gestation, using PDU. The following cerebral regions were included in the PDU color box: anterior sagittal, complete sagittal, basal ganglia, and cerebellar. Ten consecutive good-quality images of each anatomical plane were recorded and the delimitation of the region of interest (ROI) was performed off-line. FMBV was quantified in the ROI of all images and the mean considered as the final value. Differences between regions, variability, reproducibility and agreement between observers were assessed. Results Power Doppler images of the described anatomical planes were obtained in all cases, regardless of fetal position. The median time for the acquisition of the images was 7 (range 4-12) min. Mean (range) FMBV values were: anterior sagittal, 16.5 (10.7-22.8)%, inter-patient coefficient of variation (CV) 0.22; complete sagittal, 13.5 (8.8-.16.1)%, CV 0.27; basal ganglia, 18.3 (10.7-27.6) %, CV 0.27; and cerebellar, 6.6 (3.0-11.0) %, CV 0.38. There were statistically significant differences in FMBV between cerebellar and complete sagittal ROIs with the frontal and basal ganglia regions. Reproducibility analyses showed an intraclass correlation coefficient of 0.91 (95% CI 0.67-0.97) and an interclass correlation coefficient of 0.87 (95% CI 0.70-0.94). Interobserver agreement showed a mean difference between observers of -0.2 (SD 2.7) with 95% limits of agreement -5.6 to 5.2. Conclusions When the regions of interest are well defined, the FMBV estimate offers a method to quantify blood flow perfusion in different fetal cerebral areas. There appear to be regional differences in FMBV within the fetal brain. Copyright (c) 2007 ISUOG. Published by John Wiley & Sons, Ltd. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Doppler, power, fractional moving blood volume, blood perfusion, fetal brain, reproducibility, standardization
in
Ultrasound in Obstetrics & Gynecology
volume
29
issue
5
pages
556 - 561
publisher
John Wiley & Sons
external identifiers
  • wos:000246878800013
  • scopus:34249668250
ISSN
1469-0705
DOI
10.1002/uog.4005
language
English
LU publication?
yes
id
c0feea95-a399-4e4a-92b4-30d82fe7e6d5 (old id 651269)
date added to LUP
2007-12-12 13:42:37
date last changed
2017-01-01 07:16:10
@article{c0feea95-a399-4e4a-92b4-30d82fe7e6d5,
  abstract     = {Objective To standardize the evaluation of regional fetal brain blood perfusion, using power Doppler ultrasound (PDU) to estimate the fractional moving blood volume (FMBV) and to evaluate the reproducibility of this estimation. Methods Brain blood perfusion was evaluated in 35 normally grown fetuses at 28-30 weeks of gestation, using PDU. The following cerebral regions were included in the PDU color box: anterior sagittal, complete sagittal, basal ganglia, and cerebellar. Ten consecutive good-quality images of each anatomical plane were recorded and the delimitation of the region of interest (ROI) was performed off-line. FMBV was quantified in the ROI of all images and the mean considered as the final value. Differences between regions, variability, reproducibility and agreement between observers were assessed. Results Power Doppler images of the described anatomical planes were obtained in all cases, regardless of fetal position. The median time for the acquisition of the images was 7 (range 4-12) min. Mean (range) FMBV values were: anterior sagittal, 16.5 (10.7-22.8)%, inter-patient coefficient of variation (CV) 0.22; complete sagittal, 13.5 (8.8-.16.1)%, CV 0.27; basal ganglia, 18.3 (10.7-27.6) %, CV 0.27; and cerebellar, 6.6 (3.0-11.0) %, CV 0.38. There were statistically significant differences in FMBV between cerebellar and complete sagittal ROIs with the frontal and basal ganglia regions. Reproducibility analyses showed an intraclass correlation coefficient of 0.91 (95% CI 0.67-0.97) and an interclass correlation coefficient of 0.87 (95% CI 0.70-0.94). Interobserver agreement showed a mean difference between observers of -0.2 (SD 2.7) with 95% limits of agreement -5.6 to 5.2. Conclusions When the regions of interest are well defined, the FMBV estimate offers a method to quantify blood flow perfusion in different fetal cerebral areas. There appear to be regional differences in FMBV within the fetal brain. Copyright (c) 2007 ISUOG. Published by John Wiley & Sons, Ltd.},
  author       = {Hernandez-Andrade, E. and Jansson, Tomas and Figueroa-Diesel, H. and Rangel-Nava, H. and Acosta-Rojas, R. and Gratacos, E.},
  issn         = {1469-0705},
  keyword      = {Doppler,power,fractional moving blood volume,blood perfusion,fetal brain,reproducibility,standardization},
  language     = {eng},
  number       = {5},
  pages        = {556--561},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in Obstetrics & Gynecology},
  title        = {Evaluation of fetal regional cerebral blood perfusion using power Doppler ultrasound and the estimation of fractional moving blood volume},
  url          = {http://dx.doi.org/10.1002/uog.4005},
  volume       = {29},
  year         = {2007},
}