Three-Dimensional Fractional Moving Blood Volume: A Robust Bedside Tool for Evaluation of Fetal Multiorgan Perfusion

Author:

Smelt Emily,Thomas Samantha,Barber Tracie,Stevenson Gordon,Cung Alexandria Bao-Ngoc,Welsh Alec WilliamORCID

Abstract

<b><i>Introduction:</i></b> Three-dimensional fractional moving blood volume (3D-FMBV) may provide superior noninvasive measurement of feto-placental perfusion compared to current methods. This study investigated the feasibility and repeatability of producing 3D-FMBV measurements of the placenta, fetal liver, kidney, and brain in a single ultrasound consultation. <b><i>Methods:</i></b> The placenta, fetal liver, kidney, and brain were scanned in triplicate using 3D power Doppler ultrasound (3D-PDU) in 48 women ≥22 weeks of gestation with healthy fetuses. 3D-FMBV was calculated by two analyzers. Feasibility was assessed as the percentage of cases where 3D-FMBV could be evaluated; repeatability (intraobserver and interobserver) using two-way mixed measure intraclass correlation coefficients (ICCs). <b><i>Results:</i></b> 3D-FMBV was calculated for 100% of scanned organs. Intraobserver ICCs (95% CI) were good to excellent; 0.93 (0.88–0.96) and 0.87 (0.78–0.92) for placenta, 0.95 (0.92–0.97) and 0.98 (0.96–0.99) for fetal liver, 0.96 (0.94–0.98) and 0.91 (0.85–0.95) for fetal kidney, and 0.98 (0.97–0.99) and 0.97 (0.95–0.98) for fetal brain. Interobserver ICCs (95% CI) were 0.50 (0.08–0.73), 0.92 (0.85–0.96), 0.89 (0.78–0.94), and 0.71 (0.46–0.85) for placenta, fetal liver, kidney, and brain. <b><i>Conclusion:</i></b> Feto-placental perfusion assessment with 3D-FMBV is highly reliable in healthy pregnancies ≥22 weeks of gestation and can be feasibly calculated in four feto-placental vascular beds in a single ultrasound consultation.

Publisher

S. Karger AG

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