声触诊弹性成像技术量化评估孕晚期妊娠糖尿病患者胎盘弹性

Sound touch elastography technique for quantification of placental elasticity in patients with late pregnancy gestational diabetes mellitus

目的评价声触诊弹性成像(STE)技术量化评估孕晚期妊娠糖尿病(GDM)患者胎盘弹性的价值。方法前瞻性纳入51例确诊的孕晚期GDM患者,由2名医师分别以STE技术测量胎盘母体面及胎儿面弹性模量,其中1名医师测量2次;以组内相关系数(ICC)及Bland-Altman图评价观察者内及观察者间测量结果的一致性,比较胎盘母体面及胎儿面平均弹性模量(E_(mean))差异。结果观察者内及观察者间测量GDM患者胎盘母体面及胎儿面弹性模量的一致性均好(观察者内:ICC=0.908、0.887;观察者间:ICC=0.827~0.905)。Bland-Altman图示STE量化评估胎盘弹性的一致性良好。胎盘母体面及胎儿面的中位E_(mean)分别为6.01(5.62,6.51)kPa及5.02(4.46,5.52)kPa,差异有统计学意义(P<0.001)。结论STE可稳定地量化评估孕晚期GDM患者胎盘弹性;胎盘母体面及胎儿面弹性存在差异。

Objective To explore the value of the sound touch elastography(STE)technique for quantifying placental elasticity in patients with late pregnancy gestational diabetes mellitus(GDM).Methods Totally 51 late pregnancy patients with confirmed GDM were prospectively enrolled.The modulus of elasticity on the maternal and fetal sides of the maternal placenta were measured by 2 physicians using STE technique,among them one physician measured 2 times.The intra-and inter-observer consistency of measurements were evaluated with intra-class correlation coefficient(ICC)and Bland-Altman plot.The mean elastic modulus(E_(mean))on the maternal and fetal side of the placenta were compared.Results The intra-and inter-observer consistency of measurements of elastic modulus on the maternal and fetal side of the placenta were both good(intra-observer:ICC=0.908,0.887;inter-observer:ICC=0.827-0.905).Bland-Altman plot demonstrated that there was good agreement of STE technique for quantifying placental elasticity.The median E_(mean) of the maternal and fetal side of the placenta in patients with GDM was 6.01(5.62,6.51)kPa and 5.02(4.46,5.52)kPa,respectively,there were significant differences(P<0.001).Conclusion STE technique could provide stable quantification of placental elasticity in patients with late pregnancy GDM.The elasticity of the placenta on maternal side were higher than that on the fetal side.