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

Fetal Diagn Ther. 2024;51(5):432-444. doi: 10.1159/000539271. Epub 2024 Jun 20.

Abstract

Introduction: 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.

Methods: 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).

Results: 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.

Conclusion: 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.

Keywords: Brain-sparing; Doppler ultrasound; Fetal growth restriction; Perfusion; Three-dimensional fractional moving blood volume.

MeSH terms

  • Adult
  • Blood Volume
  • Brain / blood supply
  • Brain / diagnostic imaging
  • Brain / embryology
  • Feasibility Studies
  • Female
  • Fetus / blood supply
  • Fetus / diagnostic imaging
  • Humans
  • Imaging, Three-Dimensional* / methods
  • Kidney / blood supply
  • Kidney / diagnostic imaging
  • Liver / blood supply
  • Liver / diagnostic imaging
  • Liver / embryology
  • Placenta / blood supply
  • Placenta / diagnostic imaging
  • Pregnancy
  • Reproducibility of Results
  • Ultrasonography, Doppler / methods
  • Ultrasonography, Prenatal* / methods