Standardization of power Doppler quantification of blood flow in the human fetus using the aorta and inferior vena cava

Welsh, A. W., Rubin, J. M., Fowlkes, J. B. and Fisk, N. M. (2005) Standardization of power Doppler quantification of blood flow in the human fetus using the aorta and inferior vena cava. Ultrasound in Obstetrics and Gynecology, 26 1: 33-43. doi:10.1002/uog.1924


Author Welsh, A. W.
Rubin, J. M.
Fowlkes, J. B.
Fisk, N. M.
Title Standardization of power Doppler quantification of blood flow in the human fetus using the aorta and inferior vena cava
Journal name Ultrasound in Obstetrics and Gynecology   Check publisher's open access policy
ISSN 0960-7692
1469-0705
1472-1201
Publication date 2005-07-01
Sub-type Article (original research)
DOI 10.1002/uog.1924
Volume 26
Issue 1
Start page 33
End page 43
Total pages 11
Place of publication Carnforth, U.K.
Publisher Parthenon
Language eng
Subject 111402 Obstetrics and Gynaecology
1114 Paediatrics and Reproductive Medicine
Formatted abstract
Objective: This study aimed to test the applicability to the fetus of mathematical techniques developed to standardize power Doppler indices of adult regional perfusion.
Method: Fetal power Doppler imaging was performed on 14 fetuses (25-37 weeks' gestation) using a standardized parasagittal plane, examining renal and aortic blood flow, and additionally inferior vena caval (IVC) flow in one fetus. Images were stored and transferred for off-line computer analysis using purpose-designed software. We first tested the need for techniques to remove the effects of red blood cell clumping on power Doppler amplitude, then performed further analyses to: (1) investigate cardiac cycle effects on aortic amplitude; (2) determine the spatial consistency of, and influence of angle of insonation on, maximal pixel value; (3) quantify temporal consistency; and (4) compare peak pixel values in the fetal aorta and IVC.
Results: No rouleaux effect on the vascular profile was detectable, in contrast to that identified in the adult. Within each fetus a consistent value was seen in the center of the aorta corresponding to 100% vascular amplitude, which was unaltered by the phase of the cardiac cycle, with a coefficient of variation of 28.9% at 89° and 6.5% at 73°. This value was constant in the aorta and IVC.
Conclusion: Fetal blood does not appear to form rouleaux to any significant degree, so there is no artificially elevated maximal value for power Doppler amplitude as seen in the adult. We propose that the value representing 100% amplitude may be consistently measured in the center of large fetal vessels such as the aorta, allowing the direct measurement of fractional moving blood volumes in the human fetus.
Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.
Keyword Fetal perfusion
Fetus
Fractional moving blood volume
Power Doppler
Renal
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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