Quantitative imaging in medicine and surgery · 2025
Assessment of uteroplacental perfusion with 3D power Doppler for the early prediction of pre-eclampsia: a systematic review and meta-analysis.
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Wang Yurun, Zheng Mei, Bao Min, Wang Haiyu
Аннотация
BACKGROUND: The assessment of uteroplacental perfusion to identify the risk of pre-eclampsia (PE) is essential but challenging. We conducted a meta-analysis to evaluate the value of vascularization indices (VIs) derived from three-dimensional power Doppler (3D-PD) for the early prediction of PE.
METHODS: We conducted a search of the PubMed, Web of Science, Cochrane Library, and Embase databases to retrieve eligible studies, published up to October 22, 2024. Studies were considered eligible for inclusion in the meta-analysis if they assessed entire placental perfusion and/or placental bed perfusion using 3D-PD during early gestation, and reported on the occurrence of PE as a primary outcome. The measured indices included the Placental Vascularization Index (PVI), Placental Flow Index (PFI), Placental Vascularization Flow Index (PVFI), and/or Placental Bed Vascularization Index (PBVI). An adapted Quality Assessment of Diagnostic Accuracy Studies 2 tool was used to assess the risk of bias. The standardized mean difference (SMD), sensitivity, and specificity for each index were calculated. The protocol was registered in the International Prospective Register of Systematic Reviews (CRD42024600360).
RESULTS: A total of 11 articles comprising 9,622 participants were included in the meta-analysis. The SMD values of the VIs between the PE and normal groups were as follows: -0.94 for the PVI, -0.94 for the PFI, -0.76 for the PVFI, and -0.53 for the PBVI. The pooled area under the curve values for predicting PE were 0.8947 for the PVI, 0.8933 for the PFI, and 0.8900 for the PVFI, respectively.
CONCLUSIONS: Women who subsequently develop PE tend to have lower PVIs and PBVI values in the first trimester. The PVI, PFI, and PVFI obtained from 3D-PD are all valuable non-invasive predictors of PE in early pregnancy. The processes and machine settings need to be standardized before they can be applied in clinical practice.
METHODS: We conducted a search of the PubMed, Web of Science, Cochrane Library, and Embase databases to retrieve eligible studies, published up to October 22, 2024. Studies were considered eligible for inclusion in the meta-analysis if they assessed entire placental perfusion and/or placental bed perfusion using 3D-PD during early gestation, and reported on the occurrence of PE as a primary outcome. The measured indices included the Placental Vascularization Index (PVI), Placental Flow Index (PFI), Placental Vascularization Flow Index (PVFI), and/or Placental Bed Vascularization Index (PBVI). An adapted Quality Assessment of Diagnostic Accuracy Studies 2 tool was used to assess the risk of bias. The standardized mean difference (SMD), sensitivity, and specificity for each index were calculated. The protocol was registered in the International Prospective Register of Systematic Reviews (CRD42024600360).
RESULTS: A total of 11 articles comprising 9,622 participants were included in the meta-analysis. The SMD values of the VIs between the PE and normal groups were as follows: -0.94 for the PVI, -0.94 for the PFI, -0.76 for the PVFI, and -0.53 for the PBVI. The pooled area under the curve values for predicting PE were 0.8947 for the PVI, 0.8933 for the PFI, and 0.8900 for the PVFI, respectively.
CONCLUSIONS: Women who subsequently develop PE tend to have lower PVIs and PBVI values in the first trimester. The PVI, PFI, and PVFI obtained from 3D-PD are all valuable non-invasive predictors of PE in early pregnancy. The processes and machine settings need to be standardized before they can be applied in clinical practice.