Abstract：
UNASSIGNED: To assess the predictive accuracy of three-dimensional (3D) power Doppler combined with two-dimensional (2D) Doppler ultrasonography in detecting fetal growth restriction (FGR).
UNASSIGNED: The study was conducted on singleton pregnancies presenting for growth ultrasound examinations between 20 and 40 weeks of gestation. 63 patients with FGR were enrolled and matched 1:1.8 for gestational age with normal fetuses. Both groups were further divided into subgroups, with 32 weeks as the threshold-early-onset and late-onset FGR groups, and corresponding control groups. Conventional 2D Doppler parameters and standardized 3D power Doppler measurements of the placenta, including vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) were obtained for each patient.
UNASSIGNED: (1) The average gestational weeks of delivery and birth weight of newborns in early-onset and late-onset FGR case groups were lower than those in control groups, while the incidence of placenta previa and adverse pregnancy outcomes were higher than those in control groups. (2) The biparietal diameter, head circumference, abdominal circumference, femur length, estimated fetal weight, middle cerebral artery systolic/diastolic velocity ratio (S/D), pulsatility index (PI), resistance index (RI), and placental blood perfusion indices of vascular index (VI), flow index (FI), vascular flow index (VFI), and cerebro-placental ratio (CPR) of the early-onset and late-onset FGR case groups were all lower than those of the control group. Moreover, the S/D, PI, and RI of the umbilical and uterine arteries were higher than those of the corresponding control group. (3) For early-onset FGR, the area under the curve (AUC) of the umbilical artery PI was the largest (0.861), exhibiting the highest predictive value. When combined with the placental blood perfusion index, the AUC was 0.789. For late-onset FGR, the AUC of the CPR was 0.861. After integrating the placental blood perfusion index, the AUC increased to 0.877. The positive likelihood ratio (PLR) of combined 2D Doppler indexes (21.938) and negative likelihood ratio (NLR) of VFI (0.565) were the highest in the early-onset FGR group. The PLR of combined 3D Doppler indexes (8.536) and NLR of VFI (0.557) were the highest in the late-onset FGR group.
UNASSIGNED: The combination of 3D Doppler indices with 2D Doppler ultrasonography demonstrated superior predictive value in diagnosing late-onset FGR compared to other conventional indicators. The 3D Dower index, VFI, has a good true-negative predictive value for both early- and late-onset FGR.
UNASSIGNED: The study was conducted on singleton pregnancies presenting for growth ultrasound examinations between 20 and 40 weeks of gestation. 63 patients with FGR were enrolled and matched 1:1.8 for gestational age with normal fetuses. Both groups were further divided into subgroups, with 32 weeks as the threshold-early-onset and late-onset FGR groups, and corresponding control groups. Conventional 2D Doppler parameters and standardized 3D power Doppler measurements of the placenta, including vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) were obtained for each patient.
UNASSIGNED: (1) The average gestational weeks of delivery and birth weight of newborns in early-onset and late-onset FGR case groups were lower than those in control groups, while the incidence of placenta previa and adverse pregnancy outcomes were higher than those in control groups. (2) The biparietal diameter, head circumference, abdominal circumference, femur length, estimated fetal weight, middle cerebral artery systolic/diastolic velocity ratio (S/D), pulsatility index (PI), resistance index (RI), and placental blood perfusion indices of vascular index (VI), flow index (FI), vascular flow index (VFI), and cerebro-placental ratio (CPR) of the early-onset and late-onset FGR case groups were all lower than those of the control group. Moreover, the S/D, PI, and RI of the umbilical and uterine arteries were higher than those of the corresponding control group. (3) For early-onset FGR, the area under the curve (AUC) of the umbilical artery PI was the largest (0.861), exhibiting the highest predictive value. When combined with the placental blood perfusion index, the AUC was 0.789. For late-onset FGR, the AUC of the CPR was 0.861. After integrating the placental blood perfusion index, the AUC increased to 0.877. The positive likelihood ratio (PLR) of combined 2D Doppler indexes (21.938) and negative likelihood ratio (NLR) of VFI (0.565) were the highest in the early-onset FGR group. The PLR of combined 3D Doppler indexes (8.536) and NLR of VFI (0.557) were the highest in the late-onset FGR group.
UNASSIGNED: The combination of 3D Doppler indices with 2D Doppler ultrasonography demonstrated superior predictive value in diagnosing late-onset FGR compared to other conventional indicators. The 3D Dower index, VFI, has a good true-negative predictive value for both early- and late-onset FGR.
摘要：
■评估三维（3D）能量多普勒联合二维（2D）多普勒超声检查在检测胎儿生长受限（FGR）中的预测准确性。
这项研究是在妊娠20至40周之间进行生长超声检查的单胎妊娠。纳入63例FGR患者，胎龄与正常胎儿匹配1：1.8。两组进一步分为亚组，以32周为阈值-早发性和晚发性FGR组，和相应的对照组。胎盘的常规2D多普勒参数和标准化3D功率多普勒测量，包括血管化指数（VI），流量指数（FI），获得每位患者的血管化-血流指数（VFI）。
■(1)早发型和晚发型FGR病例组新生儿的平均分娩孕周和出生体重均低于对照组,而前置胎盘发生率及不良妊娠结局均高于对照组。(2)双顶直径,头围,腹围,股骨长度,估计胎儿体重，大脑中动脉收缩/舒张速度比（S/D），搏动指数(PI),阻力指数(RI)，和胎盘血液灌注指数的血管指数（VI），流量指数（FI），血管血流指数（VFI），早发性和晚发性FGR病例组的脑胎盘比率（CPR）均低于对照组。此外，S/D,PI,脐动脉和子宫动脉的RI高于相应的对照组。（3）对于早发性FGR，脐动脉PI曲线下面积(AUC)最大(0.861),表现出最高的预测值。当结合胎盘血液灌注指数，AUC为0.789。对于迟发性FGR，CPR的AUC为0.861.整合胎盘血液灌注指数后，AUC增加到0.877。在早发性FGR组中，组合2D多普勒指数的正似然比（PLR）（21.938）和VFI的负似然比（NLR）（0.565）最高。晚发性FGR组组合3D多普勒指数的PLR（8.536）和VFI的NLR（0.557）最高。
■与其他常规指标相比，3D多普勒指数与2D多普勒超声检查的组合在诊断迟发性FGR方面显示出更好的预测价值。3DDower索引，VFI,对早期和晚期FGR都有很好的真阴性预测值。
这项研究是在妊娠20至40周之间进行生长超声检查的单胎妊娠。纳入63例FGR患者，胎龄与正常胎儿匹配1：1.8。两组进一步分为亚组，以32周为阈值-早发性和晚发性FGR组，和相应的对照组。胎盘的常规2D多普勒参数和标准化3D功率多普勒测量，包括血管化指数（VI），流量指数（FI），获得每位患者的血管化-血流指数（VFI）。
■(1)早发型和晚发型FGR病例组新生儿的平均分娩孕周和出生体重均低于对照组,而前置胎盘发生率及不良妊娠结局均高于对照组。(2)双顶直径,头围,腹围,股骨长度,估计胎儿体重，大脑中动脉收缩/舒张速度比（S/D），搏动指数(PI),阻力指数(RI)，和胎盘血液灌注指数的血管指数（VI），流量指数（FI），血管血流指数（VFI），早发性和晚发性FGR病例组的脑胎盘比率（CPR）均低于对照组。此外，S/D,PI,脐动脉和子宫动脉的RI高于相应的对照组。（3）对于早发性FGR，脐动脉PI曲线下面积(AUC)最大(0.861),表现出最高的预测值。当结合胎盘血液灌注指数，AUC为0.789。对于迟发性FGR，CPR的AUC为0.861.整合胎盘血液灌注指数后，AUC增加到0.877。在早发性FGR组中，组合2D多普勒指数的正似然比（PLR）（21.938）和VFI的负似然比（NLR）（0.565）最高。晚发性FGR组组合3D多普勒指数的PLR（8.536）和VFI的NLR（0.557）最高。
■与其他常规指标相比，3D多普勒指数与2D多普勒超声检查的组合在诊断迟发性FGR方面显示出更好的预测价值。3DDower索引，VFI,对早期和晚期FGR都有很好的真阴性预测值。
