The predictive value of cerebroplacental ratio in stageⅡof twin-twin transfusion syndrome / 中华超声影像学杂志

ABSTRACT

Objective:To analyze the cerebroplacental blood flow distribution characteristics in monochorionic-diamniotic(MCDA) twin pregnancies with stageⅠ-Ⅱof twin-twin transfusion syndrome (TTTS), and investigate the predictive value of cerebroplacental ratio (CPR) in the stageⅡ of TTTS.Methods:The cerebroplacental blood flow distribution were analyzed retrospectively in 68 cases from June 2017 to June 2019 in the First Affiliated Hospital of Chongqing Medical University (34 cases for each stage) with TTTS, including the umbilical artery pulsatility index (UA-PI), middle cerebral artery peak systolic velocity (MCA-PSV), middle cerebral artery pulsatility index (MCA-PI), CPR, and their discordances(UA-PI disc, MCA-PSV disc, MCA-PI disc and CPR disc). Results:The differences of UA-PI, MCA-PI, and CPR between donors and recipients in TTTS Ⅱ were statistically significant (all P<0.05), the differences of UA-PI disc, MCA-PI disc and CPR disc between TTTS Ⅰ and TTTS Ⅱ were statistically significant (all P<0.05). Multivariate Logistic regression analyses showed that only CPR disc was independently associated with the stage Ⅱ of TTTS( P<0.05), and it had moderate predictive accuracy for the stage Ⅱ of TTTS with an area under the curve of 0.766, a sensitivity of 64.71% and a specificity of 82.35%( P<0.001). Conclusions:More cerebroplacental blood flow discordances are observed and CPR disc is closely related to stageⅡof TTTS.