E-ISSN 1305-3612
Fetal Imaging - Original Article
Shear wave elastography of placenta: in vivo quantitation of placental elasticity in preeclampsia
1 Department of Radiology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey  
2 Department of Obstetrics and Gynecology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey  
Diagn Interv Radiol 2015; 21: 202-207
DOI: 10.5152/dir.2014.14338
Abstract

PURPOSE

We aimed to evaluate the utility of shear wave elastography (SWE) for assessing the placenta in preeclampsia disease.

 

METHODS

A total of 50 pregnant women in the second or third trimester (23 preeclampsia patients and 27 healthy control subjects) were enrolled in the study. Obstetrical grayscale and Doppler ultrasonography, SWE findings of placenta, and prenatal/postnatal clinical data were analyzed and the best SWE cutoff value which represents the diagnosis of preeclampsia was determined. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of preeclampsia were calculated based on SWE measurements.

 

RESULTS

Mean stiffness values were much higher in preeclamptic placentas in all regions and layers than in normal controls. The most significant difference was observed in the central placental area facing the fetus where the umbilical cord inserts, with a median of 21 kPa (range, 3–71 kPa) for preeclampsia and 4 kPa (range, 1.5–14 kPa) for the control group (P < 0.01). The SWE data showed a moderate correlation with the uterine artery resistivity and pulsatility indices. The cutoff value maximizing the accuracy of diagnosis was 7.35 kPa (area under curve, 0.895; 95% confidence interval, 0.791–0.998); sensitivity, specificity, PPV, NPV, and accuracy were 90%, 86%, 82%, 92%, and 88%, respectively.

 

CONCLUSION

Stiffness of the placenta is significantly higher in patients with preeclampsia. SWE appears to be an assistive diagnostic technique for placenta evaluation in preeclampsia.

 

 

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