Normal Doppler Reference Values of the Pericallosal Artery

Abstract

Purpose: To provide the normal reference values of the Doppler flow of the pericallosal artery in relation to gestational age from 18 to 41 weeks of gestation.

Materials and Methods: The pericallosal artery (PCA) was studied in 466 normal pregnancies. The pulsed Doppler evaluation of the pericallosal artery was done in A3 and A4 segments, and records from PI, RI and Vmax were studied.

Results: The resistance index of the pericallosal artery in A3 / A4 segments exhibits a plateau from 18 to 31 weeks of gestation. After 31 weeks, a marked decrease becomes apparent. The pulsatility index of the pericallosal artery in A3 / A4 segments shows a plateau until 36 weeks of gestation. During the final weeks of gestation, there is a decrease in the pulsatility index. Vmax exhibits a plateau for the maximal flow velocity in A3 / A4 segments of the pericallosal artery from 18 to 28 weeks of gestation. After 28 weeks of gestation, there is a slight increase in Vmax.

Conclusion: Normal reference values of the pericallosal artery might have an impact on clinical judgment during adaptive hemodynamic changes and regarding the progression of the fetal deterioration occurring in the presence of fetal hypoxia.

Zusammenfassung

Ziel: Ziel dieser Studie war es, Dopplerfluss-Normwerte der A. pericallosa in Abhängigkeit vom Gestationsalter zwischen 18 und 41 Schwangerschaftswochen (SSW) zu erstellen.

Material und Methoden: Die A. pericallosa (PCA) wurde mit gepulstem Doppler bei 466 normalen Feten im Rahmen einer prospektiven Querschnittstudie untersucht. Die Messungen erfolgten in den A3- und A4-Segmenten der A. pericallosa, wobei die Parameter Resistance-Index (RI), Pulsatilitäts-Index (PI) und maximale Geschwindigkeit (Vmax) erfasst wurden.

Ergebnisse: Der RI der A. pericallosa zeigt in den A3/A4-Segmenten ein Plateau zwischen 18 und 31 SSW. Nach 31 SSW erkennt man einen deutlichen Abfall. Der PI der A. pericallosa weist in den A3/A4-Segmenten ein Plateau bis 36 SSW auf. Danach kommt es ebenfalls zu einem Abfall. Die Vmax zeigt in den A3/A4-Segmenten ein Plateau von 18 bis 28 SSW. Nach 28 SSW erkennt man einen leichten Anstieg der Vmax-Werte.

Schlussfolgerung: Die Normkurven von RI, PI und Vmax der A. pericallosa ergeben neben der A. cerebri media eine weitere Möglichkeit, adaptive hämodynamische Veränderungen im Gehirn zu erkennen. Inwieweit die Butflusssmessungen in der A. pericallosa eine Rolle in der frühzeitigen Erkennung einer fetalen Hypoxie spielen wird, müssen weitere Studien zeigen.

Key words

brain - blood vessels - prenatal

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