We propose an original method of complex assessment of the placental angioarchitechtonics based on computed tomography (CT) and morphological examination. A prerequisite condition of successful examination and assessment of the placental angioarchitechtonics is the pre-preparative stage including clearing of the placental and umbilical cord vessels from blood clots by placement of placenta into 10% hypertonic NaCl solution and then on a hygroscopic substrate. The major stage of this method is injection of contrast staining mixtures into the umbilical vessels followed by CT. The concentration of radiocontrast agent in water solution of gouache should be 70% for arteries and 15% for veins. The volumes of mixtures for contrast staining should be calculated according to the weight of the placenta. The contrast staining mixture was first injected into the catheterized unpaired umbilical vein, and then into both umbilical arteries. Each injection of the contrast staining mixture was visually inspected; then branching of the stained vessel was photographed and scanned by CT. The CT scans were used to construct 3D models of placental vessels and spectral color maps, which made it possible to examine the peculiarities of placental angioarchitechtonics, to identify and evaluate anastomoses of placental vessels, and to establish the type of these anastomoses.
Similar content being viewed by others
References
Sidorova IS, Makarov IO. Clinical and Diagnostic Aspects of Fetoplacental Insufficiency. Moscow, 2005. Russian.
Tumanova UN, Lyapin VM, Kozlova AV, Baev OR, Bychenko VG, Shchegolev AI. Umbilical vein aneurysm: A clinical case and a review of literature. Akush. Ginekol. 2018;(6):119-125. Russian.
Tumanova UN, Lyapin VM, Schegolev AI. Placental pathology in twin gestations. Sovremen. Probl. Nauki Obrazovaniya. 2017;(5):56. Russian.
Tumanova UN, Lyapin VM, Shchegolev AI, Baev OR, Prikhodko AM, Kozhina EA, Khodzhaeva ZS. Giant hemangioma of the placenta. Akush. Ginekol. 2017;(10):136-143. Russian.
Tumanova UN, Shchegolev AI. Placental lesions as the cause of stillbirth (review). Mezhdunarod. Zh. Prikl. Fundament. Issled. 2017;(3-1):77-81. Russian.
Shchegolev AI, Serov VN. Clinical significance of placental lesions. Akush. Ginekol. 2019;(3):54-62. Russian.
Benirschke K, Kaufmann P. Pathology of the Human Placenta. New York, 2000.
Berghella V, Kaufmann M. Natural history of twin-twin transfusion syndrome. J. Reprod. Med. 2001;46(5):480-484.
Galluzo RN, Franco MJ, Faust LW, Dacorégio KS, Braga JRD, Werner Junior H, Araujo Júnior E. Virtual three-dimensional placentoscopy: a new approach to assess residual anastomoses following laser photocoagulation in twin-to-twin transfusion syndrome. J. Matern. Fetal Neonatal Med. 2018;31(4):518-520. https://doi.org/10.1080/14767058.2017.1286321
van Gemert MJ, Sterenborg HJ. Haemodynamic model of twin-twin transfusion syndrome in monochorionic twin pregnancies. Placenta. 1998;19(2-3):195-208.
Gou C, Li M, Zhang X, Liu X, Huang X, Zhou Y, Fang Q. Placental characteristics in monochorionic twins with selective intrauterine growth restriction assessed by gradient angiography and three-dimensional reconstruction. J. Matern. Fetal. Neonatal Med. 2017;30(21):2590-2595. https://doi.org/10.1080/14767058.2016.1256995
Lewi L, Deprest J, Hecher K. The vascular anastomoses in monochorionic twin pregnancies and their clinical consequences.. Am. J. Obstet. Gynecol. 2013;208(1):19-30. https://doi.org/10.1016/j.ajog.2012.09.025
Lopriore E, Middeldorp JM, Oepkes D, Klumper FJ, Walther FJ, Vandenbussche FP. Residual anastomoses after fetoscopic laser surgery in twin-to-twin transfusion syndrome: frequency, associated risks and outcome. Placenta. 2007;28(2-3):204-208.
Lopriore E, Slaghekke F, Middeldorp J.M, Klumper FJ, van Lith JM, Walther FJ, Oepkes D. Accurate and simple evaluation of vascular anastomoses in monochorionic placenta using colored dye. J. Vis. Exp. 2011. N 55. e3208. https://doi.org/10.3791/3208
Wee LY, Taylor M, Watkins N, Franke V, Parker K, Fisk NM. Characterization of deep arterio-venous anastomoses within monochorionic placentae by vascular casting. Placenta. 2005;26(1):19-24.
Author information
Authors and Affiliations
Corresponding author
Additional information
Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 169, No. 3, pp. 380-386, March, 2020
Rights and permissions
About this article
Cite this article
Shchegolev, A.I., Tumanova, U.N., Lyapin, V.M. et al. Complex Method of CT and Morphological Examination of Placental Angioarchitechtonics. Bull Exp Biol Med 169, 405–411 (2020). https://doi.org/10.1007/s10517-020-04897-4
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10517-020-04897-4