Ultrassonografia modo b e elastografia Acoustic Radiation Force Impulse (ARFI) de tecidos materno fetais durante a gestação em ovinos
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Data
2017-02-24
Autores
Silva, Priscila Del Aguila da [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O objetivo deste estudo foi avaliar a rigidez de tecidos materno fetais em ovinos a partir da décima semana de gestação, por meio da elastografia ARFI (Acoustic Radiation Force Impulse), determinando padrões qualitativos e quantitativos, com o intuito de verificar a aplicabilidade da técnica elastográfica no estudo do desenvolvimento desses tecidos. Foram avaliadas 24 ovelhas multíparas, com peso entre 40 e 60 quilos e idade entre 2 e 5 anos, da raça Santa Inês. Após a realização de exames prévios e verificada a higidez dos animais, estes foram submetidos a um protocolo de sincronização de estro seguido da monta natural. Quando confirmada a prenhez, foram submetidos aos exames ultrassonográfico convencional e elastografia (método ARFI quantitativo e qualitativo) do tecido pulmonar, hepático, renal e placentônios, com a utilização do aparelho ultrassonográfico ACUSON S2000/SIEMENS e softwares específicos. Os exames foram realizados semanalmente, a partir da décima semana gestacional (64 a 70 dias) até a semana da parição, sendo verificados os achados sonográficos destes tecidos, velocidade de cisalhamento (avaliação elastográfica quantitativa) e suas características de rigidez (avaliação elastográfica qualitativa). O delineamento experimental foi inteiramente casualizado e se utilizou nível de significância de 5% para todos os testes realizados. Os animais não apresentaram quaisquer alterações clínicas e obstétricas durante o período gestacional e parto. Os neonatos apresentaram-se saudáveis e normais. A elastografia ARFI foi realizada de forma consistente e sem qualquer dificuldade. A elastografia qualitativa de todos os tecidos não se apresentou deformável, demonstrando imagem homogênea. À avaliação quantitativa, as velocidades de cisalhamento pulmonar (95% CI = 0.70 a 0.62 m/s) e hepática (95% IC = 0,79 a 0,96 m/s) variaram ao longo das semanas gestacionais (p < 0,001), enquanto as velocidades renal (95% IC = 1,53 a 1,36 m/s) e do placentônio (95% IC = 2,34 a 2,28 m/s) não apresentaram diferença (p = 0,076 e 0,34 respetivamente). A elastografia ARFI demostrou ser uma técnica prática e segura para a avalição do binômio materno-fetal, permitindo identificar os padrões de rigidez do placentônio, pulmão, fígado e rim fetais; apresentando correlação com o desenvolvimento gestacional das ovelhas por meio dos resultados da velocidade de cisalhamento dos tecidos pulmonares e hepáticos. Sugere-se que este método pode ser utilizado para estudos fisiológicos e patológicos na gestação de diversas espécies mamíferas.
The aim of this study was to evaluate the stiffness of maternal fetal tissues of ovines from the tenth week of gestation, using elastography ARFI (Acoustic Radiation Force Impulse), with the purpose of verifying the applicability of the elastographic technique in the study of the development of these tissues throughout the gestational period. Twenty - four multiparous ewes, weighing between 40 and 60 kilos and age between 2 and 5 years, of the Santa Inês breed were evaluated. After conducting preliminary exams and checked the healthiness of the animals, these were submitted to an estrus synchronization protocol and natural mating. When the pregnancy was confirmed, they were submitted to the conventional ultrasound examinations and elastography (quantitative and qualitative method ARFI) with the use of the ultrasound equipment ACUSON S2000 / SIEMENS and specific software. The exams were performed weekly, from the 10th gestational week (64 to 70 days) until the week of parturition and the shear wave velocity (quantitative elastographic evaluation) and stiffness characteristics were verified (Qualitative elastographic evaluation).The experimental lineation was completely randomized and used 5% significance level for all tests. The animals did not present any clinical and obstetric alterations during pregnancy and birth. The newborns presented themselves healthy and normal. ARFI elastography was performed consistently and without any difficulty. Qualitative elastography did not appear deformable, demonstrating homogeneous image. For quantitative evaluation, pulmonar (95% CI = 0.70 to 0.62 m/s) and hepatic (95% CI = 0.79 to 0.96 m/s) shear waves velocities varied over the gestational weeks (P <0.001), whereas renal (95% CI = 1.53 a 1.36 m/s) and placentomes velocities (95% CI = 2.34 to 2.28 m/s) did not present difference (p = 0.076 and 0.34 respectively). ARFI-elastography has shown to be an applicable and safe technique for placentomes, pulmonary, renal and hepatic fetal tissues stiffness evaluation in ovine experimental model. Enabled qualitative and quantitative tissues elastographic characterization, and allowed to detect pulmonary and hepatic stiffness modifications related with fetal development and gestational age. We suggest that these results could be used as reference for pregnancy pathophysiological studies in ovine and extrapolated for gestational researches in other mammal species.
The aim of this study was to evaluate the stiffness of maternal fetal tissues of ovines from the tenth week of gestation, using elastography ARFI (Acoustic Radiation Force Impulse), with the purpose of verifying the applicability of the elastographic technique in the study of the development of these tissues throughout the gestational period. Twenty - four multiparous ewes, weighing between 40 and 60 kilos and age between 2 and 5 years, of the Santa Inês breed were evaluated. After conducting preliminary exams and checked the healthiness of the animals, these were submitted to an estrus synchronization protocol and natural mating. When the pregnancy was confirmed, they were submitted to the conventional ultrasound examinations and elastography (quantitative and qualitative method ARFI) with the use of the ultrasound equipment ACUSON S2000 / SIEMENS and specific software. The exams were performed weekly, from the 10th gestational week (64 to 70 days) until the week of parturition and the shear wave velocity (quantitative elastographic evaluation) and stiffness characteristics were verified (Qualitative elastographic evaluation).The experimental lineation was completely randomized and used 5% significance level for all tests. The animals did not present any clinical and obstetric alterations during pregnancy and birth. The newborns presented themselves healthy and normal. ARFI elastography was performed consistently and without any difficulty. Qualitative elastography did not appear deformable, demonstrating homogeneous image. For quantitative evaluation, pulmonar (95% CI = 0.70 to 0.62 m/s) and hepatic (95% CI = 0.79 to 0.96 m/s) shear waves velocities varied over the gestational weeks (P <0.001), whereas renal (95% CI = 1.53 a 1.36 m/s) and placentomes velocities (95% CI = 2.34 to 2.28 m/s) did not present difference (p = 0.076 and 0.34 respectively). ARFI-elastography has shown to be an applicable and safe technique for placentomes, pulmonary, renal and hepatic fetal tissues stiffness evaluation in ovine experimental model. Enabled qualitative and quantitative tissues elastographic characterization, and allowed to detect pulmonary and hepatic stiffness modifications related with fetal development and gestational age. We suggest that these results could be used as reference for pregnancy pathophysiological studies in ovine and extrapolated for gestational researches in other mammal species.
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Palavras-chave
Santa Inês, Avaliação gestacional, Maturidade fetal