目的 通过子痫前期胎盘血管铸型及CT数字化三维结构模型分析子痫前期胎盘血管的解剖学特征，为子痫前期的临床预判提供数据支持。 方法 随机收集2018年11月至2020年6月的134例孕周≥34周胎盘，其中正常组68例，子痫前期66例（轻度组36例、重度组30例）。以自凝型牙托粉添加造影剂硫酸钡构建胎盘的血管铸型模型，对胎盘血管铸型模型进行CT扫描得到数字化的三维结构模型，测量铸型模型胎盘动静脉分级数、各级分支血管的直径及胎盘动静脉血管容积并比较3组差异。 结果 晚发型重度子痫前期胎盘与同期正常组、轻度子痫前期组相比，胎盘血管总容积及胎盘静脉容积变小（P<0.05），胎盘静脉分级数减少、静脉各级分支直径变细（P<0.05），动脉分级数减少及动脉第3、4级分支直径变细（P<0.05）。 结论 血管铸型结合CT三维模型有助于直观、全面地认识先兆子痫胎盘血管结构特点。
关键词：
血管铸型; ; ; CT三维模型; ; ; 胎盘; ; ; 子痫前期
Objective To study the vascular casting and CT digital three-dimensional structure model of placental vessels in preeclampsia, and statistically analyze the anatomical characteristics of placental vessels in preeclampsia, so as to provide technical data for clinical prediction of preeclampsia. Methods Totally 134 cases of placentas with gestational weeks ≥ 34 weeks (68 normal placenta, among 66 preeclampsia, 36 were mild and 30 were severe ) were randomly collected from November 2018 to June 2020. The placental vascular cast models were constructed by adding barium sulfate as a contrast agent to the self-coagulating denture powder. Then, the placental vascular cast models were scanned by CT and digital three-dimensional structure models were obtained. The number of placental arteriovenous grades, the diameters of various branches and the volume of placental arteriovenous vessels in the cast models were measured and compared. Results The placental vascular volume and placental vein volume of late-onset severe preeclampsia were smaller than those of normal group and mild preeclampsia group (P<0.05). Compared with the placentas of normal group and mild preeclampsia in the same period, the placentas of late-onset severe preeclampsia had fewer grades of placental veins and narrower branches (P<0.05), the number of placental artery grades in late-onset severe preeclampsia group decreased and the diameter of the third and fourth branches of the artery became smaller (P<0.05). Conclusions Vascular casting combined with CT 3D model is helpful to understand the vascular structure of placenta in preeclampsia intuitively and comprehensively.
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