Doppler Ultrasonography of Intrauterine Growth Retardation: Emphasis on the Resistive and Pulsatility Indices of the Fetal Middle Cerbral Artery and Umbilical Artery.

Kim,  J Y; Hwang,  S M; Jo,  Y J; Shin,  H S; Han,  G S; Kim,  S J; Park,  K S; Kim,  D Y

Journal of Korean Society of Medical Ultrasound 1998;17(2): 155-160.

J Y Kim, S M Hwang, Y J Jo, H S Shin, G S Han, S J Kim, K S Park, D Y Kim

Published online: January 1, 2001.

ABSTRACT

PURPOSE: To establish the diagnostic efficacy of Doppler ultrasonography using Doppler indices in the diagnosis of intrauterine growth retardation (IUGR). MATERIALS AND METHODS: 120 cases were normal pregnancies and 20 cases were IUGR. Diagnosis of IUGR was based on the recent Korean reference of fetal weight. Normal 80 cases excluding high risk 40 normal pregnancies were divided into 4 groups. We calculated the normal values of the resistive index (RI) and pulsatility index (PI) in the middle cerebral artery (MCA) and umbilical artery (UA), and the RI ratio and PI ratio between these two vessels. Diagnostic accuracy of IUGR was also calculated using these normal values. RESULTS: Normal values of RI and PI in the fetal MCA: 26- 29 wks; 0.82+/-0.07 (Mean +/- SD), 1.85 +/- 0.37, 30-33 wks; 0.83+/- 0.08, 1.97 +/- 0.52, 34-37 wks ; 0.79 +/- 0.08, 1.76 +/- 0.40, 38-41 wks; 0.75+/- 0.10, 1.33+/-0.36, in the UA: 26-29 wks; 0.66 +/- 0.06, 1.10 +/- 0.18, 30-33 wks; 0.61+/- 0.09, 0.95 +/- 0.23, 34-37 wks; 0.55 +/- 0.07, 0.82 +/- 0.15, 38-41 wks; 0.53+/- 0.07, 0.75 +/- 0.15, Normal values of MCA/UA RI ratio and MCA/UA PI ratio: 26-29 wks; 1.26 +/- 0.14, 1.71 +/- 0.42, 30-33 wks; 1.38 +/- 0.24, 2.15 +/- 0.70, 34-37 wks: 1.44 +/- 0.20, 2.17 +/- 0.48, 38-41 wks: 1.42 +/- 0.26, 1.84 +/- 0.56. In the diagnosis of IUGR, the accuracy of RI and PI in the MCA were 78.3 %, 67.7 %, the UA were 75.9%, 77.4% and the MCA/UA ratio were 74.7%, 77.4%. CONCLUSION: It seems to be valuable to use all the Doppler indices in the diagnosis of IUGR, because all these indices are almost same in accuracy.