title: Shear wave elastography of placenta: in vivo quantitation of placental elasticity in preeclampsia.
abstract: OBJECTIVE
  We aimed to evaluate the utility of shear wave elastography (SWE) for assessing the placenta in preeclampsia disease.
  
  
  METHODS
  A total of 50 pregnant women in the second or third trimester (23 preeclampsia patients and 27 healthy control subjects) were enrolled in the study. Obstetrical grayscale and Doppler ultrasonography, SWE findings of placenta, and prenatal/postnatal clinical data were analyzed and the best SWE cutoff value which represents the diagnosis of preeclampsia was determined. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of preeclampsia were calculated based on SWE measurements.
  
  
  RESULTS
  Mean stiffness values were much higher in preeclamptic placentas in all regions and layers than in normal controls. The most significant difference was observed in the central placental area facing the fetus where the umbilical cord inserts, with a median of 21 kPa (range, 3-71 kPa) for preeclampsia and 4 kPa (range, 1.5-14 kPa) for the control group (P < 0.01). The SWE data showed a moderate correlation with the uterine artery resistivity and pulsatility indices. The cutoff value maximizing the accuracy of diagnosis was 7.35 kPa (area under curve, 0.895; 95% confidence interval, 0.791-0.998); sensitivity, specificity, PPV, NPV, and accuracy were 90%, 86%, 82%, 92%, and 88%, respectively.
  
  
  CONCLUSIONS
  Stiffness of the placenta is significantly higher in patients with preeclampsia. SWE appears to be an assistive diagnostic technique for placenta evaluation in preeclampsia.
authors: Department of Radiology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey. fahrettinkilic@hotmail.com.
authors: Fahrettin
authors: F
authors: Kılıç
authors: Yasemin
authors: Y
authors: Kayadibi
authors: Mehmet Aytaç
authors: MA
authors: Yüksel
authors: İbrahim
authors: İ
authors: Adaletli
authors: Fethi Emre
authors: FE
authors: Ustabaşıoğlu
authors: Mahmut
authors: M
authors: Öncül
authors: Rıza
authors: R
authors: Madazlı
authors: Mehmet Halit
authors: MH
authors: Yılmaz
authors: İsmail
authors: İ
authors: Mihmanlı
authors: Fatih
authors: F
authors: Kantarcı
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D016022:Case-Control Studies; D004548:Elasticity / Q000502:physiology; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010920:Placenta / Q000000981:diagnostic imaging* / Q000502:physiology; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D014421:Turkey; D014470:Umbilical Cord / Q000473:pathology; D059289:Vascular Stiffness / Q000502:physiology; D055815:Young Adult