应用空间-时间成像相关技术行胎儿心脏产前筛查的可行性探讨  

The analysis of feasibility in routine fetal echocardiography with spatiotemporal image correlation technique

作　　者：王丹丹[1] 孙美玉[1] 施展[1] 刘明颖[1] 李辉[1] 

机构地区：[1]中国医科大学附属盛京医院妇产科,沈阳110004

出　　处：《中华医学超声杂志（电子版）》2009年第6期10-13,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家"十一五"科技支撑计划:"重大出生缺陷和遗传病的防治研究--严重胎儿结构异常影像学产前筛查和诊断新技术的研究"(2006BAI05A04);辽宁省科技攻关项目资助(2005225008)

摘　　要：目的探讨空间-时间成像相关(STIC)技术在临床胎儿心脏产前筛查应用及推广的可行性。方法对2007年11月至2008年12月在我院行超声心动图检查的心脏畸形高危胎儿214例(经二维心脏超声检查诊断为正常胎儿心脏),尽量在无胎动时获取有效的STIC容积数据,应用Uittenbogaard等提出的获取条件评分方法加以改良后进行STIC容积数据采集评分,最高分为10分,6分以上(含6分)为成功获得,6分以下为未成功获得。根据是否能清晰显示心脏各部分结构将所有成功获得的STIC容积信息被分为临床不可用、临床可用和临床最佳。结果根据STIC容积采集评分标准,采集的胎儿心脏容积信息评分结果为149例(69.6%)成功获得容积数据,65例(30.4%)未成功获得;影响成功率因素中,胎动因素最常见;将研究的前半年和后半年两个时间段的成功率进行比较,后半年的成功获得率明显提高(P<0.05)。对采集的胎儿心脏容积信息进行临床效果评价,临床效果最佳为27例(12.6%),临床可用为139例(65.0%),临床不可用为48例(22.4%);将研究的前半年和后半年两个时间段的临床价值评价结果进行比较,后半年的临床效果最佳率和临床可用率明显提高(P<0.05)。结论STIC技术在临床实践中获取临床最佳效果率较低,限制了其在临床上的广泛应用和推广。增加对STIC技术采集和应用的熟练程度和技巧则会明显改善信息采集的成功率和质量。Objective To investigate the feasibility in routine fetal echocardiography with spatiotem- poral image correlation （STIC） technique. Methods A total of 214 high-rlsk fetus with congenital heart disease were enrolled in this study and were diagnosed as healthy heart after fetal echocardiography. The gestation lasted from 20 to 36 weeks and the maternal ages were from 22 to 43 years old. The STIC volume data was obtained in case of the mother was holding the breath without fetal movement. The STIC volume data were evaluated as successful or non-successful obtaining data according to Uittenbogaard method, and then the successful obtaining data were achieved as insufficient quality for clinic, sufficient quality for clinic, and high quality for clinic according to the heart structures obtained. Results The STIC volume data were obtained successfully in 149 cases （69.6%） , but not successfully in 65 cases （30.4%）. The fetal movement is the most common reason for obtaining data unsuccessfully. The successful rate of the first half year was compared with the latter half year, which showed that the successful rate increased significantly in the latter half year （P 〈0.05）. Around 27 （ 12.6% ） cases were with high quality for clinic, 139 （65.0%） had suf- ficient quality for clinic and 48 （22.4%） had insufficient quality for clinic. However, the quality was im- proved significantly in the latter half year compared with that of the first half year （ P 〈 0.05 ）. Conclusions The lower successful rate for obtaining high quality STIC data restricts the widespread and application of STIC technique in the clinic. However, the successful rate of obtaining the high quality volume data can be increased significantly after familiarity with STIC technique.

关 键 词：产前超声检查 胎儿 心脏 空间-时间成像相关技术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]