超声速度向量成像技术评价胎儿左心发育不良综合征右心室功能  

Evaluation on right ventricular performance in fetal hypoplastic left heart syndrome with velocity vector imaging

作　　者：夏珣[1,2] 李胜利[1] 余艳红[2] 文华轩[1] 廖玉媚[1] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院超声科,广东深圳518028 [2]南方医科大学南方医院妇产科,广东广州510515

出　　处：《中国医学影像技术》2011年第11期2278-2282,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家"十一五"科技支撑计划课题项目(2006BAI05A04)

摘　　要：目的运用超声速度向量成像技术(VVI)评估胎儿左心发育不良综合征(HLHS)右心室功能,探讨其临床意义。方法Ⅰ组为56胎HLHS胎儿:分为Ⅰa组(心室腔狭小,30胎)和Ⅰb组(心室腔不可见,26胎),Ⅱ组为147胎正常胎儿(正常对照组)。通过Syngo US Workplace VVI工作站处理胎儿标准四腔心二维动态图,获得右心室心肌的运动参数,包括应变(S)、收缩期应变率(SRs)、舒张期应变率(SRd)、收缩期达峰速度(Vs)、舒张期达峰速度(Vd)。结果Ⅰ组与对照组比较,右心室心肌各参数差异有统计学意义(P<0.05);Ⅰa和Ⅰb组比较,右心室心肌各参数差异无统计学意义(P>0.05);Ⅰ组Vs与孕周呈正相关(r=0.835,P<0.05),Vd与孕周无显著相关性(r=0.013,P>0.05)。结论 HLHS胎儿右心室收缩功能增强,舒张功能受损,孕中晚期Vs随孕周增加的程度高于正常胎儿。VVI为探讨胎儿心肌发育的生理及病理学机制提供了一种新的方法。Objective To investigate the application value of velocity vector imaging （VVI） for evaluation of right ventric ular performance in fetal hypoplastic left heart syndrome （HLHS）. Methods Fifty-six fetus with HLHS were enrolled in group Ⅰ , and were further divided into group Ⅰ a （with small left ventricles group, n=30） and Ⅰ b （with unseen left ven tricles, n= 26）. Fetuses in group Ⅱ （147 healthy fetuses） had no contributabie history. Two-dimensional 4-chamber ima ges of the heart were interrogated offline using Syngo US Workplace VVI software. Measurements of global longitudinal strain （S）, systolic and diastolic strain rate （SRs and SRd） and systolic and diastolic time to peak velocity （Vs and Vd） were performed on the ventricles. Results The right ventricular performance between group Ⅰ and Ⅱ were significantly different （P〈0.05）. There was no significant difference of right ventricular performance between group Ⅰ a and Ⅰ b （P〈 0.05）. The gestational age had significant correlation with Vs （r=0. 835, P〈0.05）, but not with Vd （r= 0. 013, P〉 0.05） in group Ⅰ. Conclusion Left ventricular performance of HLHS are assumed to be negligible. The systolic function of right ventricle increase, and the diastolic function of right ventricle decrease in fetuses with HLHS that has significantly elevated right ventricle systolic velocity compared with normal fetuses. VVI can be applied to study the physiopathological mechanism of fetal ventricular development.

关 键 词：胎儿 左心发育不良综合征 速度向量成像 

分 类 号：R541.1[医药卫生—心血管疾病] R540.45[医药卫生—内科学]