实时三维超声心动图评价中晚孕期正常胎儿右心室功能  

Full-volume real-time three-dimensional echocardiographic assessment on right ventricular function of fetuses in the second and third trimester

作　　者：孙终霞[1] 赵博文[2] 陈方红[1] 潘美[2] 黄岩花[1] 洪晓平[1] 王立刚[1] 

机构地区：[1]丽水市中心医院超声科,浙江丽水323000 [2]浙江大学医学院附属邵逸夫医院超声科

出　　处：《全科医学临床与教育》2013年第3期249-252,共4页Clinical Education of General Practice

基　　金：浙江省科技厅公益性技术应用研究计划项目(2012C33123)

摘　　要：目的应用全容积实时三维超声心动图评价正常胎儿右心室功能。方法对109例孕妇的正常胎儿进行超声心动图检查,应用Shimazaki法、双平面Simpson法以及全容积实时三维超声心动图方法(RT-3DE)来评估胎儿右室舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)、射血分数(EF)及心输出量(CO),并比较三种方法获得的数值结果。结果三种方法比较,EDV、ESV、SV、CO值的差异均有统计学意义(F=31.22、23.30、31.67、32.61,P均<0.05),EF值的差异无统计学意义(F=1.56,P>0.05)。RT-3DE法、双平面Simpson法与Shimazaki法比较,除EF值外,胎儿EDV、ESV、SV、CO值的差异均有统计学意义(t分别=6.57、5.64、6.66、6.76;7.10、6.25、7.11、7.21,P均<0.05);RT-3DE法与Simpson法比较,胎儿EDV、ESV、SV、CO的差异无统计学意义(t分别=0.53、0.61、0.44、0.45,P均>0.05)。两个观察者一致性检验,RT-3DE法的Kappa值要高于Simpson法的Kappa值。结论全容积实时三维超声心动图能够全面、整体地评价胎儿右心室心功能。Objective To evaluate the fetal right ventricular function by using full volume real-time three-dimensional eehoeardiography（RT-3DE）. Methods The fetal right ventricular volumes of 109 normal fetuses were outlined and calcu- lated by Shimanaki rule, Simpson＇s method and full-volume RT-3DE. The right ventricular end-diastolic volume （EDV）, end- systolic volume （ESV）, stroke volume （SV）, ejection fraction （EF） and cardiac output （CO） measured by three different methods were compared. Results The EDV,ESV,SV,CO were significantly different among three methods（F=31.22,23.30, 31.67,32.61, P〈0.05） except the EF（F=l.56,P〉0.05） . EDV, ESV, SV, CO were significantly different except EF between Shimanaki and Simpson method as well as between Shimanaki and RT-3DE（t=6.57, 5.64, 6.66, 6.76; 7.10, 6.25, 7.11, 7.21, P〈0.05）. Compared with RT-3DE, the EDV, ESV, SV, CO, EF of Simpson were not significantly different （t=0.53,0.61,0.44,0.45, 0.52, P〉0.05）. The Kappa value of RT-3DE was higher than that of the Simpson. Conclusions RT-3DE is an accurate and reliable method to make a comprehensive, holistic evaluation of fetal right ventricular function.

关 键 词：全容积实时三维超声心动图 Shimazaki法 Simpson法 胎儿右心室功能 

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]