时空关联成像评价α-地中海贫血胎儿左心室功能的价值初探  

Preliminary assessment of left ventricular function of α-thalassemia fetus using spatio-temporal image correlation

作　　者：李剑[1] 吴瑛[1] 牟赛辉[1] 倪志鹏[1] 刘士龙[1] 

机构地区：[1]暨南大学第二临床学院深圳市人民医院超声科,深圳518020

出　　处：《中华超声影像学杂志》2014年第5期387-392,共6页Chinese Journal of Ultrasonography

基　　金：2007年深圳市科技计划重点项目（200701001）

摘　　要：目的 运用时空关联成像（STIC）技术测量胎儿左室容积,初步探索胎儿的左心功能特点.方法 采集20～28孕周单胎胎儿的心脏容积数据（85例心脏正常胎儿和10例α-地中海贫血胎儿）,运用三种STIC技术（VOCAL,Inversion和SonoAVC）测算胎儿左心功能参数.用组内相关系数（ICC）评测三种STIC技术在重复测量结果之间的可靠性和可重复性,对心脏正常胎儿和α-地中海贫血胎儿的左室功能参数进行两样本t检验.结果 三种技术测量左室容积的ICC均＞0.90.Bland-Altman散点图显示测量差异的95％可信区间（CI）在可允许范围.α-地中海贫血胎儿组左室收缩末期容积、每搏量、射血分数与正常胎儿组差异有统计学意义（P＜0.05）.结论 三种STIC技术均可准确测量α-地中海贫血胎儿的左室容积,有助于研究胎儿病理状态下的心功能特点.Objective To preliminary investigate fetal left heart function of fetuses in α-thalassemia using spatio-temporal image correlation （STIC）.Methods 95 volumes from fetal hearts in singleton pregnancies at 20-28 weeks of gestation were collected.STIC datasets were frozen in end-systole and enddiastole.Ventricular volumes were measured using VOCAL,Inversion and SonoAVC.The stroke volume was calculated from these measurements.Results All data sets could be measured with all three techniques in this study.The intraclass correlation coefficients （ICCs） between techniques were all 〉 0.90.The time necessary to measure the stroke volume was significantly shorter using SonoAVC than using VOCAL and Inversion.Bland-Altman plots showed no clinically significant mean percent differences between stroke volume measurements obtained from each ventricle using three techniques.The left ventricular end-systole volume（ESV）,stroke volume（SV）and ejection fraction（EF）was significantly different than fetuses with normal heart （P 〈 0.05）.Conclusions This study shows the feasibility of measuring left ventricular volumes during either systole or diastole and thereby calculating stroke volumes with all three techniques.And there was a high degree of reliability for all three techniques,as shown by excellent ICCs.There was good accuracy of STIC techniques in measuring fetal left ventricular volumes with cardiomegaly.

关 键 词：超声检查 产前 Α地中海贫血 心室功能 左 时空关联成像 

分 类 号：R714.5[医药卫生—妇产科学]