四维超声STIC技术检查早孕末期胎儿心脏的可行性探讨  

Feasibility of Fetal Heart Scanning in First-trimester Using Four-dimensional Spatiotemporal Image Correlation

作　　者：郑菊[1] 谢红宁[1] 林美芳[1] 雷婷[1] 汪南[1] 李岚[1] 

机构地区：[1]中山大学附属第一医院超声科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2015年第3期442-448,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金面上项目(81071166);广东省科委科技计划项目(2010B060900044)

摘　　要：[目的]通过分析心脏各标准切面显示率的一致性及心脏、大血管径线测量的可靠性来评估四维超声时间空间关联成像（STIC）技术进行早孕末期胎儿心脏检查的可行性.[方法]病例来自我院2012年2月-2013年6月进行早孕末期（11-13＋6周）颈后皮层超声测量并经随访心脏结构正常的胎儿115例.获取胎儿心脏四维STIC容积后由两名研究者离线分析.比较胎儿心脏各标准切面的显示率;检验心脏各标准切面显示率的组间及组内一致性及心脏、大血管径线测量的组间及组内可靠性.[结果]心脏检查完成率均达85％以上.灰阶及彩色多普勒（CDFI）条件下四腔心、左右室流出道切面的显示率达97％和85％以上;而三血管切面的显示率在灰阶条件为50％,联合CDFI技术后提高到85％.各标准切面显示率组间一致性K值分别为0.82～ 0.96;组内一致性K值分别为0.86～0.99.心脏横径、面积、周长;左、右心室内径;主、肺动脉内径组间测量的同类相关系数（ICC）为0.86～ 0.99,组内ICC为0.9 ～ 0.99.室间隔厚径、主动脉弓峡部内径、动脉导管弓内径组间测量的ICC为0.45 ～ 0.55,组内ICC为0.52～0.79.[结论]四维超声STIC技术可以显示早孕末期大部分胎儿心脏的标准筛查切面;STIC技术显示早孕末期胎儿心脏各标准切面及测量心脏、大血管径线均有良好组间及组内的一致性和可靠性.[Objective] To assess the intra-and inter-observer repeatability of the evaluation of fetal cardiac structures and measurement from the volumes obtained by four-dimensional spatiotemporal image correlation （STIC） technology in first-trimester of pregnancy.[Methods] STIC volumes were obtained from 115 singleton pregnancies with normal fetal heart from February 2012 to June 2013 at gestational age of 11 to 13＋6 weeks.Four standard cardiac views as well as ten measurements of the fetal heart were evaluated by two different reviewers respectively.The reliability of qualitative variables was evaluated using Cohen＇s kappa while that of quantitative parameters was assessed using the intraclass correlation coefficient （ICC）.[Results] Satisfactory scanning were considered in more than 85％ of cases.The differences between gray-scale and color Doppler imaging were statistically significant in identifying three vessel view.Good or excellent intra-and inter-observer agreement （K ＞ 0.82） was obtained for all four standard cardiac views.Regarding the quantitative cardiac measurements,ICC values were above 0.86 for 7/10 parameters.[Conclusion] Cardiac examination from STIC volumes showed a high repeatability between and within observers in first-trimester.STIC technology for assessing first-trimester heart are feasible and repeatable.

关 键 词：四维超声 时间空间关联成像 早孕末期 胎儿心脏 一致性 可靠性 

分 类 号：R445.1[医药卫生—影像医学与核医学]