三维超声时间－空间成像辅助诊断胎儿异构综合征的研究  

The value of two-dimensional ultrasound combined with three-dimensional spatio-temporal image correlation （STIC） in the diagnosis of fetal heterotaxy syndrome

作　　者：朱云晓[1] 谢红宁[1] 李丽娟[1] 彭软[1] 石慧娟[2] 

机构地区：[1]中山大学附属第一医院超声科,广州510080 [2]中山大学附属第一医院病理科

出　　处：《中华超声影像学杂志》2015年第9期768-773,共6页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金面上项目（81071166）;广东省自然科学基金博士启动（10451008901005911）

摘　　要：目的比较二维超声联合三维超声时间一空间相关成像（spatio-temporal image correlation，STIC）诊断胎儿异构综合征心血管异常的准确性和完整性，探讨STIC技术对胎儿异构综合征的辅助诊断价值。方法回顾性分析2007年11月至2013年2月期间，超声诊断为异构综合征、已存储心脏STIC容积数据，经病理或出生后超声心动图证实的45例胎儿，由一名具有5年以上胎儿超声心动图经验的医生，采用多平面重建及断层显像模式盲法离线分析STIC数据，统计比较二维超声与其联合STIC技术对异构综合征心血管异常等细节诊断的符合率及诊断级别。结果45例中右侧异构37例，包括397个心血管异常细节，二维超声和STIC技术的总诊断符合率分别为60．2％和96．5％（P〈0．05）；二维超声联合STIC对于心房右侧异构、大动脉连接异常、动脉弓异常、体静脉异常及完全性肺静脉异位引流等的诊断符合率比二维超声高（P〈0．05）；二维超声的诊断完整性级别（0～3级）百分比依次为10．8％、21．6％、56．8％、10．8％，联合STIC的超声诊断级别为2级8．1％、3级91．8％（P〈0．05）。左侧异构8例，共有59个心血管异常细节，两种检查方法的总诊断符合率分别为81．4％、89．8％（P〉0．05）；联合STIC超声对于心房左侧异构的诊断符合率高（P〈0．05）；两种方法的诊断级别百分比差异无统计学意义（P〉0．05）。结论对于胎儿异构综合征，尤其是右侧异构的房室异构、大动脉连接异常、动脉弓异常、体静脉及肺静脉连接异常，二维超声联合三维超声STIC可提供更加精确完整的诊断信息。Objective To evaluate the diagnostic accuracy and integrity of two-dimension ultrasound （2DUS） assisted with spatio-temporal image correlation （STIC） for cardiac and vascular abnormalities in fetal heterotaxy syndrome （HS）. Methods The retrospective study was conducted from Nov 2007 to Feb 2013. Forty-five fetuses with suspected heterotaxy syndrome on routine prenatal ultrasonic screening underwent STIC volume sweep. The diagnosis was confirmed by pathological or echocardiographic examination. STIC volume data sets of fetal hearts were off-line analyzed blindly by one doctor who had practiced fetal echocardiography for more than five years. The concordance and integrity levels of diagnosis with 2DUS or assisted with STIC were compared according with pathological results. Results There were 397 cardiac and vascular defects in 37 cases of right isomerism. The overall concordance of various defects in right isomerism diagnosed assisted with STIC （96.5 %） was significantly higher than that of 2DUS （60.2 % ） （ P ~0.05）. The concordance rates of right atria and ventricle isomerism, anomalies of ventriculo-arterial junction, arterial arch, systematic and pulmonary veins diagnosed assisted with STIC （78.9%, 96.7%, 100% ,100% ,100%） were higher（ P〈0.05） than those of 2DUS （49.1%,60%,34.7%,23.2%,62.2%）. Percentages of diagnostic integrity levels （0～3） on 2DUS ＋ STIC （8% on level 2,92% on level 3） were significantly different（ P 〈0.05） with those on 2DUS （11% on level 0,21% on level 1, 57% on level 2, 11% on level 3）. There were 59 cardiac and vascular defects in 8 cases of left isomerism with the overall concordance of defects diagnosed assisted with STIC （89.8 % ） and 2DUS （81.4 ~ ） being no difference （P 0.05）. There was no significant difference in concordance rates of various defects of left isomerism diagnosed between two methods,except that the concordance rate of left atria isomerism diagnosed assisted with STIC was higher（ P〉0.05）. There

关 键 词：超声检查 产前 心脏缺损 先天性 异构综合征 时间-空间相关成像 

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]