三维能量多普勒超声在定量评估生长受限胎儿肾脏血流量中的应用  

Application of quantitative three-dimensional power doppler sonography for assessment of the fetal renal blood flow in fetuses with growth restriction

作　　者：胡晗宇 艾芳[1] 刘玲艳 董旭东[1] HU Hanyu;AI Fang;LIU Lingyan;DONG Xudong(Department of Obstetrics and Gynecology,The First People’s Hospital of Yunnan Province/Affiliated Hospital of Kunming University of Science and Technology,Kunming,Yunnan 650032,China)

机构地区：[1]云南省第一人民医院、昆明理工大学附属医院妇产科,云南昆明650032

出　　处：《安徽医药》2020年第8期1577-1581,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨三维能量多普勒超声定量评估生长受限胎儿(fetuses with fetal growth restriction,FGR)和正常胎儿的肾脏血流灌注的价值。方法选取云南省第一人民医院2017年5月至2018年10月孕期妇女为研究对象,应用三维能量多普勒超声定量分析孕20~40周单胎FGR和正常胎儿的肾脏血管化指数(vascularization index,VI)、血流指数(flow index,FI)、血管化-血流指数(vascularization-flow index,VFI)。记录并比较两组胎儿VI、FI、VFI之间的差异,以孕周为自变量,分别进行线性回归分析,得到回归模型。结果共纳入41例正常胎儿和32例FGR胎儿。FGR胎儿与正常胎儿20周、24周、28周的VI、FI、VFI比较差异无统计学意义,32周[FGR胎儿VI(2.88±0.46)比正常胎儿VI(3.16±0.53)][FGR胎儿FI(44.62±0.97)比正常胎儿FI(45.74±0.83)][FGR胎儿VFI(1.23±0.24)比正常胎儿VFI(1.44±0.08)]、36周[FGR胎儿VI(3.59±0.44)比正常胎儿VI(3.82±0.22)][FGR胎儿FI(44.64±0.72)比正常胎儿FI(47.18±0.49)][FGR胎儿VFI(1.54±0.18)比正常胎儿VFI(1.81±0.07)]、40周[FGR胎儿VI(3.63±0.77)比正常胎儿VI(5.40±0.15)][FGR胎儿FI(44.85±0.59)比正常胎儿FI(47.97±0.58)][FGR胎儿VFI(1.36±0.38)比正常胎儿VFI(2.38±0.41)]比较,差异有统计学意义(P<0.05);FGR胎儿VI、FI、VFI与孕周(GA)的最佳拟合方程分别为:VIFGR=0.1494GA-2.001(R2=0.8210)、FIFGR=0.1587GA+39.07(R2=0.5205)、VFIFGR=0.05677GA-0.6741(R2=0.9173)。结论三维能量多普勒超声测量的胎儿肾VI、FI、VFI在产前预测FGR中有一定的价值。Objective To investigate the value of quantitative three-dimensional energy doppler ultrasound for assessment of the fetal renal blood flow in fetuses with growth restriction(FGR)and normal fetuses.Methods The pregnant women in The First People’s Hospital of Yunnan Province from May 2017 to October 2018 were selected as the research objects.Three-dimensional energy doppler ultrasound was used to quantitatively analyze the renal vascularization index(VI),flow index(FI),and vascularizationflow index(VFI)of a single fetus at 20-40 weeks pregnant with FGR and normal fetus.The differences of VI,FI and VFI of the two groups were recorded and compared.The gestational week was taken as the independent variable,and linear regression analysis was carried out to obtain the regression model.Results A total of 41 normal fetuses and 32 FGR fetuses were included.There was no statistically significant difference in VI,FI and VFI between FGR fetus and normal fetus at 20 weeks,24 weeks and 28 weeks.However,there was statistically significant difference between FGR fetus and normal fetus at 32 weeks[FGR fetus VI(2.88±0.46)vs.normal fetus VI(3.16±0.53)][FGR fetus FI(44.62±0.97)vs.normal fetus FI(45.74±0.83)][FGR fetus VFI(1.23±0.24)vs.normal fetus VFI(1.44±0.08)],36 weeks[FGR fetus VI(3.59±0.44)vs.normal fetus VI(3.82±0.22)][FGR fetus FI(44.64±0.72)vs.normal fetus FI(47.18±0.49)][FGR fetus VFI(1.54±0.18)vs.normal fetus VFI(1.81±0.07)],40 weeks[FGR fetus VI(3.63±0.77)vs.normal fetus VI(5.40±0.15)][FGR fetus FI(44.85±0.59)vs.normal fetus FI(47.97±0.58)][FGR fetus VFI(1.36±0.38)vs.normal fetus VFI(2.38±0.41)](P<0.05).The optimal fitting equations for VI,FI,VFI and gestational age(GA)were VIFGR=0.1494 ga-2.001(R2=0.8210),FIFGR=0.1587 GA+39.07(R2=0.5205),and VFIFGR=0.05677 GA-0.6741(R2=0.9173),respectively.Conclusion The VI,FI and VFI of fetal kidney measured by three-dimensional energy doppler ultrasound have definite value in prenatal detection FGR.

关 键 词：胎儿生长迟缓 超声检查 产前 胎儿 肾脏 定量分析 

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]