三维体积自动测量技术在孕8~11^+6周胎儿羊水体积测量中的应用研究  

Application of three-dimensional VOCAL technique in measurement of amniotic fluid volume at 8~11^+6 weeks gestation

作　　者：梁耀园[1] 吴子谕[1] 梁耀佳[1] 朱娟[1] 何薇[1] 饶腾子[1] Liang Yaoyuan;Wu Ziyu;Liang Yaojia;Zhu Juan;He Wei;Rao Tengzi(Guangdong Women and Children Hospital,Guangzhou 510010,Guangdong,China)

机构地区：[1]广东省妇幼保健院超声诊断科,广东广州510000

出　　处：《中国产前诊断杂志（电子版）》2020年第2期30-34,共5页Chinese Journal of Prenatal Diagnosis(Electronic Version)

基　　金：广东省科学技术厅2017年省自筹经费类科技计划项目(2017ZC0323)。

摘　　要：目的分析8~11^+6周正常胎儿羊水体积及其头臀径的关系,探讨早孕期羊水体积与胚胎预后的相关性。方法选取头臀径(crown rump length,CRL)为15~54mm的单胎妊娠400例正常胎儿及100例阳性胎儿三维容积数据,用体积自动测量(virtual organ computer aided analysis,VOCAL)技术获得体积数据,羊水容积等于羊膜囊体积减胎儿体积。分别测定正常单胎妊娠胎儿400例和阳性单胎妊娠胎儿100例,应用相关回归分析拟合正常羊水容积随胎儿CRL增长的回归方程,并用于和阳性胎儿进行对照。结果400例胎儿CRL平均测值为(33.99±11.56)mm,中位数为34.00mm;羊水体积的平均体积为(28.394±14.406)cm3,中位数为29.158cm3;其中位数测值从CRL为15mm时的6.169 cm3(3.950~11.140 cm3)增加至头臀径为54mm时的51.296cm3(43.610~61.880cm3)。CRL和羊水体积呈正相关,其回归方程:羊水容积(cm3)=-9.50+1.11×CRL(mm)(r=0.895,P<0.01)。100例阳性胎儿中有67例胚胎停止发育,15例脑室扩张,13例肾盂扩张,3例有肾积水,1例中孕期羊水过少,1例宫内生长受限。结论三维超声测量早孕期胎儿羊水体积可为临床早期评价胎儿的预后提供重要依据和参考指标。Objective To analyze the relationship of amniotic fluid volume and crown rump length(CRL)in normal fetus at 8~11^+6 weeks,and to explore the correlation between amniotic fluid volume and embryo prognosis in early pregnancy.Methods Three-dimensional volume data of 400 normal single pregnancy fetuses and 100 positive single pregnancy fetuses with head and hip diameter(CRL)of 15~54mm at 8~11^+6 weeks were selected.Volume was calculated by VOCAL technique,amniotic fluid volume was obtained by reducing embryo volume by amniotic sac volume.400 normal single-child pregnancy fetuses and 100 positive single-child pregnancy fetuses were measured respectively.Correlation regression analysis was used to fit the regression equation of normal amniotic fluid volume with the increase of fetal head and hip diameter,and it was used to control the positive fetus.Results Of 400 fetuses,the median and average CRL was 34.00mm and 33.99±11.56mm,respectively.The median and average amniotic fluid volume was 29.158 cm3 and 28.394±14.406 cm3,respectively.The amniotic fluid volume was increased with CRL from a median of 6.169 cm3(range 3.950~11.140 cm3)at a CRL15mm to 51.296 cm3(range 43.610-61.880cm3)at of 55 mm.The amniotic fluid volume of fetus was positively with CRL,The regression equations was:amniotic fluid volume(cm3)=-9.50+1.11×CRL(mm)(r=0.895,P<0.01).Of the 100 positive fetuses,67 cases had an arrest,15 had ventricular dilatation,13 had pelvic dilatation,3 had hydronephrosis,1 had too little amniotic fluid during pregnancy and 1 had intrauterine growth retardation.Conclusion Measurement of fetal amniotic fluid volume by three-dimensional ultrasound can provide important basis and reference index for early clinical evaluation of fetal prognosis.

关 键 词：三维超声 羊水体积 体积自动测量 早孕期 头臀径 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.51[医药卫生—诊断学]