超声STIC技术联合TDI在妊娠糖尿病胎儿心脏结构检查中的应用  

Value of ultrasound spatio-temporal image correlation combined with tissue Doppler imaging in the examination of fetal heart structure in pregnant women with gestational diabetes mellitus

作　　者：王芳 赵天娇[1] WANG Fang;ZHAO Tian-jiao(Department of Ultrasound Medicine,Baoji Maternal and Child Health Hospital,Baoji 721000,Shaanxi,CHINA)

机构地区：[1]宝鸡市妇幼保健院超声医学科,陕西宝鸡721000

出　　处：《海南医学》2020年第19期2533-2536,共4页Hainan Medical Journal

摘　　要：目的探讨时间-空间相关成像(STIC)技术联合组织多普勒(TDI)在妊娠糖尿病胎儿心脏结构检查中的应用效果。方法选择2018年6月至2019年6月宝鸡市妇幼保健院收治的150例妊娠糖尿病孕妇作为研究对象,所有孕妇孕24~38周,且均采用胰岛素治疗,按照血糖控制情况将其分为血糖控制良好组(A组)109例和血糖控制不良组(B组)41例。同期选择100例正常孕妇作为对照组。应用STIC后处理获得M型图像,测量胎儿的左心室壁收缩末期厚度(LVWS)、右心室壁收缩末期厚度(RVWS)、室间隔收缩末期厚度(IVSS)、左心室壁舒张末期厚度(LVWD)、右心室壁舒张末期厚度(RVWD)、室间隔舒张末期厚度(IVSD),采用TDI测量胎儿二、三尖瓣收缩期峰值(Sa)、三尖瓣舒张晚期峰值(Aa)和三尖瓣舒张早期峰值(Ea),分析各组参数的差异。结果A组、B组胎儿的LVWD[(3.35±0.11)mm、(3.37±0.11)mm]、RVWD[(3.40±0.10)mm、(3.41±0.10)mm]、LVWS[(3.42±0.12)mm、(3.45±0.12)mm]、RVWS[(3.45±0.10)mm、(3.66±0.10)mm]、IVSD[(2.73±0.09)mm、(2.68±0.10)mm]、IVSS[(2.82±0.10)mm、(2.80±0.10)mm]明显高于对照组[(3.05±0.05)mm、(2.97±0.04)mm、(3.12±0.05)mm、(3.16±0.04)mm、(2.34±0.04)mm、(2.40±0.04)mm],差异均具有统计学意义(P<0.05),但A组、B组胎儿间上述各项指标比较差异均无统计学意义(P>0.05);A组、B组胎儿的二尖瓣环Ea/Aa值分别为(0.64±0.02)、(0.64±0.01),明显低于对照组的(0.68±0.01),差异具有统计学意义(P<0.05),但A组、B组胎儿间的比较,差异均无统计学意义(P>0.05);A组、B组胎儿的三尖瓣环Ea/Aa值、二尖瓣环Sa值、三尖瓣环Sa值分别与对照组比较差异均无统计学意义(P>0.05)。结论妊娠糖尿病胎儿心室壁及室间隔厚度增加,心脏舒张功能降低,血糖控制情况的差异对胎儿心肌厚度和心脏功能改变无显著影响;STIC技术联合TDI对评价妊娠糖尿病胎儿心脏结构和功能具有一定的临床价值。Objective To analyze the effect of spatio-temporal image correlation(STIC)combined with tissue Doppler imaging(TDI)in the examination of fetal heart structure in pregnant women with gestational diabetes mellitus.Methods From June 2018 to June 2019,150 pregnant women of 24-38 gestational weeks with gestational diabetes admitted to Baoji Maternal and Child Health Hospital were taken as the research objects,which were all treated by insulin therapy.The women were divided into group A(109 cases)with good blood glucose control and group B(41 cases)with poor blood glucose control according to the blood glucose control situation.At the same time,100 normal pregnant women were selected as the control group.M-type images were obtained by STIC post-processing.The left ventricular end systolic thickness(LVWS),right ventricular end systolic thickness(RVWS),interventricular septal end systolic thickness(IVSS),left ventricular end diastolic thickness(LVWD),right ventricular end diastolic thickness(RVWD),and interventricular end diastolic thickness(IVSD)of fetuses were measured,and the peak systolic(Sa),late diastolic(Aa),and early diastolic(Ea)of fetuses were measured by TDI.The difference of parameters among the three groups was analyzed.Results LVWD,RVWD,LVWS,RVWS,IVSD,IVSS in fetuses of group A and B were(3.35±0.11)mm and(3.37±0.11)mm,(3.40±0.10)mm and(3.41±0.10)mm,(3.42±0.12)mm and(3.45±0.12)mm,(3.45±0.10)mm and(3.66±0.10)mm,(2.73±0.09)mm and(2.68±0.10)mm,(2.82±0.10)mm and(2.80±0.10)mm,respectively,which were significantly higher than corresponding(3.05±0.05)mm,(2.97±0.04)mm,(3.12±0.05)mm,(3.16±0.04)mm,(2.34±0.04)mm,(2.40±0.04)mm of the control group(all P<0.05),but there was no significant difference between group A and B(all P>0.05).The Ea/Aa value of mitral annulus in fetuses of group A and B were(0.64±0.02)and(0.64±0.01),which were significantly lower than(0.68±0.01)in the control group(P<0.05),but there was no significant difference between group A and B(P>0.05).There was no significant difference

关 键 词：时间-空间相关成像技术 组织多普勒超声 妊娠糖尿病 胎儿 心脏结构 

分 类 号：R714.256[医药卫生—妇产科学]