三维超声监测胎儿宫内缺氧颅脑和胎盘血流灌注的价值研究  

Assement of Fetal Cerebral and Placental Blood Flow Perfusion in Hyposic Fetuses with Three-dimensional Ultrousonograhy

作　　者：吴婷[1] 刘燕娜[1] 章春泉[1] 皮小兰[1] 李车英[1] 王继伟[1] 陈丽[1] 陈雪[1] Wu Ting;Liu Yanna;Zhang Chunquan;Pi Xiaolan;Li Cheying;Wang Jiwei;Chen Li;Chen Xue(Department of Ultrasound,the Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330000,China)

机构地区：[1]南昌大学第二附属医院超声科,江西省南昌市330000

出　　处：《中国超声医学杂志》2021年第6期663-666,共4页Chinese Journal of Ultrasound in Medicine

基　　金：江西省科技厅重点研发项目(No.S2016SFYBG0413)。

摘　　要：目的探讨三维能量多普勒技术(3D-CPA)分析胎儿宫内缺氧时胎盘及颅脑血流改变,为临床早期发现胎儿宫内缺血缺氧提供定量信息。方法选取40例宫内缺氧胎儿为观察组,60例正常胎儿作为正常对照组,分别测量两组胎儿大脑中动脉(MCA)、脐动脉(UA)S/D、PI、RI值以及胎儿颅脑及胎盘三维能量多普勒血管化指数(VI)、血流指数(FI)、血管化血流指数(VFI),组间及组内进行对照分析。结果 (1)观察组脐动脉S/D、PI、RI显著高于对照组,胎儿大脑中动脉S/D、PI、RI低于正常对照组,两组间比较有统计学意义;(2)观察组的胎盘VI、FI、VFI明显低于正常对照组,胎儿颅脑VI、FI、VFI明显高于正常对照组,差异有统计学意义;(3)观察组内S/D正常胎儿的胎盘及颅脑VI、FI、VFI与S/D异常胎儿比较无明显统计学意义。结论联合分析胎儿颅脑及胎盘三维能量多普勒参数能够更灵敏发现宫内缺氧胎儿血流异常变化,可为临床诊断胎儿宫内缺氧提供可靠的诊断依据。Objective To explore the application value of three-diamensional ultrasonography in diagnosis of fetal intrauterine hypoxia.Methods We enrolled 40 fetuses with intrauterine hypoxia as observation group and 60 normal fetuses as normal control group,The systolic peak velocity and end-diastolic velocity tratio(S/D),pulse index(PI),resistance index(RI)of middle cerebral artery and Umbilical artery were compared between the two groups with 2D Color Doppler.FI,VI,and VFI of fetal cerebrum and placental blood flow perfusion with 3D power Doppler,were measured and compared between the two groups.Results①The S/D,PI,and RI value of umbilical artery in the control group were significantly higher than those in the observation group,and VI,FI and VFI of the placenta in the observation group were significantly lower than those in the normal control group.②The S/D,PI,and RI value of fetal cerebrum in the observation group were significantly lower than those in the control group,and VI,FI and VFI of the fetal cerebrum in the observation group were significantly higher than those in the normal control group.③VI,FI,VFI of placenta and fetal cerebrum in the observation group with normal S/D had no significant difference with abnormal S/D fetuses.Conclusions The combined use of fetal cerebrum and placental blood flow perfusion with three-dimensional ultrousonograhy have higher clinical value for predicting fetal intrauterine hypoxia.

关 键 词：三维 超声 多普勒 胎儿 缺氧 

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]