胎儿心脏定量分析技术评价左心室流出道梗阻胎儿心脏功能和形态  

Investigation of fetal cardiac function and morphology in fetuses with left ventricular outflow tract obstruction using fetal heart quantification

作　　者：詹梦娜 赵博文[1] 彭晓慧[1] 陈冉[1] 潘美[1] 王蓓[1] Zhan Mengna;Zhao Bowen;Peng Xiaohui;Chen Ran;Pan Mei;Wang Bei(Department of Diagnostic Ultrasound&Echocardiography,Sir Run Run Shaw Hospital,Zhejiang University College of Medicine,Technical Guidance Center for Fetal Echocardiography of Zhejiang Province&Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University,Hangzhou 310016,China;Department of Ultrasound,Taizhou Hospital of Traditional Chinese Medicine,Taizhou 318000,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院超声科,浙江省胎儿心脏超声诊断技术指导中心,浙江大学邵逸夫临床医学研究所,杭州310016 [2]浙江省台州市中医院超声科,318000

出　　处：《中华超声影像学杂志》2021年第10期854-860,共7页Chinese Journal of Ultrasonography

基　　金：浙江省基础公益研究计划项目(LGF18H180004,LGF18H180015)。

摘　　要：目的探讨胎儿心脏定量分析(fetal HQ)技术在左室流出道梗阻(LVOTO)胎儿心功能及形态评价中的应用价值。方法选取2020年4-7月于浙江大学医学院附属邵逸夫医院经胎儿超声心动图诊断为LVOTO的胎儿(LVOTO组)25例。应用fetal HQ软件测量胎儿四腔心切面舒张末期基底-心尖长度、横向长度和整体球形指数(GSI),通过斑点追踪技术分析计算左右室舒张末期面积、长径、24节段舒张末期横向长度(ED)及其Z-评分、24节段球形指数(SI),同时获取左、右室24节段短轴缩短率(FS)的Z-评分。结果LVOTO胎儿左室24节段SI与右室比较差异有统计学意义(均P<0.05)。左、右室面积比较差异有统计学意义(P<0.05)。左、右室长度比较差异无统计学意义(P>0.05)。左室24节段ED的Z-评分与右室比较差异有统计学意义(均P<0.05),24节段RVED与LVED比值用箱型图进行分析,显示右室横向宽度较左室横向宽度明显增加,比值最高1.49(1.26,1.86),最低1.40(1.26,1.86),均明显大于正常值1.19。左室1~19节段FS的Z-评分与右室比较差异无统计学意义(均P>0.05),20~24节段比较差异有统计学意义(均P<0.05)。结论fetal HQ能够用于LVOTO胎儿心脏形状、大小和功能的定量分析,为胎儿心脏功能定量分析提供了新的方法。Objective To explore the application value of fetal heart quantification(fetal HQ)in evaluation of fetal cardiac function and morphology in fetuses with left ventricular outflow tract obstruction(LVOTO).Methods Twenty-five fetuses with LVOTO diagnosed by fetal echocardiography in Sir Run Run Shaw Hospital,Zhejiang University Medical College from April to July 2020 were enrolled.The end-diastolic basal apical length(BAL),transverse length(TL),global spherical index(GSI)of fetal four-chamber view,and the left and right ventricular end-diastolic area,long diameter,24-segment end-diastolic transverse length(ED)and its Z-scores adjusted by gestational age and 24-segment spherical index(SI)were calculated by using fetal HQ.Subsequently the Z-scores of left and right ventricle fractional shortening(FS)in 24 segments were obtained by gestational age.Results SI of 24-segments of left ventricles in fetuses with LVOTO were significantly different from that of right ventricles(all P<0.05).There was significant difference between left and right ventricular areas(P<0.05).There was no significant difference between left and right ventricular lengths(P>0.05).There were significant differences between the 24-segment Z-scores of left and right ventricular ED(all P<0.05).The ratios of RVED to LVED of 24 segments were analyzed by box diagram.The results showed that the transverse length of right ventricle was significantly higher than that of left ventricle.The highest value was 1.49(1.26-1.86),and the lowest value was 1.40(1.26-1.86),both significantly higher than the normal value of 1.19.There were no significant differences between the 1-19-segment Z-scores of left and right ventricular FS(P>0.05).There were significant differences between the 20-24-segment Z-scores of left and right ventricular FS(P<0.05).Conclusions Fetal HQ can be used to quantitatively analyze left ventricular shape,size and function of fetuses with LVOTO,which provides a new method for quantitative analysis of fetal heart function.

关 键 词：超声心动描记术 胎儿心脏定量分析技术 左心室流出道梗阻 球形指数 

分 类 号：R714.5[医药卫生—妇产科学]