胎儿心脏超声智能导航联合虚拟智能超声辅助技术在诊断胎儿法洛四联症中的应用  

Application of fetal intelligent navigation echocardiography combined with virtual intelligent sonographer assistance in diagnosis of fetal tetralogy of Fallot

作　　者：周超瑜 赵博文[1] 李玉惠 赵蓓 黄超 庞海苏 狄敏 Zhou Chaoyu;Zhao Bowen;Li Yuhui;Zhao Bei;Huang Chao;Pang Haisu;Di Min(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 Ultrasonography,Ningbo Medical Center Li Huili Hospital,Ningbo 315040,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]宁波市医疗中心李惠利医院超声科,315040 [3]浙江大学医学院附属邵逸夫医院

出　　处：《中华医学超声杂志（电子版）》2021年第10期967-974,共8页Chinese Journal of Medical Ultrasound(Electronic Edition)

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

摘　　要：目的探讨胎儿心脏超声智能导航技术(FINE或5D Heart)联合虚拟智能超声辅助技术(VIS-Assistance?)在诊断胎儿法洛四联症(TOF)中的价值。方法在2015年2月至2020年1月于浙江大学医学院附属邵逸夫医院接受胎儿超声心动图检查的孕妇中选取57例作为研究对象。胎儿超声心动图经验丰富的医师A负责采集每例胎儿心脏时间-空间相关成像(STIC)容积数据2~5个,经验不足的住院医师B和经验较为丰富的主治医师C筛选出每例胎儿中图像最佳的1个容积数据,应用5D Heart以及VIS-Assistance?技术进行在机后处理。按不同的脊柱位置,将57例TOF胎儿分成3个亚组:亚组A(脊柱2~4点钟)、亚组B(脊柱5~7点钟)、亚组C(脊柱8~10点钟)。分别对TOF胎儿的5个诊断切面(三血管气管切面、四腔心切面、左心室流出道切面、右心室流出道切面及胃泡切面)以及17个主要诊断要素进行评分。重点研究3个亚组5个诊断切面及17个诊断要素的显示率及亚组间的差异;2位不同年资医师分别两次对17个诊断要素显示率的比较;2位不同年资医师分别两次对5个诊断切面评分结果的重复性及一致性检验。结果应用5D Heart联合VIS-Assistance?技术,57例TOF胎儿三亚组之间5个诊断切面、17个诊断要素的显示率差异均无统计学意义(均P>0.05)。2位不同年资医师各诊断要素的显示率如下:三血管气管切面中,诊断要素(扩张的主动脉、狭窄的肺动脉主干、气管、上腔静脉)的显示率分别为94.7%~96.5%,93.0%~98.2%,70.2%~84.2%,86.0%~91.2%。四腔心切面中,诊断要素(4个房室腔、房室瓣、房室瓣距离、卵圆孔瓣、十字交叉、室间隔、调节束)的显示率分别为100.0%,100.0%,93.0%~96.5%,78.9%~82.5%,94.7%~96.5%,100.0%,100.0%。左心室流出道切面中,诊断要素(室间隔缺损、主动脉扩张、主动脉骑跨室间隔缺损)的显示率分别为96.5%~100.0%,100.0%,96.5%~98.2%。右心室流出道切面中,狭窄的�Objective To evaluate the application value of fetal intelligent navigation echocardiography(FINE,5D Heart)combined with virtual intelligent sonographer assistance(VIS-Assistance®)in the diagnosis of fetal tetralogy of Fallot(TOF).Methods From February to January 2020,57 pregnant women who received echocardiography examination for fetuses at Sir Run Run Shaw Hospital were selected as subjects in this study.Doctor A with rich fetal echocardiography experience collected two to five spatio-temporal image correlation(STIC)volume datasets for each fetal heart.The inexperienced doctor B and the more experienced doctor C screened out the best volume dataset in each fetus,and applied 5D Heart and VIS-Assistance®for post-processing.According to different spine positions,57 TOF fetuses were divided into three subgroups:A(spine 2-4 o'clock),B(spine 5-7 o'clock),and C(spine 8-10 o'clock).Five diagnostic views(three-vessel tracheal view,four-chamber view,left ventricular outflow view,right ventricular outflow view,and abdomen/stomach view)and 17 main diagnostic elements of TOF fetuses were scored,and in particular the following parameters were investigated:the display rates of five diagnostic views and 17 diagnostic elements in the three subgroups and the differences between subgroups;comparison of the display rates of 17 diagnostic elements twice by two doctors with different experience;and repeatability and consistency test of two different senior doctors'scoring results in five diagnostic views.Results With the application of 5D Heart and VIS-Assistance®,there was no significant differences in the display rates of five diagnostic views and 17 diagnostic elements between the three subgroups(P>0.05).The display rates of the diagnostic elements of two different senior doctors are as follows:in the three-vessel tracheal view,the display rates of diagnostic elements(dilated aorta,stenosis of pulmonary artery,trachea,and superior vena cava)were 94.7%-96.5%,93.0%-98.2%,70.2%-84.2%,and 86.0%-91.2%,respectively.In the four-chamb

关 键 词：法洛四联症 胎儿 超声心动图 时间-空间相关成像技术 胎儿心脏超声智能导航技术 虚拟智能超声辅助技术 

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]