斑点追踪技术评估肺动脉瓣狭窄胎儿右室功能的应用  

Application of speckle tracking technique to evaluate right ventricular function in fetuses with valvar pulmonary stenosis

作　　者：张俊[1] 潘琦[1] 殷林亮[1] 邓学东[1] ZHANG Jun;PAN Qi;YIN Lin-liang;DENG Xue-dong(Center for Medical Ultrasound,Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou Municipal Hospital,Suzhou Jiangsu 215000,China)

机构地区：[1]南京医科大学附属苏州医院苏州市立医院超声中心,江苏苏州215000

出　　处：《中国临床医学影像杂志》2022年第5期363-365,368,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:通过二维斑点追踪技术评估胎儿肺动脉瓣狭窄时右心室收缩功能,并比较其与正常胎儿右心室收缩功能的差异。方法:选取22例肺动脉瓣狭窄胎儿作为病例组,同期50例正常胎儿作为对照组。获取胎儿四腔心切面后导入TomTec心功能分析软件自动分析并计算左、右心房横径,左、右心室长径,左、右心室整体长轴应变,左、右心室面积变化率,左室射血分数及三尖瓣环位移等参数。比较肺动脉瓣狭窄对胎儿左、右心室收缩功能的影响。结果:与对照组相比,病例组右房收缩末期横径增大,右室舒张末期长径、右心室长轴整体应变及右心室面积变化率减低(P<0.05);而左房收缩末期横径、左室舒张末期长径、左心室长轴整体应变、左心室面积变化率、左室射血分数及三尖瓣环位移差异无统计学意义(P>0.05)。结论:肺动脉瓣狭窄胎儿右心室收缩功能下降,二维斑点追踪技术可以有效评估右心室收缩功能。Objective:To evaluate the right ventricular systolic function in fetal valvar pulmonary stenosis by two-dimensional speckle tracking imaging,and to compare the difference of the right ventricular systolic function between the case group and the normal fetuses.Methods:22 fetuses with valvar pulmonary stenosis were selected as the case group and 50normal fetuses were selected as the control group.After the four chambers view was obtained,parameters of the fetal heart(including left and right atrial end systolic diameter,left and right ventricular end diastolic length diameter,left and right ventricular global longitudinal strain,left and right ventricular fraction area change,left ventricular ejection fraction and tricuspid annular plane systolic excursion) were automatically analyzed and calculated by TomTec cardiac function analysis software.The effects of valvar pulmonary stenosis on fetal systolic function of left and right ventricles were compared.Results:Compared with the control group,the right atrial end systolic diameter was increased,right ventricular end diastolic long diameter,right ventricular global longitudinal strain and right ventricular fraction area change were decreased in the case group(P<0.05).Meanwhile,the left atrial end systolic diameter,left ventricular end diastolic length diameter,left ventricular global longitudinal strain,left ventricular fraction area change,left ventricular ejection fraction and tricuspid annular plane systolic excursion showed no significant differences(P>0.05).Conclusions:The right ventricular systolic function is decreased in the fetus with valvar pulmonary stenosis.Two-dimensional speckle tracking technique can effectively evaluate right ventricular systolic function.

关 键 词：肺动脉瓣狭窄 心室功能 右 超声检查 产前 

分 类 号：R714.53[医药卫生—妇产科学] R445.1[医药卫生—临床医学]