先天性心脏病胎儿脑发育超声研究  

Ultrasound study of fetal brain development with congenital heart disease

作　　者：张恒静 栗河舟[1] 王铭[1] 吴娟[1] 王新霞[1] 高静[1] 要迎春 姜竹 李丹娜 ZHANG Heng-jing;LI He-zhou;WANG Ming;WU Juan;WANG Xin-xia;GAO Jing;YAO Ying-chun;JIANG Zhu;LI Dan-na(Department of Ultrasound,Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院超声科,河南郑州450052

出　　处：《中国临床医学影像杂志》2022年第7期480-484,共5页Journal of China Clinic Medical Imaging

基　　金：河南省医学适宜技术推广项目(SYJS2020080)。

摘　　要：目的:本研究通过采用二维径线测量先天性心脏病(CHD)胎儿和正常胎儿颅脑结构,比较分析以评估CHD胎儿颅脑发育情况。方法:选取2021年11月—2022年4月我院行产前超声诊断的94例CHD胎儿作为病例组,146例正常胎儿作为对照组。前瞻性地收集所有研究对象20~32^(+6)周的颅脑二维参数,包括额叶前后径(FAPD)、枕额径(OFD)、小脑横径、双顶径(BPD)、头围(HC),计算FAPD与OFD比值。采用Pearson相关分析法分析正常胎儿FAPD、FAPD/OFD、小脑横径与孕周及HC的相关性。采用Mann-Whitney U检验比较病例组与正常对照组胎儿间FAPD/OFD及各项二维参数的差异。结果:正常对照组胎儿FAPD、小脑横径与孕周及HC均呈高度正相关(孕周:r=0.906、0.953,P<0.001;HC:r=0.900、0.939,P<0.001),FAPD/OFD与孕周及HC中度相关(r=0.525、0.586,P<0.001)。病例组FAPD、FAPD/OFD、HC均较正常对照组胎儿减小,差异均具有统计学意义(P<0.05)。病例组与正常对照组胎儿BPD、小脑横径间差异无统计学意义。结论:CHD在宫内即影响胎儿颅脑发育,且对胎儿颅脑额叶影响较为显著,二维参数FAPD及FAPD/OFD一定程度上可以对CHD胎儿额叶发育进行定量评估,指导临床产前咨询及产后干预。Objective: In this study, the brain structure of fetuses with congenital heart disease(CHD) and normal fetuses were measured by two-dimensional diameter, compared and analyzed to evaluate the development of fetuses with CHD. Methods: A total of 94 CHD fetuses who underwent prenatal ultrasound diagnosis in our hospital from November 2021 to April2022 were selected as the case group and 146 normal fetuses as the control group. Two-dimensional parameters of the cranial brain were collected prospectively for 20 to 32^(+6)weeks from all subjects, including frontal anteroposterior diameter(FAPD), occipital frontal diameter(OFD), transverse cerebellar diameter, biparietal diameter(BPD), head circumference(HC). The FAPD to OFD ratio was calculated. Pearson correlation analysis was performed to analyze the correlation of FAPD, FAPD/OFD, cerebellar transverse diameter with gestational age and HC in normal fetuses. Mann-Whitney U test was used to compare the differences in FAPD/OFD and various two-dimensional parameters between the case group and the normal control group. Results:In the normal control group, fetal FAPD and cerebellar transverse diameter were highly positively correlated with gestational age and HC(gestational age: r=0.906, 0.953, P<0.001;HC: r=0.900, 0.939, P<0.001), FAPD/OFD was moderately correlated with gestational age and HC(r=0.525, 0.586, P<0.001). The FAPD, FAPD/OFD and HC of the case group were all lower than those of the normal control group, and the differences were statistically significant(P<0.05). There was no significant difference in fetal BPD and cerebellar transverse diameter between the case group and the normal control group. Conclusion: CHD affects fetal brain development in utero and has a significant impact on fetal frontal lobe. The two-dimensional parameters FAPD and FAPD/OFD can quantitatively evaluate the development of CHD fetal frontal lobe to a certain extent, and guide clinical prenatal consultation and postpartum interventions.

关 键 词：胎儿 心脏缺损 先天性 脑 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]