彩色多普勒超声立体血流成像结合心肌做功指数在高危妊娠胎儿心功能监测中的应用价值  

Value of color Doppler ultrasound three-dimensional flow imaging combined with MPI in the monitoring of fetal cardiac function in high-risk pregnancy

作　　者：汪玉 李胜男 严晓瑞 张晓桃 WANG Yu;LI Sheng-nan;YAN Xiao-rui(Department of Ultrasound Medicine,Lu'an Hospital Affiliated to Anhui Medical University(Lu'an People's Hospital),Lu'an Anhui 237005,China;Department of Obstetrical,Lu'an Hospital Affiliated to Anhui Medical University(Lu'an People's Hospital),Lu'an Anhui 237005,China)

机构地区：[1]安徽省医科大学附属六安医院(六安市人民医院)超声医学科,安徽六安237005 [2]安徽省医科大学附属六安医院(六安市人民医院)产科,安徽六安237005 [3]淮安市第三人民医院彩超室,江苏淮安223001

出　　处：《临床和实验医学杂志》2023年第8期879-883,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省医学会临床研究项目(编号:2019005641)。

摘　　要：目的探讨彩色多普勒超声立体血流成像(3D-CDFI)结合心肌做功指数(MPI)在高危妊娠(HRP)胎儿心功能监测中的应用价值。方法采用回顾性研究,将2019年4月至2022年3月安徽医科大学附属六安医院收治的60例高危妊娠孕妇纳入本次研究的高危妊娠组,另选同时间段的60例正常孕妇纳入对照组。2组孕妇均进行3D-CDFI检查和胎儿MPI自动智能检测,比较2组孕妇胎儿的心脏结构参数[右室舒张末期内径(RVDd)、右室收缩末期内径(RVDs)、左室壁厚度(LVWT)、右室壁厚度(RVWT)、四腔心横径和四腔心长径、左室舒张末期内径(LVDd)、左室收缩末期内径(LVDs)和全心球指数]、心功能指标[二尖瓣舒张早期峰值流速(E峰)(MVE)、舒张晚期峰值流速(A峰)(MVA)、MV-E/A、三尖瓣舒张早期峰值流速(E峰)(TVE)、舒张晚期峰值流速(A峰)(TVA)、TV-E/A]、心肌收缩功能及应变指标[左室整体长轴应变(LVGLS)、右室整体纵向应变(RVGLS)、右室游离壁应变(RVFWSt)、左室面积变化分数(LVFAC)、右室面积变化分数(RVFAC)、左室射血分数(LVEF)、二尖瓣环平面收缩期位移(MAPSE)、三尖瓣环平面收缩期位移(TAPSE)]和MPI。结果高危妊娠组胎儿RVDd、RVDs、LVWT、RVWT、四腔心横径和四腔心长径分别为(13.37±2.58)、(9.14±1.82)、(4.85±1.17)、(5.03±1.30)、(33.25±3.52)、(43.08±5.31)mm,较对照组[(12.04±2.07)、(8.21±1.29)、(4.02±0.98)、(4.14±1.02)、(31.57±3.06)和(41.60±4.28)mm]均显著上升,差异均有统计学意义(P<0.05),但2组LVDd、LVDs和全心球指数比较,差异均无统计学意义(P>0.05)。高危妊娠组胎儿的MVE、MVA、MV-E/A、TVE、TVA、TV-E/A分别为(56.22±7.68)cm/s、(55.23±5.04)cm/s、1.75±0.18、(60.42±8.91)cm/s、(56.01±7.60)cm/s和1.26±0.14,均较对照组[(47.62±6.74)cm/s、(50.04±4.30)cm/s、0.99±0.12、(46.30±5.24)cm/s、(51.42±7.01)cm/s和0.89±0.11]显著升高,差异均有统计学意义(P<0.05)。高危妊娠组胎儿的LVGLS、RVGObjective To evaluate the value of three-dimensional color Doppler flow imaging(3D-CDFI)combined with myocardial performance index(MPI)in the monitoring of fetal cardiac function in high-risk pregnancy(HRP).Methods A retrospective study was used,60 HRP women treated in Lu'an Hospital Affiliated to Anhui Medical University from April 2019 to March 2022 were included in the high-risk pregnancy group,and 60 normal pregnant women in the same period were selected as the control group.3D-CDFI and fetal MPI were detected in both groups.The cardiac structure parameters[right ventricular end-diastolic diameter(RVDd),right ventricular end-systolic diameter(RVDs),left ventricular wall thickness(LVWT),right ventricular wall thickness(RVWT),four-chamber transverse diameter and four-chamber long diameter,left ventricular end-diastolic diameter(LVDd),left ventricular end-systolic diameter(LVDs),global index],cardiac function indexes[mitral early diastolic peak velocity(E peak)(MVE),late diastolic peak velocity(A peak)(MVA),MV-E/A,tricuspid early diastolic peak velocity(E peak)(TVE),late diastolic peak velocity(A peak)(TVA),TV-E/A],myocardial contractile function and strain indexes[left ventricular global long-axis strain(LVGLS),right ventricular global longitudinal strain(RVGLS),right ventricular free wall strain(RVFWSt),left ventricular area change fraction(LVFAC),right ventricular area change fraction(RVFAC),left ventricular ejection fraction(LVEF),mitral annular plane systolic displacement(MAPSE),tricuspid annular plane systolic displacement(TAPSE)]and MPI of fetuses were compared.Results The RVDd,RVDs,LVWT,RVWT,four-chamber transverse diameter and four-chamber long diameter in high-risk pregnancy group were(13.37±2.58),(9.14±1.82),(4.85±1.17),(5.03±1.30),(33.25±3.52),(43.08±5.31)mm,respectively,which were much higher than those in the control group[(12.04±2.07),(8.21±1.29),(4.02±0.98),(4.14±1.02),(31.57±3.06)and(41.60±4.28)mm],and the differences were statistically significant(P<0.05),but there were no statistic

关 键 词：高危妊娠 彩色多普勒超声立体血流成像 心肌做功指数 胎儿 心功能 

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]