胎儿心脏定量分析技术在中孕晚期正常胎儿心脏结构及功能的研究  

Fetal heart quantification technique study on the structure and function of normal fetal heart in late middle pregnancy

作　　者：韩艳丽 杨汀阳 满婷婷[1] 赵映[1] 谷孝艳[1] 张烨[1] 韩建成[1] 武玉多 朱皞罡 何怡华[1] HAN Yanli;YANG Tingyang;MAN Tingting;ZHAO Ying;GU Xiaoyan;ZHANG Ye;HAN Jiancheng;WU Yuduo;ZHU Haogang;HE Yihua(Echocardiography Medical Center,Beijing Anzhen Hospital,Maternal-Fetal Medicine Center in Fetal Heart Disease,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心脏超声医学中心胎儿心脏病母胎医学中心,100029 [2]北京航空航天大学软件开发环境国家重点实验室

出　　处：《心肺血管病杂志》2023年第8期844-849,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：胎儿心脏病母胎医学研究北京市重点实验室(BZ0308);心血管疾病精准医学北京实验室(PXM2018_014226_000013)。

摘　　要：目的:用定量分析技术(fetal heart quantification,Fetal HQ),对中孕晚期正常胎儿心脏结构及功能等参数进行初步分析。方法:收集2019年9月至2020年1月,在北京安贞医院母胎医学中心就诊的,妊娠22~27周间的153例正常单胎妊娠胎儿,进行系统超声心动图检查,存储胎儿标准四腔心切面,通过Fetal HQ软件后处理操作计算出心脏整体及左、右心室不同节段的球形指数(sphericity index,SI),左、右心室24节段舒张末期内径及短轴缩短分数(fractional shortening,FS)、左、右心室面积变化率(left and right ventricular area change rate, FAC)及整体纵向应变(global left and right ventricular longitudinal strain,GLS)和LVEF并探讨各参数数据分布情况及与孕周之间的相关性。并进行检查者间和检查者自身的重复性检验。结果:除左心室1~24节段LVEDD及右心室第4~13节段舒张末期内径(right ventricular diastolic diameter, RVED)与孕周(gestational age, GA)呈正相关,且符合正态分布外,其他参数均与GA无相关性,其中右心室面积变化率(the right ventricular area change rate,RVFAC)、左心室短轴缩短分数(the left fractional shortening, LVFS)、右心室短轴缩短分数(the right fractional shortening,RVFS)及第10~17节段LVSI呈正态分布,整体球形指数(the sphericity index,GSI)、左心室面积变化率(the left ventricular area change rate,LVFAC)、LVEF、左心室纵向应变(left ventricular longitudinal strain,LVGS)、右心室纵向应变(right ventricular longitudinal strain,RVGS)、1~24节段右心室球形指数(right ventricular sphericity index,RVSI)、第1~9节段、18~24节段左心室球形指数(left ventricular sphericity index,LVSI)符合非正态分布。各参数观察者自身ICC为GSI:0.89,LVEF:0.79,LVGS:0.83, LVFAC:0.82, RVFAC:0.75, RVGS:0.74;观察者间ICC为GSI:0.83, LVEF:0.75, LVGS:0.78, LVFAC:0.74, RVFAC:0.70, RVGS:0.62。结论:Fetal HQ技术可以分析胎儿心脏整体及左、右心室24节段结构及功Objective:Using Fetal HQ quantitative analysis technology to conduct preliminary analysis on the structure and function of normal fetal heart in Beijing Anzhen Hospital Materal-Fetal.Methods:Fetal Echocardiography was performed on 153 normal fetuses between 22 and 27 weeks of gestation in our center from 2019.9-2020.1.Through the Fetal HQ post-processing operation,the sphericity index(SI)of the whole heart and different segments of the left and right ventricles,the 24 segments of the left and right ventricles end-diastolic diameter and fractional shortening(FS),left and right ventricular area change rate(FAC),overall left and right ventricular longitudinal strain(GLS)and EF were derived.The data distribution and correlation of each parameter with gestational age(GA)were calculated.Results:Except for the segment 1-24 LVEDD and the right ventricle segment 4-13 segment end diastolic diameter(RVED),which were positively correlated with gestational age(GA),and accorded with normal distribution,other parameters were all related to GA has no significant correlation.RWFAC,LVFS,RVFS and LVSI in segments 10-17 are normally distributed,GSI,LVFAC,LVEF,LVGS,RVGS,RVSI in segments 1-24,RVSI in segments 1-9,18-24-segment LVSI conforms to non-normal distribution.Conclusions:The application of fetal HQ technology to analyze the evaluation of the structure and function of the 24 segments of the fetal ventricle provides a new method for understanding the differences in different segments during the development of the fetal heart.

关 键 词：超声心动图 胎儿心脏定量分析技术 胎儿心功能 

分 类 号：R54[医药卫生—心血管疾病]