二维斑点追踪技术评价小于胎龄儿心脏大小重塑的临床价值  

Clinical Value of the Two-Dimensional Speckle Tracking Technique for Evaluating Cardiac Size Remodeling in Small for Gestational Age Fetuses

作　　者：朱晨 刘芮 蔡琪 李嫚 项金莲 任芸芸 Zhu Chen;Liu Rui;Cai Qi;Li Man;Xiang Jinlian;Ren Yunyun(Department of Ultrasound,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China)

机构地区：[1]复旦大学附属妇产科医院超声科,上海市200011

出　　处：《中国超声医学杂志》2024年第6期679-682,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家重点研发计划项目(No.2023YFC2705700);上海市卫生健康委员会卫生行业临床研究专项课题(No.202140217);复旦大学附属妇产科医院临床研究项目(No.FC2023CR010)。

摘　　要：目的 利用二维斑点追踪胎心定量分析技术(fetalHQ)测量胎儿心脏大小,并探讨小于胎龄(SGA)胎儿心脏大小重塑的量化指标。方法 前瞻性收集28~39+6周的单胎妊娠孕妇。采用fetalHQ对453例低风险胎儿和210例SGA胎儿的四腔心和心室的长径、宽径(24节段)和面积进行测量计算。结果 估测胎儿体质量的标准化后,脐动脉正常的SGA胎儿四腔心和右心室的宽径、面积均大于低风险胎儿(P<0.05)。脐动脉正常的SGA胎儿心脏大小径线>95th%的比例,排前3位的依次为右心室宽径至少一个节段(35.0%)、右心室宽径中间段(22.9%)、四腔心宽径(19.7%),均大于低风险胎儿(P<0.05)。结论 1/3的SGA胎儿出现右心室宽径异常增大(以中间段为著)早于脐动脉。Objective To analyze the fetal cardiac size by the two-dimensional speckle tracking technique(fetal-HQ package)and to explore the quantification of cardiac size remodeling in the small for gestational age(SGA)fetu-ses.Methods Prospective collection of singleton pregnancies at 28 to 39+6 weeks of gestation.The length,width and area of the four-chamber view and two ventricles were measured and calculated using fetalHQ in 453 low-risk and 210 SGA fetuses.Results After normalization for estimated fetal weight,the four-chamber view and right ventricular(RV)width and area were greater in SGA fetuses with normal umbilical arteries(UA)than in low-risk fetuses,P<0.05.The top three ratios of cardiac size parameters>95th%in SGA fetuses with normal UA were at least one seg-ment of RV width(35.0%),the mid segment of RV width(22.9%),and four-chamber view width(19.7%),which were greater than those of low-risk fetuses(all P<0.05).Conclusions 1/3 of SGA fetuses present with an abnormal enlargement of the RV width(predominantly in the mid)earlier than the UA.

关 键 词：小于胎龄 二维斑点追踪 fetalHQ 心脏大小 重塑 胎儿 

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]