3D-PDUS评估胎儿肾脏对胎儿生长受限的诊断价值  

Diagnostic value of 3D-PDUS assessment of fetal kidney for fetal growth restriction

作　　者：王琴晓 张雯 尤利益 杨思思 陈海迎 焦岩 WANG Qinxiao;ZHANG Wen;YOU Liyi;YANG Sisi;CHEN Haiying;JIAO Yan(Department of Gynecology and Obstetrics Ultrasound,Wenzhou People’s Hospital,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州市人民医院妇产超声科,浙江温州325000

出　　处：《中国现代医生》2024年第28期30-33,共4页China Modern Doctor

基　　金：浙江省温州市基础性医疗卫生科技项目(Y20211034)。

摘　　要：目的探讨三维能量多普勒超声(three-dimensional power Doppler ultrasound,3D-PDUS)对胎儿生长受限(fetal growth restriction,FGR)的诊断价值。方法选取2021年9月至2023年12月于温州市人民医院产检并分娩的孕晚期孕妇120例为研究对象,经临床和超声证实的FGR孕妇50例纳入病例组,胎儿宫内发育正常的孕妇70例纳入对照组,比较两组胎儿的肾脏容积和肾脏血流参数,比较两组孕妇的妊娠结局和围产期情况。绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)并计算曲线下面积(area under the curve,AUC),评价各血流参数对FGR的诊断效能。结果病例组胎儿的肾脏体积/孕周、肾脏血管化指数、血管化-血流指数、肾动脉收缩期峰值流速均显著低于对照组,肾动脉收缩期峰值流速/舒张末期血流速度比值、搏动指数、阻力指数均显著高于对照组(P<0.05);两组胎儿的肾脏血流指数比较差异无统计学意义(P>0.05)。ROC曲线结果显示,肾脏体积/孕周和肾动脉收缩期峰值流速的诊断效能较高,而联合应用的诊断效能最高,AUC为0.89。病例组的低出生体重儿发生率显著高于对照组,新生儿Apgar评分显著低于对照组(P<0.01)。结论使用3D-PDUS定量分析参数评估肾脏容积和血液灌注情况可预测FGR,有利于早期诊断FGR并指导临床干预,有效减少不良妊娠结局。Objective To investigate the diagnostic value of three-dimensional power Doppler ultrasound(3D-PDUS)in fetal growth restriction(FGR).Methods A total of 120 pregnant women in the third trimester who were given birth in Wenzhou People’s Hospital from September 2021 to December 2023 were selected as study objects,50 pregnant women with FGR confirmed by clinical and ultrasound were included in case group,and 70 pregnant women with normal fetal development were included in control group.The renal volume and renal blood flow parameters of the fetuses in two groups were compared.The pregnancy outcomes and perinatal conditions of two groups were compared.Receiver operating characteristic(ROC)curve was plotted to calculate the area under the curve(AUC),and the diagnostic efficacy of various blood flow parameters for FGR was evaluated.Results The renal volume/gestational week,renal vascularization index,vascularization flow index and renal artery peak systolic velocity of the fetuses in case group were significantly lower than those in control group,while renal artery peak systolic velocity/end diastolic velocity,pulsation index and resistance index were significantly higher than those in control group(P<0.05).There was no significant difference in renal flow index between two groups(P>0.05).ROC curve results showed that the diagnostic efficacy of renal volume/gestational week and renal artery peak systolic velocity were higher,while the diagnostic efficacy of combined application was the highest,with an AUC of 0.89.The rate of low birth weight infants in case group was significantly higher than that in control group,and neonatal Apgar score was significantly lower than that in control group(P<0.01).Conclusion 3D-PDUS quantitative analysis parameters evaluated renal volume and blood perfusion could predict FGR,which is conducive to early diagnosis of FGR and guide clinical intervention,and effectively reduce adverse pregnancy outcomes.

关 键 词：胎儿生长受限 肾动脉 肾脏容积 肾脏血流参数 妊娠结局 

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]