应用超声三维容积技术评估先天性心脏病胎儿脑组织发育  

Ultrasound three-dimensional volumetric technique for evaluating fetal brain tissue development in congenital heart disease

作　　者：邱敬涛[1] 苏杭[1] 王晨雨[1] QIU Jingtao;SU Hang;WANG Chenyu(The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州大学第二附属医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2025年第3期311-315,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划项目(编号:LHGJ2022492)。

摘　　要：目的探讨应用超声三维容积参数评估先天性心脏病胎儿脑组织发育的价值。方法选择2022-01—2024-06于郑州大学第二附属医院行产前检查的孕妇120例,其中正常胎儿60例为对照组,复杂先天性心脏病(cCHD)胎儿30例为cCHD组,室间隔小缺损(sVSD)胎儿30例为sVSD组。采集胎儿颅脑二维参数、血流参数以及三维容积参数进行比较分析,包括:双顶径(BPD)、头围(HC)、脐动脉搏动指数(UA-PI)、大脑中动脉搏动指数(MCA-PI)、脑胎盘比(CPR)、额叶容积、丘脑容积。结果与对照组相比,≥28周cCHD组胎儿额叶容积及丘脑容积减小(P<0.05),经HC标准化额叶容积减小(P<0.05)。与对照组相比,cCHD组胎儿UA-PI增高(P<0.05),MCA-PI及CPR降低(P<0.05)。与对照组相比,sVSD组胎儿额叶容积、丘脑容积、BPD、HC、UA-PI、MCA-PI、CPR等差异均无统计学意义。对照组胎儿额叶容积与孕周、BPD、HC均显著相关(r=0.987、0.973、0.969,P<0.05);对照组胎儿丘脑容积与孕周、BPD、HC均显著相关(r=0.968、0.948、0.950,P<0.05)。cCHD组胎儿额叶容积、丘脑容积均与CPR显著相关(r=0.605、0.616,P<0.05)。结论cCHD胎儿孕晚期额叶及丘脑容积减小,提示cCHD胎儿存在脑组织发育减慢,而sVSD胎儿脑组织发育不受影响;脑血流参数与三维容积参数有良好相关性。Objective To investigate the application value of ultrasound three-dimensional volumetric parameters to evaluate fetal brain tissue development in congenital heart disease.Methods A total of 120 pregnant women who underwent prenatal examination in the Second Affiliated Hospital of Zhengzhou University from January 2022 to June 2024 were selected,including 60 normal fetuses as control group,30 fetuses with complex congenital heart disease(cCHD)as cCHD group,and 30 fetuses with small ventricular septal defect(sVSD)as sVSD group.Two dimensional parameters,hemodynamic parameters and three dimensional volume parameters of fetal brain were collected for comparative analysis,including biparietal diameter(BPD),head circumference(HC),umbilical artery pulse index(UA-PI),middle cerebral artery pulse index(MCA-PI),cerebroplacental ratio(CPR),frontal volume and thalamic volume.Results Compared with control group,fetal frontal lobe volume and thalamic volume decreased in cCHD group with gestational age≥28 weeks(P<0.05),fetal frontal lobe volume standardized by HC decreased(P<0.05).Compared with control group,fetal UA-PI in cCHD group increased(P<0.05),MCA-PI and CPR in cCHD group decreased(P<0.05).No statistically significant differences were observed between the control group and the sVSD group,including fetal frontal lobe volume,thalamic volume,BPD,HC,UA-PI,MCA-PI and CPR.In control group,fetal frontal lobe volume was significantly correlated with gestational age,BPD and HC(r=0.987,0.973,0.969,P<0.05).In control group,fetal thalamic volume was significantly correlated with gestational age,BPD and HC(r=0.968,0.948,0.950,P<0.05).In cCHD group,fetal frontal lobe volume and thalamic volume were significantly correlated with CPR(r=0.605,0.616,P<0.05).Conclusion The decrease of frontal lobe and thalamic volume in the third trimester of pregnancy in fetuses with cCHD indicates that the development of brain tissue in fetuses with cCHD is slowed,while the development of brain tissue in fetuses with sVSD is not affected.There is a g

关 键 词：脑组织发育 超声三维容积技术 先天性心脏病 胎儿 额叶容积 丘脑容积 

分 类 号：R714.51[医药卫生—妇产科学]