时间-空间相关成像M型技术联合组织多普勒成像技术评价三尖瓣反流胎儿右心功能
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摘要
目的:探讨时间-空间相关成像(Spatiotemporal image correlation,STIC)-M型技术联合组织多普勒成像(tissue Doppler imaging,TDI)技术评价单纯三尖瓣反流胎儿右心功能的价值。方法:选取孕20～41+6周孕妇243例(除外心内及心外畸形),其中三尖瓣反流胎儿83例,依照反流程度不同分为:轻度反流组(63例)、中度反流组(20例),160例无三尖瓣反流胎儿为对照组。应用STIC-M型技术测量各组胎儿三尖瓣环位移(tricuspid annular displacement,TAD),并用TDI技术测量各组胎儿三尖瓣环舒张早期运动速度(E')、舒张晚期运动速度(A')、并计算E'/A'值,比较各组参数。结果:轻度反流组胎儿TAD、E'、A'、E'/A'值与对照组比较,差异均无统计学意义(P>0.05),中度反流组胎儿TAD、E'、A'、E'/A'值均低于对照组及轻度反流组,差异均有统计学意义(P<0.05)。结论:应用STIC-M型技术联合TDI技术能够评价准确评价三尖瓣反流胎儿右心收缩及舒张功能的变化情况,为指导临床积极治疗及适当时机分娩提供重要依据。
Objective: To explore the application value of spatio-temporal image correlation M-mode(STIC-M) together with tissue Doppler imaging(TDI) in evaluation of right ventricular function of the fetus with tricuspid regurgitation. Methods:243 fetuses from 20 to 41 +6 weeks were divided into 3 groups, 160 fetuses without tricuspid regurgitation as the control group, 63 fetuses with mild tricuspid regurgitation as the mild regurgitation group, 20 fetuses with moderate tricuspid regurgitation as the moderate regurgitation group. STIC-M was used to measure the tricuspid annular displacement(TAD). TDI was used to measure early and late diastolic tricuspid annular velocity(E' and A'), as well as E'/A'. Statistical analysis was per-formed to compare these parameters. Results: There were no significant differences in TAD, E', A' and E'/A' between the mild regurgitation group and the control group(P>0.05). The TAD, E', A', and E'/A' of the moderate regurgitation group were significantly lower than those of the control group and the mild regurgitation group(P<0.05). Conclusion: STIC-M combined with TDI can accurately evaluate right ventricular systolic and diastolic function of the fetuses with tricuspid regurgitation,which can provide important information in guiding the active clinical treatment and choosing the appropriate delivery opportunity.
Objective: To explore the application value of spatio-temporal image correlation M-mode(STIC-M) together with tissue Doppler imaging(TDI) in evaluation of right ventricular function of the fetus with tricuspid regurgitation. Methods:243 fetuses from 20 to 41 +6 weeks were divided into 3 groups, 160 fetuses without tricuspid regurgitation as the control group, 63 fetuses with mild tricuspid regurgitation as the mild regurgitation group, 20 fetuses with moderate tricuspid regurgitation as the moderate regurgitation group. STIC-M was used to measure the tricuspid annular displacement(TAD). TDI was used to measure early and late diastolic tricuspid annular velocity(E' and A'), as well as E'/A'. Statistical analysis was per-formed to compare these parameters. Results: There were no significant differences in TAD, E', A' and E'/A' between the mild regurgitation group and the control group(P>0.05). The TAD, E', A', and E'/A' of the moderate regurgitation group were significantly lower than those of the control group and the mild regurgitation group(P<0.05). Conclusion: STIC-M combined with TDI can accurately evaluate right ventricular systolic and diastolic function of the fetuses with tricuspid regurgitation,which can provide important information in guiding the active clinical treatment and choosing the appropriate delivery opportunity.
引文
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[2]Gardiner HM, Pasquini L, Wolfenden J, et al. Myocardial tissue Doppler and long axis function in the fetal heart[J]. Int J Cardiol, 2006, 113(1):39-47.
[3]接连利.胎儿心脏病理解剖与超声诊断学[M].北京:人民卫生出版社,2010:7-8.
[4]Coleman A, Kline-Fath B, Keswani S, et al. Prenatal solid tumor volume index:novel prenatal predictor of adverse outcome in sacrococcygeal teratoma[J]. J Surg Res, 2013, 184(1):330-336.
[5]Taweevisit M, Thorner PS. The contribution of extramedullary hematopoiesis to hepatomegaly in anemic hydrops fetalis:a study in alphathalassemia hydrops fetalis[J]. Pediatr Dev Pathol, 2012,15(3):206-212.
[6]陈炳华,李晓琴,杨敏,等.时间-空间相关成像M型超声技术在测量胎儿二尖瓣环位移中的应用[J].中国超声医学杂志,2015,31(10):926-929.
[7]卢洪涛,李清.四维时空关联成像对胎儿心脏畸形的产前诊断价值[J].山东医药,2015,55(1):72-73.
[8]Carlsson M,Ugander M,Heiberg E, et al. The quantitative relationship between longitudinal and radial function in left, right,and total heart pumping in humans[J]. Am J Physiol Heart Circ Physiol, 2007, 293(1):H636-H644.
[9]林忠英,蔡爱露,孙璐,等.时间-空间关联成像-M模式测量三尖瓣瓣环位移评估正常胎儿右心收缩功能[J].中国医学影像技术,2016,32(2):279-283.
[10]夏珣,李胜利,余艳红,等.超声速度向量成像技术评价胎儿左心发育不良综合征右心室功能[J].中国医学影像技术,2011,27(11):3321-3322.
[11]冯艳红,张华荣,吴世慧,等.脉冲组织多普勒超声评价妊娠高血压综合征胎儿心脏功能[J].中国医学影像技术,2011,27(7):88-90.
[12]高全霞,杨贵岚,全艳,等.二维超声联合多普勒超声评价胎儿右心功能及血流动力学随孕周变化规律[J].中国妇幼保健,2018,33(1):194-197.