时间-空间相关成像技术评估中孕期胎儿心功能的初步研究

目的 评估时间-空间相关成像( STIC)技术在中孕期胎儿心功能检查中的应用.资料与方法 110例孕20～27+6周胎儿常规超声筛查心脏无异常,用STIC技术扫描获得胎儿心脏整个心动周期的容积数据,存盘后采用体器官计算机辅助分析软件(VOCAL)进行脱机分析,手动描画出心室舒张末期容积(EDV)、收缩末期容积(ESV).计算心室的每搏量(SV)、心排血量(CO)、射血分数(EF),评价SV、CO、EF与孕龄的相关性.结果 110例胎儿中,94例(85.5％)获得满意的心脏容积数据.左、右心室SV从孕20周的(0.33±0.06) ml和(0.40±0.07) ml增加至孕27+6周的(1.13±0.11) ml和(1.29±0.11) ml,左、右心室CO从孕20周的( 49.66±8.10) ml/min和(59.96±9.43) ml/min增加至孕27+6周的(163.51±17.68) ml/min和(187.57±15.98) ml/min;左、右心室SV和CO随孕龄增加而增加,与孕龄呈正相关(左心室SV及CO r=0.93,P＜0.05.右心室:SV r =0.95,P＜0.05; CO r=0.94,P＜0.05).左、右心室EF分别为(49.48±4.12)％和(51.07±4.00)％,与孕龄无明显相关性(r=0.02、0.04,P＞ 0.05).结论 STIC技术能较为准确客观地测量胎儿心室容积,评价胎儿心功能,有望成为胎儿心功能检查的一种新方法.

A Preliminary Study of Assessing Fetal Cardiac Function in Second-trimester Pregnancy Using Spatio-temporal Image Correlation

Purpose To assess the application of the STIC in second-trimester fetal cardiac function examination.Materials and Methods Fetal heart ventricular volumes were measured using STIC in 110 normal second-trimester fetuses.Data were analyzed using virtual organ computer-aided analysis method.The volumes of each ventricular in end-systole (EDV) and end-diastole (ESV) were manually drawn to calculate the stroke volume (SV) of the left and right ventricles,cardiac output (CO) and ejection fraction (EF).The correlation of SV,CO,EF with gestational age was analyzed.Results Among the 110 normal fetuses,ventricular volume analyses were satisfactory in 94 (85.5%).Mean left and right stroke volumes (SV) and cardiac output (CO) increased from (0.33±0.06) ml and (0.40±0.07) ml,(49.66±8.10) ml/min and (59.96±9.43) ml/min at 20 weeks,to (1.13±0.11) ml and (1.29±0.11) ml,(163.51±17.68) ml/min and (187.57±15.98) ml/min at 27 +6 weeks,respectively.Mean LVEF and RVEF was (49.48±4.12)% and (51.07±4.00)% respectively.The left and right SV and CO increased with gestation age and r-values were both positive (r=0.93,P < 0.05,r=0.95,P < 0.05;r=0.94,P < 0.05).The left and right EF had no significant correlation with gestation age (r=0.02,0.04,P > 0.05).Conclusion STIC technique can accurately measure fetal ventricular volumes and evaluate fetal cardiac function thus has the potential of becoming a new method of choice in evaluating fetal cardiac function.