应用时间-空间相关成像技术评估妊娠期高血压疾病胎儿心功能

目的 探讨时间-空间相关成像(spatio-temporal image correlation,STIC)技术评价妊娠期高血压疾病胎儿心功能的临床应用。方法 运用STIC技术采集110例正常孕妇胎儿及84例妊娠期高血压疾病（PIH）孕妇胎儿心动周期图像，通过VOCAL功能获得容积参数，包括左、右心室舒张末期容积（LVEDV、RVEDV），左、右心室收缩末期容积（LVESV、RVESV），计算出左、右心室每搏量（LVSV、RVSV），左、右心室射血分数（LVEF、RVEF），左、右心室心排出量（LVCO、RVCO）。根据孕妇高血压严重程度及临床症状分为:PIH I组(孕妇血压轻度升高或轻度子痫前期):即孕妇妊娠20周后第1次出现血压升高，140/90 mmHg≤血压值<160/110 mmHg(1 mmHg=0.133 kPa),间隔6 h以上，至少出现过两次,尿蛋白弱阳性；PIH II组(重度子痫前期):血压≥160/110 mmHg，和(或)尿蛋白阳性或者强阳性(++),或伴有微血管溶血、神经系统及肺水肿等症状。结果 ①与对照组相比，PIH I组胎儿左、右EDV、ESV、SV、EF、CO差异均无统计学意义；②与对照组、PIH I组相比，PIH II组胎儿的左、右EDV、ESV增大、差异有统计学意义（P<0.05，P<0.01），PIH II组胎儿的SV、EF、CO均减小，差异有统计学意义（P<0.05，P<0.01）。结论 STIC技术可以评价妊娠期高血压病胎儿心功能的变化。

Evaluation of fetal ventricular volume and systolic function in gestational hypertensive states by spatiotemporal image correlation

AIM To investigate the value of Spatio-temporal Image Correlation (STIC) technique in evaluating fetal ventricular volume and systolic function in pregnancy induced hypertensive states, (PIH). METHODS Fetal heart ventricular volumes were measured using a STIC technique in 84 women with PIH (PIH group) and 110 women with normal pregnancy (normal group). The virtual organ computer-aided analysis (VOCAL) technique was used to obtain systolic and diastolic ventricular volumes. The stroke volume (SV), ejection fraction (EF) and cardiac output (CO) were calculated. Patients with gestational hypertensive states were divided into two groups: PIH I group: the mothers with the hypertensive states and the mildly pre-eclamptic were devided into a PIH I group whose blood pressure after 20 weeks of pregnancy was higher than 140/90 mmHg , was less than 160/110 mmHg and measured once every 6 hours, more than two times and whose proteinuria was negative; PIH II group: The mothers with severe pre-eclampsia were devided into PIH II group whose blood pressure was higher than 160/110 mmHg and whose proteinuria was positive. RESULTS When compared with normal group, the systolic and diastolic ventricular volumes, stroke volume (LVSV, RVSV)， ejection fraction (LVEF, RVEF) and cardiac output (LVCO, RVCO) of the PIH I group were significantly different. When compared with normal and the PIH I group, the systolic and diastolic ventricular volumes of the PIH II group were higher (P<0.05, P<0.01). The stroke volume (SV), ejection fraction (EF) and cardiac output (CO) of PIH II group were decreased (P<0.05, P<0.01). CONCLUSION SSTIC is an adaptable, reliable, and noninvasive investigative tool for fetal ventricular volume in gestational hypertensive states.