三维能量多普勒及彩色多普勒超声评估先天性心脏病胎儿脑血流灌注的研究
Three-dimensional power Doppler and color Doppler ultrasound for evaluation of cerebral blood perfusion in fetuses with congenital heart disease
查看参考文献16篇
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文摘
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目的应用三维能量多普勒及彩色多普勒超声研究先天性心脏病胎儿脑血流灌注。方法选取2017年1月至2018年8月在南京医科大学附属苏州医院进行二维彩色多普勒超声测量的156例孕妇(胎儿正常对照组105例,胎儿先天性心脏病组51例),应用脉冲多普勒测量胎儿脐动脉搏动指数(PI)及大脑中动脉PI值,并计算大脑中动脉PI与脐动脉PI比值(CPR)。同时应用三维能量多普勒超声成像,通过虚拟器官计算机辅助分析技术勾勒并计算大脑中动脉近心端区域血流灌注参数:血管化指数(VI)、血流指数(FI)和血管化血流指数(VFI),从而评估2组胎儿脑血流灌注情况。对脐动脉、大脑中动脉各组数据所测数据进行Z值校正,再采用方差分析比较组间差异,然后利用Bonferron法进行正常组与先天性心脏病[完全型大动脉转位(TGA),左心发育不良综合征(HLHS),左心梗阻性疾病(LSOL),右心梗阻性疾病(RSOL)]各组的两两比较。结果与正常对照组相比,HLHS和LSOL胎儿大脑中动脉PI(1.27±0.30 vs 1.30±0.30 vs 2.15±0.48)和CPR(1.26±0.29 vs 1.32±0.18 vs 1.92±0.58)均减少,大脑中动脉VI(71.71±19.57 vs 68.11± 14.35 vs 42.19±16.29)、FI(88.71±12.53 vs 81.80±14.21 vs 50.15±17.76)和VFI(34.70±7.17 vs 35.98±6.52 vs 20.90±11.06)均增加,差异均具有统计学意义(P均< 0.001),RSOL、TGA胎儿与正常胎儿之间大脑中动脉VI、FI和VFI比较,差异均无统计学意义(P > 0.05)。结论先天性心脏病胎儿脑血流灌注明显增加,特别是HLHS和LSOL胎儿,产前应用三维能量多普勒及彩色多普勒能有效评估此类先天性心脏病胎儿脑血流灌注。 |
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其他语种文摘
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Objective To evaluate cerebral blood perfusion in fetuses with congenital heart disease by three-dimensional power Doppler and color Doppler ultrasound. Methods The umbilical artery pulsation index (UA-PI) and the middle cerebral artery pulsation index (MCA-PI) were calculated by two-dimensional color Doppler ultrasound in 156 fetuses at Suzhou Hospital Affiliated to Nanjing Medical University from January 2017 to August 2018, including 105 normal fetuses (control group) and 51 fetuses with congenital heart disease. The ratio of MCA-PI to UA-PI was also calculated (CPR=MCA-PI/UA-PI). Three-dimensional power Doppler ultrasound combined with virtual organ computer-assisted analysis (VOCAL) technology was utilized to assess blood perfusion parameters of the proximal part of the middle cerebral artery, including vascularization index (VI), blood flow index (FI), and vascularization blood flow index (VFI), to evaluate the fetal cerebral perfusion during pregnancy. Z value was corrected for the measured data. ANOVA was then used to compare the above parameters among normal fetuses and fetuses with different congenital heart diseases including transposition of the great arteries (TGA), hypoplastic left heart syndrome (HLHS), left sided obstructive lesions (LSOL), and right sided obstructive lesions (RSOL), followed by Bonferronni's method for pairwise comparisons. Results Compared with the normal control group, there was a significant reduction in MCA-PI (1.27±0.30 vs 1.30±0.30 and 2.15±0.48) and CPR (1.26±0.29 vs 1.32±0.18 and 1.92±0.58), and a significant increase in VI (71.71±19.57 vs 68.11±14.35 and 42.19±16.29), FI (88.71±12.53 vs 81.80±14.21 and 50.15±17.76), and VFI (34.70±7.17 vs 35.98±6.52 and 20.90±11.06) in HLHS fetuses and LSOL fetuses (P < 0.001 for all). However, there was no significant difference in MCA VI, F, or VFI among the RSOL fetuses, TGA fetuses, and the normal fetuses (P > 0.05). Conclusion Fetal cerebral perfusion with congenital heart disease significantly increases, especially in fetuses with HLHS and LSOL. Prenatal application of three-dimensional power Doppler and color Doppler ultrasound can effectively evaluate cerebral perfusion in fetuses with these congenital heart diseases. |
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来源
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中华医学超声杂志（电子版）
,2020,17(9):874-879 【核心库】
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DOI
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10.3877/cma.j.issn.1672-6448.2020.09.010
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关键词
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大脑中动脉
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先天性心脏病
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脑血流
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地址
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南京医科大学附属苏州医院超声中心, 江苏, 苏州, 215000
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语种
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中文 |
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文献类型
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研究性论文 |
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ISSN
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1672-6448 |
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学科
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临床医学;妇产科学 |
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基金
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江苏省卫计委面上科研项目
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苏州市科技局科研项目
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文献收藏号
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CSCD:6836085
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