时间-空间关联成像评价正常胎儿及心律失常胎儿心功能的研究

doi:10.3969/j.issn.1006-7795.2014.02.006

首都医科大学学报 ›› 2014, Vol. 35 ›› Issue (2): 168-172.doi: 10.3969/j.issn.1006-7795.2014.02.006

时间-空间关联成像评价正常胎儿及心律失常胎儿心功能的研究

孙丽娟, 吴青青, 姚苓, 张铁娟, 马玉庆, 王莉, 李晓菲, 玄英华

首都医科大学附属北京妇产医院超声科, 北京 100006

收稿日期:2013-12-18 出版日期:2014-04-21 发布日期:2014-04-16
基金资助:
首都医科大学附属北京妇产医院科研基金（201103）。

A study of evaluating normal and arrhythmic fetal cardiac function with spatio-temporal image correlation

Sun Lijuan, Wu Qingqing, Yao Ling, Zhang Tiejuan, Ma Yuqing, Wang Li, Li Xiaofei, Xuan Yinghua

Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100006, China

Received:2013-12-18 Online:2014-04-21 Published:2014-04-16
Contact: 吴青青 E-mail:wuqq2007@163.com
Supported by:
This study was supported by Fund of Beijing Obstetrics and Gynecology Hospital, Capital Medical University(201103).

摘要/Abstract

摘要：

目的评估时间-空间关联成像（spatio-temporal image correlation，STIC）技术在孕21~32⁺⁶周正常胎儿及心律失常胎儿心功能检查中的应用价值。方法使用GE voluson E8彩色多普勒超声诊断仪STIC技术对孕21~32⁺⁶周的60例正常胎儿及12例单纯性心律失常胎儿扫描，获得胎儿心脏整个心动周期的容积数据，存盘后采用虚拟器官计算机辅助分析软件（virtual organ computer aided analysis，VOCAL）进行脱机分析，手动勾勒出心室舒张末期容积（end-diastole volume，EDV）及收缩末期容积（end-systole volume，ESV）。计算心室的每搏量（stroke volume，SV）、心排血量（cardiac output，CO）和射血分数（ejection fraction，EF），统计分析左/右心室EDV、ESV、SV、CO和EF的正常参考值及其与孕龄的相关性，随访所有胎儿结局。结果 60例正常胎儿心功能，21~32⁺⁶周正常胎儿不同孕龄左心室及右心室的EDV、ESV、SV及CO的正常参考值均随孕龄的增长而增加，与孕龄呈正相关（P均<0.001）；孕21~32⁺⁶周正常胎儿左心室射血分数（left ventricular ejection fraction，LVEF）和右心室射血分数（right ventricular ejection fraction，RVEF）的正常参考值分别为55%~57%、53%~56%，2者与孕龄有负相关性（r=-0.41、-0.41，P均为0.001）。12例单纯性心律失常胎儿心律失常类型包括房性期前收缩7例、心动过缓2例（短暂心动过缓后均可恢复正常心律）、房早伴短阵房速1例、房早伴房室传导阻滞1例及不能明确类型1例。12例心律失常胎儿LVEF（波动范围48%~66%）和RVEF（波动范围48%~64%）大致正常；左/右心室EDV、ESV、SV及CO与相应孕周正常胎儿参考值相比大致正常。12例胎儿均足月分娩，随访至新生儿均身体健康。结论 STIC技术能较为准确、客观的测量胎儿心室容积及评价胎儿心功能，对心律失常胎儿的心功能评估也有一定价值。

关键词: 时间-空间关联成像, 动态三维超声, 胎儿心功能, 胎儿心律失常

Abstract:

Objective To assess the application of spatio-temporal image correlation(STIC) for normal and arrhythmic fetal cardiac function examination from 21 to 32⁺⁶ gestational weeks. Methods Fetal heart ventricular end-diastole volumes(EDV) and end-systole volumes(ESV) were measured with STIC and virtual organ computer aided analysis(VOCAL) in 60 normal fetuses and 12 fetuses with isolated arrhythmia from 21 to 32⁺⁶ gestational weeks. The stroke volume(SV), cardiac output(CO) and ejection fraction(EF) of each ventricle were calculated with EDV and ESV.The normal reference values of EDV, ESV, SV, CO and EF of left and right ventricles were calculated with statistical methods. The correlation between cardiac parameters(including EDV, ESV, SV, CO and EF) and gestational age were analyzed. Every fetus had a follow-up outcome after birth. Results The cardiac functions of 60 normal fetuses: We obtained the normal reference values of EDV, ESV, SV and CO of left and right ventricles according to different gestational weeks(Table 1), which increased and had significant positive correlations with gestational age(P<0.001). The normal reference values of LVEF(left ventricular ejection fraction) and RVEF(right ventricular ejection fraction) were(55%-57%) and (53%-56%) respectively from 21 to 32⁺⁶ gestational weeks, which had negative correlations with gestational age(r=-0.41, -0.41, all P=0.001). The cardiac functions of 12 fetuses with isolated arrhythmia: The types of fetal arrhythmia included 7 cases with atrial premature beats, 2 cases with bradyarrhythmias, 1 case with atrial premature beat and atrial tachycardia, 1 case with atrial premature beat and atrioventricular block and 1 case with undefined type. EDV, ESV, SV, CO, LVEF(48%-66%) and RVEF(48%-64%) of 12 isolated arrhythmic fetuses were roughly normal according to normal reference values of different gestational weeks. All of 12 fetuses with isolated arrhythmia were full term deliveries, and healthy after birth. Conclusion STIC technique can accurately measure fetal ventricular volumes and evaluate fetal cardiac function.It is also helpful to assess arrhythmic fetal cardiac function.

Key words: spatio-temporal image correlation, dynamic three-dimensional ultrasonography, fetal cardiac function, fetal arrhythmia

中图分类号:

R447.1

孙丽娟, 吴青青, 姚苓, 张铁娟, 马玉庆, 王莉, 李晓菲, 玄英华. 时间-空间关联成像评价正常胎儿及心律失常胎儿心功能的研究[J]. 首都医科大学学报, 2014, 35(2): 168-172.

Sun Lijuan, Wu Qingqing, Yao Ling, Zhang Tiejuan, Ma Yuqing, Wang Li, Li Xiaofei, Xuan Yinghua. A study of evaluating normal and arrhythmic fetal cardiac function with spatio-temporal image correlation[J]. Journal of Capital Medical University, 2014, 35(2): 168-172.

参考文献

[1] 李剑, 吴瑛.时间-空间相关成像在胎儿心功能测定上的应用进展[J].中华医学超声杂志:电子版, 2010, 7:1-3.

[2] Goncalves L F, Lee W, Chaiworapongsa T, et al. Four-dimensional ultrasonography of the fetal heart with spatiotemporal image correlation[J]. Am J Obstet Gynecol, 2003, 189(6):1792-1802.

[3] 赵胜, 邓又斌. 双胎输血综合征胎儿心功能改变的超声研究进展[J].中华超声影像学杂志, 2010, 19(5):628-630.

[4] 何志明, 方群.双胎输血综合征胎儿心功能评估中的方法及临床应用[J].中华妇产科杂志, 2012, 47(3):546-548.

[5] DeVore G R, Falkensammer P, Sklansky M S, et al. Spatio-temporal image correlation(STIC): new technology for evaluation of the fetal heart[J]. Ultrasound Obstet Gynecol, 2003, 22(4):380-387.

[6] Hamill N, Romero R, Hassan S S, et al. Repeatability and reproducibility of fetal cardiac ventricular volume calculations using spatiotemporal image correlation and virtual organ computer-aided analysis[J]. J Ultrasound Med, 2009, 28(10):1301-1311.

[7] 姬宏娟, 汪龙霞, 王军燕, 等.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[J].中国医学影像学杂志, 2012, 20(2):118-122.

[8] Simioni C, Nardozza L M, Araujo Júnior E, et al. Fetal cardiac function assessed by spatio-temporal image correlation[J]. Arch Gynecol Obstet, 2011, 284(1):253-260.

[9] Veille J C, Hanson R steele L, et al. M-mode echocardiographic evaluation of fetal and infant hearts: Longitudinal follow-up study from intrauterine life to year one[J]. AM J Obstet Gynecol, 1 996, 175(4 Pt 1):922-928.

[10] Hamill N, Yeo L, Romero R, et al. Fetal cardiac ventricular volume, cardiac output, and ejection fraction determined with 4-dimensional ultrasoundusing spatiotemporal image correlation and virtual organ computer-aided analysis[J]. Am J Obstet Gynecol, 2011, 205(1):76.

[11] Simioni C, Araujo Júnior E, Martins W P, et al. Fetal cardiac output and ejection fraction by spatio-temporal image correlation(STIC): comparison between male and female fetuses[J]. Rev Bras Cir Cardiovasc, 2012, 27(2):275-282.

[12] 孙微, 张颖, 蔡爱露, 等.时间-空间关联成像技术评价正常胎儿心功能[J].中国医学影像技术, 2011, 27(1):202-203.

[13] Api O, Carvalho J S. Fetal dysrhythmias[J]. Best Pract Res Clin Obstet Gynaecol, 2008, 22(1):31-48.

[14] 孙春旭.产前胎儿心脏彩超的诊断价值[J].中国煤炭工业医学杂志, 2011, 14(8):1186.

时间-空间关联成像评价正常胎儿及心律失常胎儿心功能的研究

A study of evaluating normal and arrhythmic fetal cardiac function with spatio-temporal image correlation

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 1

编辑推荐

Metrics

本文评价