目的：探讨彩色多普勒超声检测妊娠中期胎儿大脑中动脉 M1段不同节段（M1段近中1/3处、M1段远端）血流动力学指标的差异，探查最佳的检测部位。方法选取2014年12月—2015年5月在江苏大学附属医院超声科行妊娠中期胎儿结构筛查的孕妇124例为研究对象。检测胎儿大脑中动脉 M1段近中1/3处和 M1段远端的血流动力学指标〔收缩期峰值流速（PSV）、阻力指数（RI）、搏动指数（PI）和收缩期峰值流速/舒张末期流速（S/ D）〕。结果排除胎儿宫内活动频繁、脐带绕颈、羊水量异常等孕妇16例，最终共有108例孕妇纳入本研究，成功率为87.1％。彩色多普勒超声胎儿大脑中动脉 M1段不同节段的血流频谱均呈锯齿状，在整个心动周期中均为单向血流，舒张期无反向血流信号。大脑中动脉 M1段近中1/3处 PSV、RI、PI、S/ D 高于 M1段远端（P ＜0.05）。结论妊娠中期胎儿大脑中动脉 M1段近中1/3处血流动力学指标高于 M1段远端，M1段近中1/3处得到的血流动力学指标更加准确客观。%Objective To explore the difference in the hemodynamic parameters of different parts of M1 segment of fetal middle cerebral artery(the 1 / 3 point of M1 segment nearer to the middle point and the far end of M1 segment),in order to find the optimal detection site. Methods 124 pregnant women who received screening for fetus structure in the Department of Ultrasound of the Affiliated Hospital of Jiangsu University from December 2014 to May 2015 were enrolled in the study. The hemodynamic parameters(PSV,RI,PI and S/ D)of different parts of M1 segment of fetal middle cerebral artery(1 / 3 points of M1 segment nearer to the middle point and the far end of M1 segment)were detected. Results Apart from 16 cases of pregnant women with the fetal frequent activities,umbilical cord around the neck and amniotic fluid volume abnormality,108 normal fetal were included,with a success rate of 87. 1%. Blood flow frequency spectrum of different parts of the M1 segment of fetal middle cerebral artery with color ultrasound was one - way flow ofindentation throughout the cardiac cycle,without diastolic reverse blood flow signals. Hemodynamic parameters,such as PSV,RI,PI and S/ D,at the 1 / 3 point of M1 segment nearer to the middle point,were higher than those at the far end of M1 segment(P < 0. 05). Conclusion Conclusion hemodynamic parameters at the 1 / 3 point of M1 segment of fetal middle cerebral artery nearer to the middle point are higher than those at the far end of M1 segment,thus the hemodynamic parameters at the 1 / 3 point are more accurate and objective.
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