增强型血流成像技术检测胎儿肺静脉优越性的分析

摘要

目的：探讨增强型血流成像技术（ E－flow）检测胎儿肺静脉方面的优势，评价产前检测胎儿肺静脉在筛选和协助早期诊断胎儿先天性心脏病中的临床应用价值。方法选择190例正常胎儿（正常胎儿组）和产前诊断为心脏发育异常的胎儿6例（先天性心脏病组），比较应用E－flow和多普勒彩色超声血流成像（CDFI）2种技术对胎儿肺静脉的显示情况，并测量及评价相关肺静脉血流参数。结果16～24周胎儿肺静脉的显示率E－flow技术明显高于CDFI （χ2＝14．769， P ＜0．05）；而24＋1～40周对肺静脉的显示率无统计学意义（χ2＝1．920， P ＞0．05）。肺静脉的内径随孕周增长而增宽，S峰、D峰及A波随孕周增长而增快；PI、PVI随孕周增长而逐渐降低。胎儿肺静脉内径及S、D、A与胎龄呈明显的正相关（ r ＝0．973、0．959、0．944、0．950， P ＜0．05）；PI、PVI与胎龄呈负相关（ r ＝－0．821、－0．855， P ＜0．05）。先天性心脏病组肺静脉PI及PVI较胎龄相匹配的正常胎儿组较高，A波较低，2组比较差异有统计学意义（ P ＜0．05）。结论应用E－Flow技术产前检查胎儿肺静脉，可更早更清晰地显示胎儿肺静脉的走行情况，对临床尽早诊断胎儿先天性心脏病提供有价值的信息。%Objective To investigate the advantage of enhanced imaging techniques ( E-flow) in detection of fetal pulmonary vein,and to evaluate the clinical application value of prenatal detection of fetal pulmonary veins in screening and help for the early diagnosis of fetal congenital heart disease.Methods 190 cases of normal fetal ( normal fetus group) and 6 cases of prenatal diagnosed as fetal cardiac abnormalities ( congenital heart disease group) were enrolled, E-flow and color Doppler flow imaging (CDFI) were compared in display the fetal pulmonary veins, measured and evaluated the pulmonary ve-nous flow parameters.Results 16-24 weeks’ fetal pulmonary veins display rate, E-flow technology was significantly better than that of CDFI (χ2 =14.769, P <0.05) 24 +1 -40 weeks on pulmonary vein display rate was not statistically significant (χ2 =1.920, P >0.05) .Pulmonary vein diameter were grew with gestational age growth, S peak, D peak and A wave were went faster with the gestational age increased;PI and PVI gradually decreased with increase of gestational weeks.There were obvious positive correlation of fetal pulmonary vein diameter, S, D, A and gestational age ( r =0.973, r =0.959, r =0.944, r =0.950, P <0.05);PI, PVI were negatively correlated with gestational age ( r =-0.821, r =-0.855, P <0.05).CHD group’s pulmonary venous PI and PVI were higher than the gestational age matched normal fetal group, A wave was low, there was significant difference between the 2 groups ( P <0.05) .Conclusion E-flow technology in antenatal ex-am the fetal pulmonary vein with advantage of earlier and more clearly show the path of fetal pulmonary veins, and provide val-uable for clinical early diagnosis of fetal congenital heart disease information.