Objective To evaluate the quality of fetal heart volumes acquired with different initial planes with three-dimensional ultrasound and investigate the value of tomographic ultrasound imaging technique in evaluation normal fetal heart.Methods The fetal heart volumes were acquired with the apical four chamber view and transversal four chamber view as the initial planes using three-dimensional ultrasound in 158 fetuses,whose gestational ages were range from 16 to 40 weeks.And then the volumes were rotated with TUI software for showing the nine standard views of four chamber view,five chamber view,three vessels-trachea view,left ventricular outflow tract view,right ventricular outflow tract view,short-axis view of great arteries,sagittal view of aortic arch,sagittal view of ductus arteriosus,superior vena cava view and inferior vena cava view.All the volumes were divided into three groups according to gestational age.The gestational age were range from 16 to 24 weeks in group A,25 to 32 weeks in group B and 33 to 40 weeks in group C.Then the display rates of the nine views were compared among the three groups.Results One hundred and forty-nine volumes were acquired in these 158 fetuses.Seventy-two volumes were acquired withthe apical four chamber view as the initial plane and 77 volumes were acquired with the transversal four chamber view as the initial plane.The display rate(2 point section rage) of the superior vena cava view and the inferior vena cava view were significantly different in A and B groups and the results were similar for both volumes acquired with the two different initial planes (χ2=4.927,22.938,6.312,21.761,all P<0.05).The display rate (2 point section rage)of aortic arch section and arterial duct arch section,in the apex cordis four cavity cherished surface,has significant differences in A and B groups (χ2=8.053,4.967,all P<0.05),as the display rate in B group is the best,that in C group is next,and that in A group is the worst.Conclusions Both of the apical four chamber view and transversal four chamber view could be used as the initial planes for acquiring fetal heart volumes with three-dimensional ultrasound.The qualities of the volumes are influenced by the external conditions.The volumes acquired with the apical four chamber view as initial plane may be impacted more significantly.The optimal time for fetal heart screening is between 25 to 32 weeks.The fetal heart volumes that are acquired with the apical four chamber view and transversal four chamber view as the initial planes are very important for the standard fetal heart screening and remote consultation.%目的 研究不同初始切面胎儿心脏三维容积包图像质量,探讨三维成像技术联合断层超声显像技术在正常胎儿心脏超声检查中的价值.方法 应用胎儿三维成像技术对158例胎儿(孕16~40周)心脏以心尖四腔心切面和胸骨旁四腔心切面作初始切面采集三维容积数据.应用软件进行离机分析,用断层超声显像模式对胎儿四腔心、五腔心、三血管气管、左心室流出道、右心室流出道、大动脉短轴、主动脉弓、动脉导管弓、上下腔静脉长轴9个标准切面进行显示.按不同孕龄将158例胎儿分为3组,A组(16~24周)、B组(25~32周)和C组(33~40周),对3组胎儿9个标准切面显示情况进行组间对比分析.结果 应用心脏三维容积技术在158例胎儿中采集到满意的心脏容积数据包图像149个,其中心尖四腔心切面容积包72个,胸骨旁四腔心切面容积包77个.(1)上下腔静脉切面、大动脉短轴切面图像清晰显示率(2分切面率),心尖四腔心切面容积包图像及胸骨旁四腔心切面容积包图像的A组与B组间对比,差异均有统计学意义(心尖四腔心切面容积包χ2=4.927、22.938,胸骨旁四腔心切面容积包χ2=6.312、21.761,P均<0.05).(2)主动脉弓切面、动脉导管弓切面图像清晰显示率(2分切面率),仅在心尖四腔心切面容积包图像的A组与B组间对比差异有统计学意义(χ2=8.053、4.967,P均<0.05).(3)心尖四腔心切面容积包和胸骨旁四腔心切面容积包B组图像清晰显示率最高,C组其次,A组最低.结论 心尖四腔心切面和胸骨旁四腔心切面均可作为胎儿心脏三维容积成像采集初始切面,三维容积成像中重建切面受外部条件影响明显.胎儿心脏三维超声检查最佳孕龄范围为25~32孕周,孕龄大小对以心尖四腔心作初始切面的心脏三维图像质量影响较大.这两个初始切面可为胎儿心脏三维容积图像规范化采集和远程会诊图像规范化采集提供参考.
展开▼
