四维时空关联成像技术在不同孕周产前胎儿心脏筛查中的应用

摘要

目的 探讨四维时空关联成像(STIC)技术在不同孕周产前胎儿心脏筛查中的应用.方法 2015年6月至2016年6月应用STIC技术对168例健康胎儿心脏容积数据进行采集,采用动态正交三平面模式收集9个筛查切面数据.结果 168例健康胎儿中共152例(90.47%)获满意STIC数据,采集数据时间短于二维超声采集时间(P<0.05).STIC采集的四腔心、五腔心、三血管气管、大动脉短轴、左室流出道、右室流出道、动脉导管弓、主动脉弓、腔静脉长轴等9个平面图像满意率与二维超声比较差异无统计学意义(P>0.05).在不同孕周孕妇中STIC采集的动脉导管弓、主动脉弓、腔静脉长轴等3个平面的图像满意率差异有统计学意义(P<0.05),其中孕35+0~39+6周孕妇图像满意率较低.经分析可知,胎动频繁、背位四腔心、母体肥胖、羊水异常、肢体遮挡与容积采集满意率有关,差异有统计学意义(P<0.05).结论 STIC技术可缩短胎儿心脏扫描时间,且处理的图像质量满意,可应用于孕妇胎儿心脏筛查,但对于孕35+0~39+6周胎儿在动脉导管弓、主动脉弓、腔静脉长轴切面的显示率稍低,主要受胎动频繁、胎儿脊柱声影及母体因素影响.%Objective To explore the application of four-dimensional spatiotemporal correlation imaging (STIC) in prenatal fetal heart screening during different gestational weeks.Methods A total of 168 cases of normal fetal heart volume data were collected by STIC technique from June 2015 to June 2016.The data in 9 screening sections were collected by dynamic orthogonal three-plane model.Results Among 168 cases of normal fetus,satisfactory STIC data were obtained in 152 cases (90.47%).The time of data acquisition was shorter than that of 2D ultrasound (P<0.05).The satisfactory rate of 9-plane images of four-chamber,five-chamber,three-vessel trachea,aorta short axis,left ventricular outflow tract,right ventricular outflow tract,arterial duct arch,aortic arch and vena cava long axis by STIC were compared with two-dimensional ultrasound,no statistical difference was found (P>0.05).There were statistically significant differences in the satisfaction rate of the images of ductus arteriosus,aortic arch and long axis of the vena cava (P<0.05).The image satisfaction rate of pregnant women with gestational age of 35+0-39+6 weeks was lower.The analysis showed that frequenfetal movement,back four chamber heart,maternal obesity,amniotic fluid abnormalities and limb occlusion were related with the volume acquisition satisfaction rate (P<0.05).Conclusion The STIC technique can shorten fetal heart scan time,and the processed image quality is satisfactory,which can be used in fetal heart screening,but in fetal artery arch bow,aortic arch and vena cava long axis for fetus with the gestational weeks of 35+0-39+6,the section display rate is lower,which is mainly affected by frequent fetal movement,fetal spinal sonogram and maternal factors.