超声评估主动脉缩窄胎儿主动脉弓狭窄部位的血流动力学特点

发布时间：2018-05-10 10:27

本文选题：主动脉缩窄 + 胎儿心脏　；参考：《中国医学影像技术》2017年02期

【摘要】：目的通过胎儿超声心动图动态评估孕中晚期主动脉缩窄(COA)胎儿主动脉弓狭窄部位血流动力学特点。方法回顾性分析本院诊断为COA的45胎胎儿的孕中晚期(24~38~(+6)周)不同孕周超声心动图资料,测量主动脉弓缩窄处收缩期峰值流速(SPv)、舒张期末流速(EDv)、搏动指数(PI),并与同孕周正常胎儿进行比较。结果 COA胎儿中孕期至晚孕初期(24~32周)主动脉弓部的SPv与EDv较正常胎儿增快,PI减低(P均0.05);血流频谱形态表现为舒张期前向血流量较正常胎儿增多。晚孕中后期(32~38~(+6)周)主动脉弓狭窄处的SPv、Edv及PI值与正常胎儿差异无统计学意义(P均0.05);血流频谱形态多数表现为收缩末期反向血流信号。结论 COA胎儿主动脉弓部狭窄处的血流状态在不同孕周可表现不同,采用频谱多普勒参数诊断COA时还需结合胎儿孕周大小进行评价。
[Abstract]:Objective to evaluate the hemodynamic characteristics of fetal aortic arch stenosis by fetal echocardiography. Methods the echocardiographic data of 45 fetuses diagnosed as COA during the third trimester of pregnancy and different gestational weeks were retrospectively analyzed. The peak systolic velocity (SPV), end diastolic velocity (EDV), pulsatility index (PIN) at the constricted aortic arch were measured and compared with the normal fetuses at the same gestational week. Results both SPv and EDv in the aortic arch in COA fetuses were significantly faster than those in normal fetuses (P < 0.05), and the flow spectrum showed that the diastolic blood flow was higher than that in normal fetuses. There was no significant difference between the SPvV Edv and Pi values of aortic arch stenosis in the middle and late gestation period and normal fetuses (P < 0.05), and most of the blood flow spectrum showed reverse blood flow signal at the end of contraction. Conclusion the blood flow in the stenosis of aortic arch in COA fetus can be different in different gestational weeks. It is necessary to evaluate the fetal gestational age in the diagnosis of COA by using spectrum Doppler parameters.
【作者单位】：首都医科大学附属北京安贞医院超声心动科二部胎儿心脏病母胎医学研究北京市重点实验室心血管疾病精准医学北京实验室;
【基金】：“扬帆”计划临床技术创新项目(XMLX201604)
【分类号】：R540.45;R714.5

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