彩色多少普勒超声在胎儿法洛氏四联症诊断中的应用

发布时间：2018-02-10 20:23

  本文关键词： 彩色多普勒 法洛氏四联症 高分辨率血流显像技术　出处：《中南大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的： 应用HDF与传统彩色多普勒分别在胎儿法洛氏四联症中室间隔缺损、主动脉骑跨、肺动脉狭窄处血流显示情况,并通过两者在血流显示上差异性,提高对室间隔小缺损及法洛氏四联症的检出率。 对象与方法： 采集2011年1月～2013年12月期间于浏阳市妇幼保健院的门诊和住院孕妇近2.96万人次于行系统超声检查,室间隔缺损152例,其中最终确诊法洛氏四联症者22例,孕26.3±3.5周(23～35周)。其中胎儿入选标准：可疑室间隔缺损并主动脉骑跨患者。 采用飞利浦IU22和GE voluson E8彩色超声诊断仪,常规系统检查每例胎儿,测量胎儿双顶、小脑横径,头围、腹围、股骨、肱骨、胎盘及羊水等基本情况,估测胎儿体重；选用胎儿心脏模式,八步法排除常见的先天性心脏畸形如：单心房、单心室、大动脉转位、永存动脉干等。取样容积置于室间隔缺损,声束垂直于室间隔,调节至最佳频谱状态,保存最佳图像,记录室间隔缺损大小,2-3.9mm定义为室间隔小缺损,≥4mm为大缺损。在提高室间隔缺损的检出率基础上,筛查主动脉骑跨,监测左右心室的血流同时进入主动脉内,进而查看有无主肺动脉狭窄及右心室肥厚。 结果： 1.在疑有室间隔缺损中,≥4mm的室间隔缺损,HDF及传统彩色多普勒检查阳性率相近,无明显统计学差异(P0.05)；2-3.9mm的室间隔缺损,HDF及传统彩色多普勒检查阳性率有差别,HDF显示血流更敏感,其差异有显著性意义(P0.05)。 2.在疑有室间隔缺损中,4mm的室间隔缺损并主动脉骑跨时,HDF及传统彩色多普勒检查无明显特异性(P0.05),2～3.9mm的室间隔缺损并主动脉骑跨时,HDF及传统彩色多普勒检查无明显特异性(P0.05)。 3.比较传统的四腔心切面与四个切面扫查(四腔心+左、右室流出道+三血管-气管)、胎儿心脏系统八切面扫查,连续动态扫查明显提高法洛氏四联症的检出率。 结论： 1.HDF作为一种无创、经济、便捷的检查技术应用于胎儿法洛氏四联症的检查,可更敏感、更准确地提高检出率。 2.比较传统的四腔心切面与四个切面扫查(四腔心+左、右室流出道+三血管-气管)、胎儿心脏系统八切面,胎儿心脏系统八切面连续动态扫查明显提高法洛氏四联症的检出率。
[Abstract]:Objective:. HDF and traditional color Doppler were used to display ventricular septal defect (VSD), aortic straddle and pulmonary artery stenosis in fetal tetralogy of Fallot, respectively. To improve the detection rate of ventricular septal defect and tetralogy of Fallot. Objects and methods:. From January 2011 to December 2013, nearly 29,600 pregnant women in Liuyang Maternal and Child Health Hospital were examined with systemic ultrasound and ventricular septal defect (VSD). Among them, 22 cases were diagnosed as tetralogy of Fallot. Gestation was 26.3 卤3.5 weeks and 2335 weeks after pregnancy. Fetal inclusion criteria: suspected ventricular septal defect (VSD) with aortic straddle. Using Philips IU22 and GE voluson E8 color ultrasound diagnostic instrument, routine system was used to examine each fetus, to measure the fetal diapause, transverse diameter of cerebellum, head circumference, abdominal circumference, femur, humerus, placenta and amniotic fluid, and to estimate fetal weight. The fetal heart model was selected to exclude common congenital heart malformations such as single atrium, single ventricle, transposition of great artery, trunk of persistent artery, etc. The sampling volume was placed in ventricular septal defect, and the sound beam was perpendicular to the ventricular septum. The size of ventricular septal defect (VSD) was defined as small ventricular septal defect (VSD) and large ventricular septal defect (VSD). On the basis of improving the detection rate of VSD, aortic straddle was screened. The left and right ventricle flow into the aorta at the same time to see if there are pulmonary artery stenosis and right ventricular hypertrophy. Results:. 1. In the suspected ventricular septal defect, the positive rate of HDF in the ventricular septal defect 鈮，

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