三维超声MPR技术在评估胎儿心脏结构中的价值研究

发布时间：2018-03-31 07:07

  本文选题：三维超声　切入点：MPR技术　出处：《泰山医学院》2014年硕士论文

【摘要】：目的:为了提高检查成功率,缩短检查时间,进而为临床诊断胎儿心脏发育异常提供依据,本研究通过比较三维超声和二维超声对胎儿心脏标准切面的显示率,分析探讨三维超声MPR技术在中孕期胎儿心脏检查中的应用技巧和优势。材料与方法:1.研究对象:回顾性分析2011年10月至2013年12月在泰山医学院附属聊城市第二人民医院建档,并在超声科行常规产前超声检查的正常单胎孕妇52例。2.仪器设备:应用西门子SC2000心脏超声诊断仪,配置有二维成人心脏探头4V1c、实时三维超声成像技术及三维成像探头4Z1c,频率为1~3 MHz,并自带三维容积数据分析软件。3.检查方法:入选病例仰卧于检查床上,操作者运用SC2000心脏超声诊断仪,选用4V1c探头,调节相关参数,显示胎儿心脏7个标准切面。然后选用三维成像4Z1c探头,首先在二维模式下调整清晰图像,转换为三维容积模式,调整各项参数,分别显示胎儿心脏不同的三个初始切面(标准心尖四腔心切面、大动脉短轴切面及主动脉弓长轴切面)。储存三个切面所得到的三维容积数据。4.三维容积数据分组及数据分析:各个数据根据心脏不同的三个初始切面分为三组:A组:标准心尖四腔心组;B组:大动脉短轴组;C组:主动脉弓长轴组。应用西门子SC2000心脏超声诊断仪所配备的三维超声图像工作站进行图像处理,在多平面重建(MPR)模式下调整出三组原始参考平面,调整X、Y、Z三个空间坐标轴,显示胎儿心脏7个标准切面,观察分析标准切面图像显示的结构。根据标准评价各个标准切面的图像质量:应显示的解剖结构显示者为清晰,不能显示应显示的解剖结构者为模糊。5.数据统计分析:应用SPSS 13.0统计学软件进行统计分析。胎儿心脏各标准切面的显示率采用R×C卡方检验分析,P0.05认为差异有统计学意义;当三组数据进行两两比较时,P0.017时差异具有统计学意义。结果:1.基本情况:52例正常单胎作为研究对象,胎儿心脏结构和心律均正常。孕周20~24周,平均22.6±3.2周。孕妇年龄21~35岁,平均28.2±3.7岁。双顶径41~64mm,平均53±11.2mm。心胸比0.29~0.35,平均0.33±0.15。胎心率131~160次/分,平均147±18次/分。三维超声共获得113个容积数据,A组42个(37.2%)、B组39个(34.5%)、C组32个(28.3%)。2.二维超声和三维超声对胎儿心脏切面的显示率比较:二维超声检查对胎儿心脏7个标准切面的显示率为75.5%(275/364),三维超声检查显示率为85.6%(677/791)。两组比较差异具有统计学意义(P0.05)。3.三组容积数据对心脏7个标准切面的显示情况:A组对LAV-Ao A及LAV-DA显示率较低,对其它切面显示率高,总显示率87.8%(258/294);B组对7个标准切面的显示率均较高,总显示率93.0%(254/273);C组对LAV-Ao A及LAV-DA显示率较高,对其它切面显示率较低,总显示率73.7%(165/224)。C组与A、B组比较差异有统计学意义(P0.05)。LAV-Ao A与LAV-DA在C组中显示率最高,分别为100%(32/32)及96.9%(31/32);A组中显示率最低,分别为64.3%(27/42)及59.5%(25/42);B组中显示率为87.2%(34/39)。三组显示率差异具有统计学意义(PA-B-C0.017)。结论:三维超声对胎儿心脏标准切面的显示率明显优于二维超声。以胎儿心脏不同的三个初始切面(4CV、SAV及LAV-Ao A)获取的三维容积数据可影响其显示胎儿心脏各标准切面的能力。因此,应该根据胎儿心脏不同的三个初始切面的容积数据综合分析评价,以相互补充图像信息。
[Abstract]:Objective: to improve the success rate, shorten the inspection time, and for the clinical diagnosis of fetal cardiac abnormalities provide the basis for this study by comparing the three-dimensional ultrasound and two-dimensional ultrasound for fetal heart rate display standard section, analysis of 3D ultrasound MPR technology in fetal heart screening skills and advantages. Materials and methods: 1. research subjects: a retrospective analysis from October 2011 to December 2013 in the second people's Hospital Affiliated to Taishan Medical University Liaocheng city building, and in the routine prenatal ultrasound examination of Department of ultrasound for normal singleton pregnant women in 52 cases of.2. equipment: application of SIEMENS SC2000 heart ultrasound diagnostic apparatus, equipped with two-dimensional adult cardiac probe 4V1c, real-time three-dimensional ultrasound imaging and 3D imaging the 4Z1c probe, the frequency is 1~3 and MHz, with 3D volume data analysis software.3. examination methods cases supine on the examination bed, The operator uses the SC2000 cardiac ultrasound diagnostic apparatus using 4V1c probe, adjust relevant parameters, display the fetal heart 7 standard sections. Then using 3D 4Z1c imaging probe, first adjust the clear image in the two-dimensional mode, converted to three-dimensional volume model, adjust the parameters, respectively, show three different initial planes of fetal heart (apical four chamberview, great artery short axis view and long axis view of aortic arch). The three-dimensional data storage.4. three-dimensional volume data packet and data analysis of the three section are: all data according to three different initial sections of heart were divided into three groups: group A: standard apical four chamber group; B group: arterial short axis group; group C: aortic arch axis group. Three dimensional ultrasound image workstation application SIEMENS SC2000 heart ultrasound diagnostic apparatus equipped with image processing, the multi planar reconstruction (MPR) mode adjustment three The original reference plane, X, Y, Z three space axes, display fetal heart 7 standard sections, observe and analyze the standard section image display structure. The image quality evaluation standard according to the standards of each section: anatomy should display is not clear, display should show the anatomical structure analysis for fuzzy.5. statistics: Using SPSS 13 statistical software for statistical analysis. The standard section shows the fetal heart rate was analyzed by chi square test of R * C, P0.05 believes that the difference was statistically significant; when the data of the three groups were compared at 22 P0.017, the difference was statistically significant. Results: 1. basic conditions: 52 normal singleton as the research object, structure and rhythm of fetal heart were normal. The gestational age of 20~24 weeks, average 22.6 + 3.2 weeks. Pregnant women aged 21~35 years old, average 28.2 + 3.7 years. Biparietal diameter 41~64mm, average 53 + 11.2mm. cardiothoracic ratio 0.29~0.35 ,骞冲潎0.33卤0.15.鑳庡績鐜，

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