应用三维超声对正常胎儿与先心病胎儿全脑容积的研究

发布时间：2018-06-28 22:35

本文选题：胎儿 + 先天性心脏病　；参考：《中南大学》2014年硕士论文

【摘要】：目的：应用三维超声结合虚拟器官计算机辅助技术(virtual organ computer-aided analysis,VOCAL)对正常胎儿及患有先天性心脏病的胎儿的全脑容积进行测量。探讨正常胎儿全脑容积与孕周、双顶径以及头围变化的关系,比较先心病胎儿与正常胎儿全脑容积间有无差异。研究对象与方法：本研究采集2013年2月至2014年2月间在本院进行产前常规超声检测的孕妇共241例,其中正常胎儿组168例,孕龄20-36周,平均孕龄为27.76±4.5周；产前超声诊断为先天性心脏病的胎儿73例,孕龄20-36周,平均孕龄为27.75±4.1周。采用GE Voluson Expert E8彩色多普勒超声诊断仪,常规检查胎儿整体生长发育情况及心脏情况后,使用三维容积探头获取胎儿颅脑的三维图像使用VOCAL技术进行分析,计算胎儿全脑容积。分析胎儿全脑容积与胎儿孕周、双顶径及头围间的关系,将正常组与先心病组胎儿全脑容积进行比较。结果：在正常胎儿组中,胎儿全脑容积随孕周、双顶径、头围的增长而增长。胎儿全脑容积随孕周及双顶径的增长符合S曲线,随头围的增长符合幂函数。正常胎儿组与先心病胎儿组的头围及双顶径间的差异无统计学意义(P0.05)。但将其分为小于30周组及大于等于30周组后,结果显示小于30孕周组胎儿中,先心病组与正常组相比头围及双顶径间的差异无统计学意义(P0.05)；而在大于等于30孕周组中,先心病组的头围及双顶径小于正常组,两者间的差异具有统计学意义(P0.05)；先心病胎儿组的全脑容积小于正常胎儿组的全脑容积,两者间的差异具有统计学意义,将两组胎儿分别分为小于30孕周组与大于等于30孕周组后,小于30孕周组胎儿中,先心病组与正常组胎儿全脑容积间的差异无统计学意义(P0.05)；而在大于等于30孕周组中,先心病组的全脑容积小于正常组,两者间的差异具有统计学意义(P0.05)。结论： 1.三维超声可应用于测量胎儿全脑容积,具有可操作性及可重复性。 2.正常胎儿三维全脑容积随孕周、双顶径、头围的增长而增长。 3.先天性心脏病胎儿三维全脑容积较正常胎儿三维全脑容积减小,两者间差异有统计学意义。
[Abstract]:Objective: to measure the global brain volume of normal fetus and fetus with congenital heart disease by using three-dimensional ultrasound and virtual organ computer aided technique (virtual organ computer-aided analysis Vacal). To explore the relationship between the whole brain volume of normal fetus and the changes of gestational week, biparietal diameter and head circumference, and to compare the difference between fetal whole brain volume of congenital heart disease and that of normal fetus. Subjects and methods: a total of 241 pregnant women with normal prenatal ultrasound were collected from February 2013 to February 2014 in our hospital. 168 normal fetuses were enrolled. The gestational age ranged from 20 to 36 weeks with an average gestational age of 27.76 卤4.5 weeks. There were 73 cases of congenital heart disease diagnosed by prenatal ultrasound. The gestational age was 20-36 weeks, and the average gestational age was 27.75 卤4.1 weeks. GE Voluson expert E8 color Doppler ultrasound was used to detect the whole fetal growth and development and the heart condition. The three-dimensional image of fetal brain was obtained by using three-dimensional volume probe and the volume of fetal whole brain was calculated by VOCAL technique. The relationship between fetal whole brain volume and fetal gestational week, biparietal diameter and head circumference was analyzed, and the fetal whole brain volume was compared between normal group and congenital heart disease group. Results: in normal fetal group, fetal whole brain volume increased with gestational week, biparietal diameter and head circumference. The increase of fetal whole brain volume with gestational week and biparietal diameter accords with S curve, and with the increase of head circumference, it accords with power function. There was no significant difference in head circumference and biparietal diameter between normal fetal group and congenital heart disease group (P0.05). The results showed that there was no significant difference in head circumference and biparietal diameter between the CHD group and the normal group (P0.05), but in the group greater than 30 weeks of gestation, there was no significant difference in the head circumference and biparietal diameter between the CHD group and the normal group (P0.05). The head circumference and biparietal diameter of congenital heart disease group were smaller than that of normal group, the difference between them was statistically significant (P0.05), the whole brain volume of congenital heart disease group was smaller than that of normal fetus group, and the difference between them was statistically significant. There was no significant difference in the fetal brain volume between the CHD group and the normal group after the two groups were divided into three groups: the gestational age group was less than 30 weeks and the gestational age group was greater than 30 gestational weeks group (P0.05), while in the group greater than 30 weeks of gestational age, there was no significant difference in the fetal brain volume between the heart disease group and the normal group (P0.05). The whole brain volume of CHD group was smaller than that of normal group, the difference between them was statistically significant (P0.05). Conclusion: 1. Three-dimensional ultrasound can be used to measure fetal whole brain volume, which is operable and repeatable. 2. 2. The three-dimensional global brain volume of normal fetus increased with the increase of gestational age, biparietal diameter and head circumference. The fetal global brain volume of congenital heart disease was significantly lower than that of normal fetus.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.5;R445.1

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