时空关联成像技术联合自由解剖平面技术诊断胎儿先心病的临床研究

发布时间：2018-04-27 12:33

本文选题：先天性心脏病 + 胎儿心脏　；参考：《中南大学》2014年硕士论文

【摘要】：目的通过研究联合利用STIC技术和OmniView技术在正常和异常胎儿心脏中的声像特点,探讨STIC-OmniView技术在胎儿心脏产前检查中的临床应用价值。方法选择孕周为20-40周的130例心脏正常胎儿和孕周为21-32周41例已行二维超声心动图拟诊为先天性心血管畸形的异常胎儿,应用STIC技术采集心脏容积数据,存盘后进行脱机研究及分析,获取心脏检查所需的8个常规诊断切面,比较正常组胎儿心脏图像质量显示满意率的差异有无统计学差异,以及比较CHD胎儿STIC-OmniView技术诊断的结果与产前二维超声、产后新生儿心动图或引产儿尸检结果,评价STIC-OmniView技术在胎儿心脏产前筛查及先天性心脏病胎儿产前诊断的临床价值。结果正常组130例胎儿心脏超声检查均获得满意的容积数据。130例正常胎儿心脏通过STIC-OmniView技术获得的四腔心、五腔心、右室流出道、左室流出道、三血管—气管、主动脉弓和导管动脉弓切面图像的显示合格率与常规二维超声检查显示相应切面图像合格率的差异均无统计学意义(x2=0.50,2.25,0.50,0.001,1.33,2.25,0.50,P0.05)；胃泡切面与常规二维超声检查显示相应切面图像合格率比较差异有统计学意义(x2=12.00,P=0.0005),联合使用二维超声和STIC-OmniView技术显示8个常规诊断切面的满意率为100%。使用自由解剖平面技术对41例先天性心脏病胎儿容积数据进行后处理,结果如下：38例样本与产前二维超声心动图及产后新生儿超声心动图或尸检结果相符,1例二维超声诊断为主动脉离断,STIC-OmniView技术诊断为主动脉弓缩窄,胎儿引产后病检结果为主动脉弓缩窄。1例二维超声诊断为正常心脏胎儿,STIC-OmniView技术诊断为室间隔缺损,新生儿产后超声心动图为室间隔缺损。1例二维超声诊断为右室双出口,STIC-OmniView技术诊断为完全性大动脉转位,胎儿引产后病检结果为完全性大动脉转位。结论STIC-OmniView技术能清晰显示常规胎儿心脏检查的标准切面,将其应用于胎儿心脏的产前筛查是可行的,并有助于胎儿先天性心脏病的产前诊断研究,也有利于胎儿先天性心脏病的医学教学和远程医疗。但目前STIC-OmniView技术只能作为二维超声心动图的有力补充,无法取代。
[Abstract]:Objective to study the ultrasonographic characteristics of STIC and OmniView in normal and abnormal fetal heart, and to explore the clinical value of STIC-OmniView in prenatal examination of fetal heart. Methods 130 normal fetuses aged 20-40 weeks and 41 abnormal fetuses aged 21-32 weeks were selected. Cardiac volume data were collected by STIC technique. Off-line study and analysis were carried out after storage to obtain 8 routine diagnostic sections needed for cardiac examination, and to compare the difference of satisfactory rate of fetal heart image quality in normal group with or without statistical difference. The diagnostic results of CHD fetal STIC-OmniView were compared with the results of two dimensional prenatal echocardiography, postpartum cardiogram or fetal autopsy. The clinical value of STIC-OmniView technique in prenatal screening of fetal heart and fetal prenatal diagnosis of congenital heart disease was evaluated. Results satisfactory volume data were obtained in 130 cases of normal fetal heart by echocardiography. Four chamber heart, five chamber heart, right ventricular outflow tract, left ventricular outflow tract, three vessels trachea were obtained by STIC-OmniView technique in 130 normal fetal hearts. There was no statistical difference between the eligible rate of aortic arch and ductal arterial arch section image and that of conventional two-dimensional ultrasound examination. There was no significant difference between the two dimensional ultrasound examination and the corresponding section image was found by conventional two-dimensional ultrasound. There was no statistical significance between the two dimensional ultrasound examination and the corresponding cross section of gastric vesicle section was shown by conventional two-dimensional ultrasound examination and gastric alveolar section was not significantly different from that of conventional two-dimensional ultrasound examination on the sectional image of aortic arch and ductal arterial arch, and there was no statistically significant difference between conventional two-dimensional ultrasound and conventional two-dimensional ultrasound. The difference of image qualified rate was statistically significant. The satisfactory rate of using two-dimensional ultrasound and STIC-OmniView to display 8 conventional diagnostic sections was 100. 5%. The fetal volume data of 41 cases of congenital heart disease were postprocessed by the technique of free anatomical plane. Results the following 38 samples were consistent with the results of prenatal echocardiography and postpartum echocardiography or autopsy. One patient was diagnosed as aortic arch constriction by STIC-OmniView technique. After induced labor, 1 cases of aortic arch constriction were diagnosed as ventricular septal defect (VSD) by STIC-OmniView technique. Postpartum echocardiography showed ventricular septal defect (VSD) in 1 cases. STIC-OmniView technique was used to diagnose complete transposition of great arteries. Conclusion STIC-OmniView can clearly display the standard section of routine fetal heart examination, and it is feasible to apply it to prenatal screening of fetal heart, and it is helpful for prenatal diagnosis of fetal congenital heart disease. Also conducive to fetal congenital heart disease medical teaching and telemedicine. But at present, STIC-OmniView technique can only be used as a powerful supplement of two-dimensional echocardiography.
【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】：R445.1;R714.5

【参考文献】