摘要
目的探讨胎儿静脉导管(DV)频谱特征对不同类型肺动脉狭窄的产前预测能力。方法对成功获得DV频谱的16胎有心室水平分流的肺动脉狭窄胎儿、11胎无心室水平分流的肺动脉狭窄胎儿以及51胎正常胎儿进行频谱评估,比较不同组间异常DV频谱的发生率以及其他指标的差异。结果肺动脉狭窄胎儿发生DV异常、三尖瓣反流以及心室比例改变的几率均明显高于正常胎儿(P均<0.001);其中,无心室水平分流的胎儿发生DV异常以及三尖瓣反流的几率高于有心室水平分流的胎儿(P=0.005、0.040)以及正常胎儿(P均<0.001),心室比例改变以及水肿的发生率则高于正常胎儿(P<0.001、P=0.029),有心室水平分流的胎儿发生三尖瓣反流以及心室比例改变的几率高于正常胎儿(P=0.038、P<0.001)。结论肺动脉狭窄胎儿可伴有多项指标异常,尤其是DV频谱的异常,其中以无心室水平分流者更为明显,多提示右心室流出道受阻严重,右心室压力负荷增高。在胎儿体位不佳时,该征象对疾病的诊断亦有重要的提示作用。
Objective To observe the predictive capability of fetal ductus venosus waveforms for prental diagnosis of pulmonary stenosis. Methods Fetal ductus venosus waveforms were successfully obtained in 16 fetuses with pulmonary stenosis and interventricular shunt,11 fetuses with pulmonary stenosis but without interventricular shunt and 51 normal fetuses. The prevalences of abnormal ductus venosus waveforms and other parameters among 3 groups were compared. Results Fetuses with pulmonary stenosis had higher incidence of abnormal ductus venosus blood flow,tricuspid regurgitation and right/left ventricular end-diastolic diameter （RV/LV） ratio change than normal fetuses （all P〈0.001）. Within them,fetuses without interventricular shunt had higher incidence of abnormal ductus venosus blood flow and tricuspid regurgitation than those fetuses with interventricular shunt （P=0.005,0.040）,and normal fetuses （all P〈0.001）,it also had higher incidence of RV/LV ratio change and fetal edema than normal fetuses （P〈0.001,P=0.029）. Fetuses with interventricular shunt had higher incidence of tricuspid regurgitation and RV/LV ratio change than normal fetuses （P=0.038,P〈0.001）. Conclusion A variety of abnormal parameters can be found in fetuses with pulmonary stenosis,especially the ductus venosus waveforms. Abnormal ductus venosus blood flow is more common in fetuses without interventricular shunt,indicating a severe obstruction of right ventricular outlet,which can cause right ventricle pressure overload. It is quite useful for diagnosis in poor fetal position.
出处
《中国医学影像技术》
CSCD
北大核心
2010年第7期1314-1317,共4页
Chinese Journal of Medical Imaging Technology
基金
国家科技支撑计划(2006BAI05A04)
