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中华医学超声杂志(电子版) ›› 2020, Vol. 17 ›› Issue (11) : 1076 -1083. doi: 10.3877/cma.j.issn.1672-6448.2020.11.004

所属专题: 文献 妇产科超声

妇产科超声影像学

胎儿心脏超声智能导航技术在常见胎儿圆锥动脉干畸形关键诊断切面获得与显示中的应用价值
郭俏俏1, 赵博文2,(), 庞海苏2, 潘美2, 王蓓2, 彭晓慧2, 陈冉2   
  1. 1. 310016 杭州,浙江大学医学院附属邵逸夫医院超声科 浙江省胎儿心脏超声诊断技术指导中心 浙江大学邵逸夫临床医学研究所;322100 浙江东阳,东阳市人民医院超声科
    2. 310016 杭州,浙江大学医学院附属邵逸夫医院超声科 浙江省胎儿心脏超声诊断技术指导中心 浙江大学邵逸夫临床医学研究所
  • 收稿日期:2019-11-24 出版日期:2020-11-01
  • 通信作者: 赵博文
  • 基金资助:
    浙江省基础公益研究计划项目(LGF18H180004)

Application value of fetal intelligent navigation echocardiography in acquisition and display of critical section of common fetal conotruncal defects

Qiaoqiao Guo1, Bowen Zhao2,(), Haisu Pang2, Mei Pan2, Bei Wang2, Xiaohui Peng2, Ran Chen2   

  1. 1. Department of Diagnostic Ultrasound & Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Technical Guidance Center for Fetal Echocardiography of Zhejiang Province & Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University, Hangzhou 310016, China; Department of Ultrasound, Dongyang People’s Hospital, Dongyang 322100, China
    2. Department of Diagnostic Ultrasound & Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Technical Guidance Center for Fetal Echocardiography of Zhejiang Province & Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University, Hangzhou 310016, China
  • Received:2019-11-24 Published:2020-11-01
  • Corresponding author: Bowen Zhao
  • About author:
    Corresponding author: Zhao Bowen, Email:
引用本文:

郭俏俏, 赵博文, 庞海苏, 潘美, 王蓓, 彭晓慧, 陈冉. 胎儿心脏超声智能导航技术在常见胎儿圆锥动脉干畸形关键诊断切面获得与显示中的应用价值[J/OL]. 中华医学超声杂志(电子版), 2020, 17(11): 1076-1083.

Qiaoqiao Guo, Bowen Zhao, Haisu Pang, Mei Pan, Bei Wang, Xiaohui Peng, Ran Chen. Application value of fetal intelligent navigation echocardiography in acquisition and display of critical section of common fetal conotruncal defects[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(11): 1076-1083.

目的

评价胎儿心脏超声智能导航技术(FINE)在常见胎儿圆锥动脉干畸形关键诊断切面获得与显示中的应用价值。

方法

选取2018年1月至9月期间在浙江大学医学院附属邵逸夫医院超声科行胎儿超声心动图检查后明确诊断为圆锥动脉干畸形(CTD)的65例胎儿,其中法洛四联症(TOF)胎儿31例,完全型大动脉转位(TGA)胎儿24例,右心室双出口(DORV)胎儿10例,采用时间-空间成像技术(STIC)采集以四腔心切面为初始切面的胎儿心脏三维容积数据,然后通过FINE分析软件对每个容积数据进行分析,比较起始心尖不同位置时容积获取与分析成功率;分别对TOF、TGA、DORV胎儿的切面1周前后获取成功率和诊断符合率及所有CTD胎儿整体结果进行比较;并采用χ2检验对FINE技术的重复性进行分析。

结果

心尖任意位置的65例胎儿共采集容积数据337个,可分析245个,成功分析226个,成功率92.24%,TOF、TGA、DORV、CTD胎儿1周前后2次诊断符合率分别为77.42%、80.65%;87.50%、87.50%;60.00%、70.00%;78.46%、81.54%。心尖位于A组(11~1点)的39例胎儿共采集容积数据207个,可分析192个,成功分析182个,成功率94.79%,TOF、TGA、DORV、CTD胎儿1周前后2次诊断符合率分别为94.12%、88.24%;93.75%、87.50%;66.67%、66.67%;89.74%、84.61%。1周前后2次诊断符合率比较,差异均无统计学意义(P均>0.05)。

结论

FINE对胎儿CTD的诊断有一定的价值,且重复性高,在CTD的胎儿图像规范化采集与分析、远程会诊、培训及教学方面具有重要的应用前景。

Objective

To evaluate the application value of fetal intelligent navigation echocardiography in the acquisition and display of the critical section of common fetal conotruncal defects (CTD).

Methods

From January to September 2018, 65 fetuses with fetal CTD were diagnosed by fetal echocardiography at Department of Ultrasound, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, including 31 fetuses with tetralogy of Fallot (TOF), 24 with complete transposition of great arteries (TGA), and 10 with double-outlet right ventricle (DORV). Fetal cardiac spatio-temporal image correlation (STIC) volume datasets were acquired with four-chamber cardiac section as the initial section. Then, the three-dimensional STIC volume data were analyzed with fetal intelligent navigation echocardiography (FINE) analysis software, and the success rates of volume acquisition at different locations of the initial apex were compared. The success rates of fetal section acquisition and diagnostic coincidence rates for TOF, DORV, and TGA, and the overall results for all CTD fetuses were compared by rate or percentage, and the repeatability of FINE technique was analyzed by the chi-square test.

Results

A total of 337 volumetric data were acquired at any position of the apex in 65 fetuses, of which 245 could be analyzed and 226 were successfully analyzed. The success rate was 92.24%. The coincidence rates for diagnoses of TOF, TGA, DORV, and CTD were 77.42%, 80.65%, 87.50%, and 87.50%, and 60.00%, 70.00%, 78.46%, and 81.54%, respectively, in the first time and one week later. A total of 207 volumetric data were acquired from group A (fetal apex located between the 11- and 1-o’clock positions), of which 192 could be analyzed and 182 were successfully analyzed, with a success rate of 94.79%. The diagnosis coincidence rates for TOF, TGA, DORV, and CTD in the first time and one week later were 94.12%, 88.24%, 93.75%, and 87.50%, and 66.67%, 66.67%, 89.74%, and 84.61%, respectively. There was no statistical difference between the diagnosis coincidence rates in the first time and one week later (P>0.05).

Conclusion

FINE could be useful in the diagnosis of fetal CTD with high repeatability. It has important potentials in standardized fetal image acquisition and analysis, remote consultation, and training and teaching of fetal echocardiography.

图1 法洛四联症胎儿通过智能导航超声心动图技术处理后获取9个标准切面图。三血管气管切面显示肺动脉与主动脉内径比例失调,肺动脉内径明显小于主动脉内径(图a);四腔心切面:心房正位、心室右襻,未见明显异常(图b);左心室流出道切面可见室间隔连续性中断,主动脉增宽、起于左心室并骑跨于室缺之上(图d);右心室流出道切面:右心室流出道变窄、肺动脉变细、起于右心室并可见分叉、右心室壁未见增厚(图e);胃泡水平腹部横切面:胃泡位于左侧,肝位于右侧,内脏正位(图f)
图2 大动脉转位胎儿通过FINE技术处理后获取9个标准切面图。三血管气管切面显示一根粗大血管,为主动脉弓,主动脉前移,肺动脉未显示,上腔静脉位于主动脉右侧(图a);四腔心切面:心房正位,心室右襻,未见室间隔缺损(图b);左心室流出道切面:可见肌性圆锥,肺动脉起于解剖学左心室并可见分叉(图d);右心室流出道切面:解剖学右心室经过圆锥与主动脉相连,肺动脉环抱主动脉结构消失(图e);胃泡水平腹部横切面:胃泡位于左侧,肝位于右侧,内脏正位(图f)
表1 胎儿智能导航超声心动图技术心尖任意位置各切面显示成功率[例(%)]
表2 胎儿智能导航超声心动图技术心尖A组各切面显示成功率[例(%)]
表3 胎儿智能导航超声心动图技术的重复性检验[例(%)]
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