多功能超声检测胎儿右室双出口及法洛四联症右心室功能.docVIP

多功能超声检测胎儿右室双出口及法洛四联症右心室功能 李晓瑜1，郑俊平2，蒋 演1，高云华1，夏红梅1 (400037 重庆，第三军医大学新桥医院超声科1；844200 新疆 疏勒，解放军第12医院特诊科2) [摘要] 目的 探讨脉冲多普勒（PW）、M型(MME)、实时三维容积(RT-3DE) 超声心动图 在右室双出口及法洛四联症胎儿右心功能检测中的应用价值。方法 采用PW、MME、RT-3DE三种方法，分别测量30例右室双出口及法洛四联症胎儿和30例正常胎儿的Tei 指数、右室舒张末期容积(RVEDV)、收缩末期容积(RVESV)、每搏量(SV)和射血分数(EF)等指标，并进行对比分析。结果 PW测量胎儿右室Tei指数病例组明显高于正常组；MME与 RT-3DE在病例组中测得的相关数值差异有统计学意义(P0.05)；脉冲多普勒与RT-3DE的ROC诊断曲线较一致，与MME差异较大。结论 RT-3DE可不依赖于任何解剖假设准确地评价胎儿心功能，且具有较好的重复性；由于右心室形态的不规则，MME在心室内径的测量上存在较大的误差，其相关测值的准确性和可重复性均较RT-3DE差。 [关键词] 脉冲多普勒；M型超声；RT-3DE；胎儿；右心室功能 [中图法分类号] [文献标志码] A Evaluation of right heart function by multifunctional echocardiography in fetuses suffering from double outlet right ventricle or Tetralogy of Fallot Li Xiaoyu, Zheng Junping, Jiang Yan, Gao Yunhua, Xia Hongmei（Department of Ultrasound, XinQiao Hospital, the Third Military Medical University，Chongqing 400037，China ） [Abstract] Objective To evaluate the value of the Pulsed Doppler (PW), M-mode echocardiography (MME), real-time three-dimensional volumetric echocardiography (RT-3DE) in diagnosing right heart function of fetuses with double outlet right ventricle (DORV) or Tetralogy of Fallot (TOF). Methods PW, MME, RT-3DE were performed in 30 fetuses with DORV or TOF and 30 normal fetuses. Datas including Tei index (TI), right ventricular end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (SV) and ejection fraction (EF) were analyzed. Results The result of fetal right ventricular TI by PW was significantly higher in the abnormal group than that of the normal group. The results of RVEDV, RVESV, SV and EF by MME and RT-3DE was different significantly in the abnormal group (P 0.05). The results of Pulsed Doppler were consistent with that of the diagnostic RT-3DE ROC curve, but defferent from that of the M-type difference. Conclusion RT-3DE evaluat the right heart function of fetuses with complex congenital heart disease accurately and not depend on any