三维超声体积自动测量技术对胎儿肺体积的研究

目的：探讨正常孕中晚期胎儿肺体积随孕周、胎儿体重的变化规律，以及超声肺重比（UFLB）对胎儿肺发育不良（PH）的诊断价值。方法：超声检查315例正常胎儿和28例PH高危胎儿，应用三维超声体积自动测量（VOCAL）技术测量胎儿肺体积，采用二维超声测得的生物参数经Hadlock方程系统获得胎儿质量，计算得到胎儿UFLB，随访胎儿产后及引产结果，并与产前诊断结果作对照。结果：正常胎儿肺体积与胎儿质量（r=0.97，P<0.05）的相关性高于胎儿肺体积与孕周（r=0.93，P<0.05）的相关性。28例PH高危胎儿中，2例因羊水过少未能获得满意的三维图像，PH高危胎儿应用VOCAL技术获得肺体积的成功率为92.90%。在成功获得肺体积的26例胎儿中，应用UFLB诊断胎儿PH的敏感度为89.47%，特异度为85.71%，阳性预测值为94.44%，阴性预测值为75.00%，诊断准确率为88.46%。结论：正常胎儿的肺体积随孕周、胎儿体重的增加而增大，应用UFLB可以较准确的诊断PH。

Study of fetal lung volume using virtual organ computer aided analytical technique

Objective： To evaluate the correlation between fetal lung volumes and gestational age, and estimated fetal weight, and to evaluate the potential diagnostic value of ultrasound fetal lung to body weight ratio （UFLB） in fetal pulmonary hypoplasia （PH）. Methods： The fetal lung volumes were assessed in 315 normal fetuses and 28 fetuses with high risk of PH using the technique of virtual organ computer-aided analysis （VOCAL）. The relationships between the lung volumes and gesta- tional age, and fetal weight were assessed by correlation and regression analysis. The value of UFLB in the diagnosis of fetal PH was acquired by compared with the postnatal findings. Results： Fetal lung volumes were highly correlated with gestational age（r=0.93,P〈0.05）, and with fetal weight（r=0.97,P〈0.05）. The sensitivity, specificity, positive and negative predictive values of UFLB in diagnosing fetal PH was 89.47%, 85.71%, 94.44% and 75.00%, respectively, and the accuracy was 88.46%. Conclu- sion： In normal fetuses, fetal lung volumes increase with gestational age and fetal weight. UFLB may be useful in the prenatal diagnosis of fetal PH.