实时三维超声双平面技术评价胎儿卵圆孔处血流的应用

目的探讨实时三维超声双平面(Bi-plane)技术在评价胎儿卵圆孔处血流中的应用价值。方法纳入186胎无心内外畸形的正常胎儿,获得下腔静脉右心房入口冠状切面。于该切面测量卵圆孔内径(DFO)及下腔静脉右心房入口处内径(DIVC),计算两者的比值(DFO/DIVC),并分析该比值与孕周的相关性。结果 DFO/DIVC与孕周无明显相关性(r=-0.228,P0.05)。中孕期(21~28周)胎儿共155胎,DFO为(4.46±0.57)mm,DIVC为(4.55±1.22)mm,DFO/DIVC为1.03±0.22;晚孕期(29~36周)胎儿共31胎,DFO为(5.20±0.43)mm,DIVC为(5.90±1.33)mm,DFO/DIVC为0.92±0.17。DFO/DIVC均值95%可信区间为(0.98,1.04),个体值95%正常参考值范围为(0.80,1.44)。结论采用实时三维超声Biplane技术可获得胎儿心脏下腔静脉右心房入口冠状切面,可观察到下腔静脉血流在进入右心房后正对房间隔上缘,并被房间隔上缘分为两部分的血流走行全程,在评价房间隔卵圆孔处血流方面具有重要意义。

Application of real-time three-dimensional ultrasound Bi-plane technology in assessment of foramen ovale blood

Objective To explore the application value of the real-time three-dimensional ultrasound Bi-plane technology in evaluation of the foramen ovale blood in fetus.Methods The coronal plane of inferior vena cava entering the right atrium in 186 normal fetuses were obtained. The dimensions of foramen ovale (D_FO) and inferior vena cava at the entrance of right atrium (D_IVC) were measured in the coronal plane. The ratio of D_FO and D_IVC (D_FO/D_IVC) was calculated. The correlation between D_FO/D_IVC and gestational age was analyzed.Results There was no correlation between D_FO/D_IVC and gestational age (r=-0.228, P>0.05). There were 155 cases during second trimester (21-28 weeks), and the D_FO was (4.46±0.57)mm, D_IVC was (4.55±1.22)mm, D_FO/D_IVC was 1.03±0.22. There were 31 cases during late pregnancy (29-36 weeks), and the D_FO was (5.20±0.43)mm, D_IVC was (5.90±1.33)mm, D_FO/D_IVC was 0.92±0.17. The mean 95% confidence interval of D_FO/D_IVC was (0.98, 1.04), the 95% normal reference range was (0.80, 1.44).Conclusion The coronal plane of inferior vena cava entering the right atrium can be obtained with real-time three-dimensional ultrasound Bi-plane technology, the flow from the inferior vena cava enters right atrium which is divided by the upper atrial septum can be observed, which is important in evaluating the foramen ovale blood.