彩色多普勒及无应激试验监测胎儿窘迫的临床应用

目的探讨彩色多普勒超声及无应激试验（NST）监测胎儿窘迫的临床价值。方法80例孕龄37-42周的孕妇,其中40例胎儿窘迫及40例胎儿正常。均于产前进行彩色多普勒超声探测及NST。结果胎儿窘迫组其血流阻力指标：胎儿大脑中动脉（MCA）的S/D、血流阻力指数（RI）、搏动指数（PI）明显低于胎儿正常组（P〈0.01）,而母体子宫动脉（UTA）的血流阻力指标均明显高于胎儿正常组（P〈0.01）。此外,胎儿窘迫组与胎儿正常组S/D与NST对胎儿缺氧检测,其灵敏度、特异度、阳性预测值、阴性预测值分别为92.5%、95.0%、94.5%、92.7%,NST为75.0%、62.5%、66.7%、71.4%。S/D对胎儿窘迫的检出率明显高于NST。结论应用彩色多普勒超声检测血流动力学中阻力指标对胎儿窘迫的诊断优于NST。     

子痫前期孕妇肾动脉血流参数变化的彩超论断价值

目的探讨彩色多普勒血流显像检测子痫前期孕妇肾动脉血流参数变化的意义。方法本研究随机选取100例正常妊娠妇女为对照组,选取经临床确诊的116例子痫前期患者为研究对象,按病情分为轻度子痫前期60例,重度子痫前期56例。应用彩色多普勒超声检测各组孕妇肾门处肾动脉主干及肾叶间动脉（IRA）收缩期峰值流速（Vs）、舒张末期最低流速（Vd）、上升加速度（AC）、阻力指数（RI）。结果与对照组及轻度子痫前期组比较,重度子痫前期组肾门处及肾内叶间动脉血流参数Vs、RI、AC均明显升高（P〈0．01）,Vd明显下降（P〈0．05）,差异均有统计学意义;而轻度子痫前期组与对照组比较,其肾门处及肾内叶间动脉各项血流参数均无统计学差异（P〉0．05）。结论随着病情严重程度的增加,重度子痫前期患者肾门处及肾内叶间动脉收缩期流速明显升高,阻力增大,而舒张期流速明显减低,彩色多普勒超声无创、可重复性好,能较准确检测子痫前期患者肾动脉血流动力学变化,有较好的临床应用价值。     

血清和肽素联合子宫动脉血流参数对子痫前期的早期筛查价值分析

目的探讨血清和肽素(CPT)联合子宫动脉血流参数对子痫前期(PE)的早期筛查价值。方法前瞻性随机选取2018年4月至2019年5月期间在我院行孕检的孕妇504例作为研究对象,所有孕妇均随访至分娩,并根据在孕期是否发生PE进行分组,将其中发生PE的38例孕妇纳入PE组,其余466例孕妇纳入对照组。于孕20~24周时采用酶联免疫吸附法检测所有研究对象血清CPT的水平,采用彩色多普勒超声诊断仪检测血流搏动指数(PI)、子宫动脉收缩期与舒张期血流速度比值(S/D)、阻力指数(RI)。结果PE组的S/D、PI、RI及血清CPT均明显高于对照组,差异均有统计学意义(P<0.05),经Pearson分析显示,PE患者血清CPT与舒张压、收缩压、S/D、PI、RI均呈正相关(P<0.05),ROC曲线分析显示,血清CPT对PE的预测价值较高,曲线下面积为0.797,而各项子宫动脉血流参数对PE亦有一定的预测价值,其中PI的预测价值最高,曲线下面积为0.813。血清CPT联合PI可明显提高预测价值,其灵敏度为84.21%、特异性为83.91%,约登指数为0.681。结论血清CPT和各项子宫动脉血流参数对PE的早期筛查有一定的临床应用价值,且血清CPT联合PI可明显提高预测价值。     

TCD血流动力学指标评价急性脑梗死患者认知功能损伤程度的价值

目的 探讨经颅多普勒超声（TCD）检查评价急性脑梗死（ACI）后患者认知功能受损的价值。方法 选取2015年5月~2019年4月我院收治的ACI后合并认知功能障碍的患者110例设为认知障碍组,ACI后认知功能正常患者110例设为ACI组,比较两组的大脑中动脉（MCA）平均血流速度（Vm）、阻力指数（RI）、搏动指数（PI）、MCA的屏气指数（BHI）、不同程度认知障碍患者Vm、RI、PI、BHI测定值及认知障碍患者的MCA的Vm、RI、PI、BHI测定值与MoCA评分的关系。结果 认知障碍组的PI测定值高于ACI组,差异具有统计学意义（P＜0.05）;认知障碍组的BHI测定值、MoCA评分低于ACI组,差异具有统计学意义（P＜0.05）;两组Vm、RI测定值比较,差异无统计学意义（P＞0.05）;中度认知障碍患者的PI测定值高于轻度认知障碍患者,差异具有统计学意义（P＜0.05）;中度认知障碍患者BHI测定值、MoCA评分低于轻度认知障碍患者,差异具有统计学意义（P＜0.05）;认知障碍组PI测定值与MoCA评分呈负相关（r=-0.492,P=0.000）;认知障碍组的BHI测定值与MoCA评分呈正相关（r=0.507,P=0.000）;两组Vm、RI与MoCA评分无相关性（r=-0.084、-0.107,P=0.226、0.214）。结论 ACI患者认知功能障碍患者MCA的PI指数升高、BHI降低,TCD血流动力学指标用于评价ACI患者发生认知功能损害具有一定的临床价值。     

Resistive index of renal artery and blood pressure in postmenopausal women

Causal association between perimenopausal changes and symptoms and disease is commonly accepted even if not definitely explained. Resistive index (RI) of renal artery assessed by Doppler echography is related to renal function and systemic circulatory adaptation in patients with chronic renal failure and hypertension. Echocardiographic measurement of left ventricular myocardial mass (LVMM) is a useful tool for assessing effects of arterial hypertension on heart. Aim of the study was to assess RI in normotensive postmenopausal women and relationship, if any, with blood pressure and LVMM. We studied 28 normotensive, non-obese postmenopausal women, age 52.21 +/- 5.40 years, with normal creatinine clearance. Renal colour-Doppler echography was performed assessing intra-parenchimal renal artery mean velocity (mVRA) and intra-parenchimal RI [(peak systolic velocity - end diastolic velocity)/peak systolic velocity]. Echocardiography was performed as well. RI of intra-parenchimal renal artery is 0.67 +/- 0.05 and it shows correlations vs. diastolic blood pressure (r=0.41; P<0.03) and vs. mean BP (r=0.47; P<0.01). LVMM has correlation (r=0.41; P>0.03) with RI. Age, body weight, body mass index, menarche age, fertility years and postmenopausal years do not show correlation with RI. Heart rate, creatinine clearance, hemoglobin, serum albumin do not show any correlation with RI. Higher RI is associated with alcohol intake, liver steatosis, biliary gallstones and family history of diabetes mellitus, but not with postmenopausal years, unrespective of surgical or non-surgical menopause. Among echocardiographic measurements only LVMM is correlated with RI; mVRA does not show correlation. LVMM and BP do not show other independent correlation except that the one already reported vs. RI. RI, as a pathophysiological measurement whose increase preludes to arterial hypertension, could help to ascertain perimenopausal women at risk for arterial hypertension and left ventricular hypertrophy, but does not seem directly associated with the loss of ovarian function.     

彩色多普勒超声诊断胎儿单脐动脉的临床价值

目的探讨超声对胎儿单脐动脉的诊断意义。方法应用彩色多普勒超声连续观察21405例中晚孕期孕妇单脐动脉的发生情况并测量其脐动脉血流频谱（PI、RI及S/D比值）。结果共发现单脐动脉胎儿140例,99例单纯性单脐动脉,41例合并畸形,它们分别与正常胎儿的PI、RI、S/D值比较均无显著性差异（P〉0.05）。结论应用彩色多普勒超声可准确诊断胎儿单脐动脉的发生情况,为遗传生殖提供临床价值。     

老年大鼠模型视网膜血管改变及视网膜中央动脉血流变化的高分辨率超声图像检测

背景：视网膜对缺血非常敏感,所以眼部血流动力学的改变可直接影响眼的功能,目前评估眼部血液循环可借助多种仪器设备。 目的：应用高分辨率小动物超声影像系统检测视网膜中央动脉的血流动力学变化,结合视网膜血管消化铺片技术检测视网膜血管结构变化,以明确老年大鼠视网膜中央动脉血流动力学的变化规律。 方法：使用高分辨率小动物超声影像系统测量老年大鼠和青年大鼠及视网膜中央动脉的血流参数,包括收缩期峰值血流速度、舒张末期血流速度,计算搏动指数、阻力指数和收缩期舒张期血流速度比值。同时使用视网膜血管消化铺片技术检测视网膜血管形态学改变。 结果与结论：与青年大鼠组相比,老年组大鼠视网膜血管内皮细胞增生,排列紊乱,管径增粗,血管壁不光滑;视网膜中央动脉血流速度、舒张末期血流速度均降低(P < 0.01),计算搏动指数、阻力指数及收缩期峰值与舒张末期血流速度比值则升高(P < 0.01)。说明使用高分辨率小动物超声影像系统检测视网膜中央动脉收缩期和舒张期峰值速度及阻力指数能较敏感地反映血管的老化过程。     

Increasing sensitivity and specificity of Doppler sonographic detection of renal transplant rejection with serial investigation technique

Acute rejection episodes are the most common cause leading to loss of renal grafts in the early postoperative phase. Doppler sonography presents a noninvasive tool to detect increased arterial blood flow resistance as a result of rejection. This can be measured by the increase in the resistive index (RI) and the pulsatility index (PI). In a prospective study including 65 consecutive patients we investigated whether the detection of rejection episodes is improved by determining RI or PI serially twice a week instead of performing a single examination in cases of transplant dysfunction. In 330 examinations with a color-coded Doppler device (Philips QAD 1, Philips Medical Systems Hamburg, Germany) flow profiles were obtained by means of pulse-wave Doppler over at least three interlobar arteries of the renal transplant and RI and PI were calculated. In 41 cases primary rejections were better recognized by an increase in PI compared to the preceding value than by the absolute PI value (with a sensitivity of 90%; specificity was 76% and 42% respectively). The RI was less specific (with a sensitivity of 90%; specificity was 47% for the relative RI increase and 30% for the absolute RI value). The continuous PI increase started an average of 3.3 days (95% CI –15.25 to + 1.55) before rejection was diagnosed. Vascular rejection episodes showed higher PI values than interstitial rejections (3.86 ± 2.14 vs. 2.19 ± 0.87; P < 0.01). The serial investigation technique of PI allows better recognition of rejection episodes than the single measurement of RI or PI performed so far. Doppler sonography recognizes rejection at an early stage.Abbreviations RI resistive index - PI pulsatility index - ARF acute renal failure - ROC receiver operating characteristic     

Endometrial and subendometrial blood flow measured by three-dimensional power Doppler ultrasound in patients with small intramural uterine fibroids during IVF treatment

BACKGROUND: The impact of intramural fibroids on the success of IVF treatment is controversial and the mechanisms leading to poor treatment outcomes remain unknown. We compared endometrial and subendometrial blood flow between women with and without intramural fibroids during IVF treatment. METHODS: Three-dimensional (3D) ultrasound examination with power Doppler was performed on the day of oocyte retrieval in 50 patients with intramural fibroids not distorting the uterine cavity and in 50 matched controls to measure endometrial thickness, uterine pulsatility index (PI)/resistance index (RI), endometrial volume and vascularization index (VI)/flow index (FI)/vascularization flow index (VFI) of endometrial and subendometrial regions. Smokers, patients with serum estradiol concentrations > or =20,000 pmol/l on the day of HCG and previous history of myomectomy were excluded. RESULTS: Endometrial thickness and pattern, averaged uterine PI and RI and endometrial and subendometrial VI/FI/VFI were similar between the fibroid group and the control group. There was no correlation between the total volume of fibroids and endometrial and subendometrial 3D power Doppler flow indices in the fibroid group. CONCLUSION: Endometrial and subendometrial 3D power Doppler flow indices were similar in patients with and without small intramural fibroids.     

肝移植术后肝动脉狭窄频谱Tardus Parvus波形和超声造影微灌注定量技术的临床价值

目的　探讨肝移植术后肝动脉狭窄频谱Tardus Parvus波形和超声造影微灌注定量技术的临床意义。 方法　收集60例肝移植术后病人的相关影像资料,记录肝动脉多普勒超声的收缩期峰值血流速度（PSV）、舒张末期血流速度（EDV）、阻力指数（RI）及加速时间（SAT）等参数,Tardus Parvus波形的诊断标准为RI＜0.5且SAT＞0.8 s;超声造影分别记录肝边缘区域和中心区实质基础强度（BI）、到达时间（AT）、峰值强度（PI）、达峰时间（TTP）及中心区域与边缘区域的实质增强程度差异绝对值（REI）等定量参数,以CTA或DSA诊断肝动脉直径狭窄率≥50%为标准,将患者分为肝动脉狭窄组和非狭窄组。 结果 肝动脉狭窄组多普勒超声表现为Tardus Parvus波形阳性（P<0.05),超声造影狭窄组与非狭窄组相比,REI减小（P<0.05）,中心区域TTP延长（P<0.05）。 结论　Tardus Parvus波形和超声造影微灌注定量技术对肝移植术后肝动脉狭窄诊断具有一定的价值。     

高频超声与CT在良恶性浅表淋巴结鉴别诊断中的应用价值

目的:探讨超声及电子计算机断层扫描（CT）在浅表淋巴结病变筛查诊断中的价值。方法:回顾性分析均行超声及CT检查的96例浅表淋巴结病变患者,根据病理组织活检结果将患者分为良性淋巴结组（n=41例）和恶性淋巴结组（n=55例）。根据超声、CT检查结合病理学诊断,描述不同类型浅表淋巴结的声像学特点。采用Kappa一致性得到CT、超声及两种检查方法联合检测的灵敏度、特异度、阳性预测值、阴性预测值;根据高频超声图像测量淋巴结最长径值、最短径值,采用血流频谱多普勒彩超和流量计算公式测定血流阻力指数（RI）、动脉收缩期及舒张末期血流速度。结果:CT诊断准确率显著低于超声和联合检测（P<0.05）;CT误诊率显著高于超声和联合检测（P<0.05）;CT、超声、联合检测的AUC值分别为0.617、0.723、0.787,其中联合检测AUC值最高（P<0.05）。良性结节组患者行超声检测的最长径值、最短径值及RI值显著低于恶性结节组患者（P<0.05）;良性结节组患者的动脉收缩期血流速度显著高于恶性结节组患者（P<0.05）。两组患者行超声检测浅表淋巴结的最长径值、最短径值、RI值、动脉收缩期血流速度、定量值联合预测的AUC分别为0.753、0.686、0.787、0.698、0.897,其中定量值联合预测的预测价值最大（P<0.05）。结论:CT与超声联合和超声检测在浅表淋巴结良恶性诊断准确率较CT高,且联合检测和彩色多普勒超声检测具有相同诊断价值;彩色多普勒超声检测中浅表淋巴结的最长径值、最短径值及血管RI值、动脉收缩期血流速度的联合检测有较好预测价值。     

Comparison of blood velocity measurements between ultrasound Doppler and accelerated phase-contrast MR angiography in small arteries with disturbed flow

Ultrasound Doppler (UD) velocity measurements are commonly used to quantify blood flow velocities in vivo. The aim of our work was to investigate the accuracy of in vivo spectral Doppler measurements of velocity waveforms. Waveforms were derived from spectral Doppler signals and corrected for intrinsic spectral broadening errors by applying a previously published algorithm. The method was tested in a canine aneurysm model by determining velocities in small arteries (3-4 mm diameter) near the aneurysm where there was moderately disturbed flow. Doppler results were compared to velocity measurements in the same arteries acquired with a rapid volumetric phase contrast MR angiography technique named phase contrast vastly undersampled isotropic projection reconstruction magnetic resonance angiography (PC-VIPR MRA). After correcting for intrinsic spectral broadening, there was a high degree of correlation between velocities obtained by the real-time UD and the accelerated PC-MRA technique. The peak systolic velocity yielded a linear correlation coefficient of r = 0.83, end diastolic velocity resulted in r = 0.81, and temporally averaged mean velocity resulted in r = 0.76. The overall velocity waveforms obtained by the two techniques were also highly correlated (r = 0.89 ± 0.06). There were, however, only weak correlations for the pulsatility index (PI: 0.25) and resistive index (RI: 0.14) derived from the two techniques. Results demonstrate that to avoid overestimations of peak systolic velocities, the results for UD must be carefully corrected to compensate for errors caused by intrinsic spectral broadening.     

彩色多普勒超声在肾移植后监测中的应用

背景：超声检查已经成为了肾移植后的常规检查及监测方法。 目的：探讨彩色多普勒超声在肾移植后监测的应用价值。 方法：对61例同种异体肾移植后患者采用彩色多普勒超声进行检测,其中移植肾正常组35例,急性排斥反应组22例,慢性排斥反应组4例。对所有患者进行常规超声探查,结合彩色多普勒及能量多普勒观察移植肾的观察移植肾结构、血流灌注情况,测量各级血管的血流参数。 结果与结论：急性排斥反应组移植肾较功能正常组明显肿大,彩色多普勒显像、多普勒能量图显示肾实质血流信号减少,舒张期明显,各级动脉阻力指数和搏动指数明显增高;慢性排斥反应组移植肾体积较功能正常组明显减小,彩色多普勒显像、多普勒能量图显示肾动脉内径明显缩小,动脉阻力指数和搏动指数明显升高。提示,应用超声能早期无创的观察移植肾的血流灌注情况,测量移植肾各级血管的血流参数能敏感的反应移植肾的功能状况。     

彩色多普勒检测子宫动脉预测妊高征的价值研究

目的探讨彩色多普勒检测子宫动脉预测妊娠高血压综合征（妊高征）的价值及临床意义。方法应用彩色多普勒超声对587例20～24周妊娠妇女的子宫动脉进行检测,通过观察追踪随访孕妇至分娩,根据是否出现高血压,把检测20～24周妊娠妇女的子宫动脉参数分为两组：正常组（560例）和高危组（27例）,进行对照研究,对比分析两组受检者子宫动脉血流动力学变化及声像图表现。结果①高危组子宫动脉收缩期峰值血流速度（Vd）较正常组快,舒张期最小血流速度（Vs）和平均血流速度（Vm）减慢（P〈0.01）,高危组子宫动脉阻力指数（RI）、搏动指数（PI）和收缩期峰值血流速度/舒张期最小血流速度（S/D）比正常组高（P〈0.01）,②高危组子宫动脉多普勒频谱表现典型者出现舒张早期＂V＂切迹。结论高危组患者子宫动脉血流动力学和多普勒频谱形态与正常组妊娠妇女有明显的不同,常规定期监测20～24周妊娠妇女子宫动脉血流动力学变化及多普勒频谱形态,对早期发现和治疗妊高征,保障母婴健康具有极其重要的意义。     

The relationships between endometrial thickness, and blood flow and pregnancy rates in in-vitro fertilization

To establish whether endometrial blood flow and thickness can predict the success rate of in-vitro fertilization, 156 cycles were evaluated. The parameters were: endometrial colour and power Doppler pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D) and endometrial thickness. Each patient was studied: on the day of ovum retrievalpickup, and on the day of embryo transfer. Non-endometrial parameters studied were: age, oestrestrogen and progesterone concentrations, number of oocytes, and number of embryos. Pregnancy was achieved in 31 cycles. On the day of ovum retrieval, patients who conceived had PI, RI, and S/D values of 0.997, 0.563, and 2.403, respectively. Patients who did not conceive had values of 0.994, 0.584, and 2.477 respectively. The power Doppler technique provided similar results. On the day of embryo transfer, pregnant patients had PI, RI and S/D values of 1.096, 0.590 and, 2.597 respectively, while in the non-pregnant patients the values were 1.104, 0.603 and, 2.723 respectively. Power Doppler showed similar numbers. The differences between pregnant and non-pregnant patients were not statistically significant in any of the parameters. Endometrial thickness and blood flow does not seem to correlate with pregnancy rate in IVF.     

The role of endometrial and subendometrial blood flows measured by three-dimensional power Doppler ultrasound in the prediction of pregnancy during IVF treatment

BACKGROUND: A good blood supply towards the endometrium is usually considered to be an essential requirement for implantation. We aimed to evaluate the role of endometrial and subendometrial blood flows in the prediction of pregnancy during IVF treatment. METHODS: Patients undergoing the first IVF cycle were recruited. A three-dimensional (3D) ultrasound examination with power Doppler was performed on the day of oocyte retrieval to determine endometrial thickness, endometrial pattern, pulsatility index (PI) and resistance index (RI) of uterine vessels, endometrial volume, vascularization index (VI), flow index (FI) and vascularization flow index (VFI) of endometrial and subendometrial regions. RESULTS: Uterine RI, endometrial VI and VFI were significantly lower in the pregnant group than the non-pregnant group. There was a non-significant trend of higher implantation and pregnancy rates in patients with absent endometrial or subendometrial blood flow. The number of embryos replaced and endometrial VI were the only two predictive factors for pregnancy. Receiver operator characteristic curve analysis revealed that the area under the curve was approximately 0.5 for all ultrasound parameters for endometrial receptivity. CONCLUSION: Endometrial and subendometrial blood flows measured by 3D power Doppler ultrasound were not good predictors of pregnancy if they were measured at one time-point during IVF treatment.     

新生儿前脑动脉血流速度波的测定及临床意义

本文应用ＳＯＢ－Ⅱ型伪彩色血流分析仪对围产期窒息新生儿前脑动脉血流阻抗指数（ＲＩ）进行测定。结果表明：宫内窘迫和出生窒息，新生儿ＲＩ值分别为０．６３８±０．０７２，０．６１２±０．０７６，显著高于正常对照组（０．５６６±０．０６３），３例诊断为ＨＩＥ及ＰＶＨ－ＩＶＨ，新生儿不仅ＲＩ值显著升高，而且前脑动脉的血流速度波表现为不规则形。认为ＲＩ值的测定可以较为直接地反映新生儿中枢神经系统的血流灌注情况，结合其血流速度波型的改变，对新生儿ＨＩＥ及ＰＶＨ－ＩＶＨ的早期诊断有一定价值。     

The role of endometrial and subendometrial vascularity measured by three-dimensional power Doppler ultrasound in the prediction of pregnancy during frozen-thawed embryo transfer cycles

BACKGROUND: A good blood supply to the endometrium is usually considered as an essential requirement for implantation. OBJECTIVE: The aim of this study was to evaluate the role of endometrial and subendometrial vascularity in the prediction of pregnancy during frozen-thawed embryo transfer (FET) cycles. METHODS: Women undergoing FET in natural or clomiphene-induced cycles after the first stimulated IVF treatment were recruited. A three-dimensional (3D) ultrasound examination with power Doppler was performed 1 day after the LH surge to determine endometrial thickness, endometrial pattern, pulsatility index (PI) and resistance index (RI) of uterine vessels, endometrial volume, vascularization index, flow index and vascularization flow index of endometrial and subendometrial regions. RESULTS: Women in the pregnant group were significantly younger and used less gonadotrophins in their stimulated cycle. Endometrial thickness, endometrial volume, endometrial pattern, uterine PI, uterine RI, endometrial and subendometrial 3D power Doppler flow indices were similar between the nonpregnant and the pregnant groups. The age of women was the only predictive factor for pregnancy. Receiver operating characteristic curve analysis revealed that the area under the curve was around 0.5 for all ultrasound parameters for endometrial receptivity. CONCLUSION: Vascularity of endometrial and subendometrial layers measured by 3D power Doppler ultrasound is not a good predictor of pregnancy in FET cycles if measured at one time point only.     

Endometrial and subendometrial blood flow measured during early luteal phase by three-dimensional power Doppler ultrasound in excessive ovarian responders

BACKGROUND: Impaired implantation in assisted reproduction cycles with high serum estradiol (E(2)) concentrations may be related to suboptimal endometrial perfusion. Endometrial and subendometrial blood flow were compared between excessive responders (serum E(2) on the day of HCG >20 000 pmol/l) and moderate responders (E(2) < or =20 000 pmol/l). METHODS: Three-dimensional (3D) ultrasound examination with power Doppler was performed 2, 4 and 7 days after HCG in 32 patients who did not have embryo transfer in order to measure endometrial thickness, pulsatility index (PI)/resistance index (RI) of uterine vessels, and endometrial volume, vascularization index (VI)/flow index (FI)/vascularization flow index (VFI) of endometrial and subendometrial regions. RESULTS: Excessive responders tended to have lower endometrial and subendometrial VI/VFI on HCG +2 and more absent endometrial/subendometrial blood flow. They had significantly higher endometrial FI and subendometrial VFI than moderate responders on HCG +7. Only in the excessive responder group, uterine PI/RI declined significantly from HCG +2 to HCG +7 and endometrial VI/VFI increased significantly from HCG +4 to HCG +7. CONCLUSION: Changes in uterine Doppler flow indices, and endometrial and subendometrial 3D power Doppler flow indices during the early luteal phase were significantly different between moderate and excessive responders.     

胎儿心脏畸形孕早期筛查中脐静脉导管血流频谱参数与染色体异常的关系分析

目的探讨胎儿心脏畸形孕早期筛查中脐静脉导管血流频谱参数与染色体异常的关系。方法本研究回顾性分析了2013年1月至2018年5月期间1326例孕11~14w胎儿的临床资料。采用GE E8型彩色多普勒超声诊断仪检查胎儿脐静脉导管血流频谱参数,其中包括心室收缩期波峰(S波)、心室舒张早期波峰(D波)、心房收缩期波峰(a波)、阻力指数(RI)、搏动指数(PI)和S/a比值。结果1326例孕11~14w胎儿中共有1267例为正常胎儿,59例为异常胎儿。随着孕周的升高,胎儿的RI、PI和S/a比值均逐渐降低。43例脐静脉导管异常胎儿中38例为a波反向,5例为a波消失。脐静脉导管异常组的胎儿异常率(18.60%)显著高于正常组(3.98%),差异有统计学意义(P<0.001)。脐静脉导管正常组和异常组的染色体异常具有显著差异(P<0.05)。脐静脉导管血流频谱参数诊断染色体异常的特异度为0.74%,阴性预测值为96.08%。结论在孕11~14w胎儿的早期筛查中,脐静脉导管血流频谱参数异常主要表现为a波反向和消失。脐静脉导管血流频谱参数诊断胎儿染色体异常的特异度和阴性预测值较高,可作为胎儿染色体异常早期筛查的诊断指标。