彩超观察胎儿肺静脉在产前二级筛查中的应用

目的探讨彩超观察胎儿肺静脉在产前二级筛查中的应用价值。方法对113例妊娠20～34周孕妇进行常规胎儿产前彩超筛查,重点观测胎儿肺静脉及其血流参数:S波(心室收缩期峰值流速)、D波(心室舒张期峰值流度)、A波(心房收缩期流速),计算S/D值和PVI值〔峰值血流指数,PVI=(S-A)/D〕。将其中100例正常胎儿列入对照组(A组),对比分析其4条肺静脉血流参数;将13例产前彩超筛查有先天性心脏病(CHD)的胎儿列入实验组(B组),比较两组的右下肺静脉血流参数。结果 A组4条肺静脉的S波、D波、S/D及PVI差异均有统计学意义(P<0.05),多数A波表现为正向波,但差异无统计学意义(P>0.05)。B组与A组S波、D波及S/D无显著差异(P>0.05),B组A波均值反转,与A组比较差异显著(P<0.05),PVI明显高于A组(P<0.05)。结论观测肺静脉A波、PVI可作为CHD产前筛查的一项指标。在测量肺静脉血流参数时应选取某一条固定的肺静脉进行测量。

The application of color Doppler ultrasound in secondary prenatal screening on fetal pulmonary vein

Objective To explore the significance in application of color Doppler ultrasound in observation of fetal pulmonary veins in secondary prenatal screening.Methods One hundred and thirteen pregnant women with pregnancy of 20-34 weeks were screened by color Doppler ultrasound to check fetal pulmonary vein.Peak systolic velocity(S),peak diastolic velocity(D) and atrial-systolic velocity(A) of pulmonary venous flow were measured and S / D and PVI were calculated.One hundred normal fetuses were allocated into control group((group A),then the flow parameters of their four pulmonary veins were compared and analyzed.Thirteen fetuses having congenital heart disease(CHD) during prenatal ultrasonographic screening were allocated into experimental group(group B),and the flow parameters in their right inferior pulmonary vein were compared between these two groups.Results There was significant difference in S wave,D wave,S / D and PVI of four pulmonary veins in group A(P < 0.05),and most A wave showed a pulsatile forward flow,but the difference was not statistically significant(P > 0.05).There was no difference in S wave,D wave and S / D between groups A and B(P > 0.05).The mean value of A wave is inverted in group B,it was significantly different with group A(P < 0.05),and PVI was higher than that of group A(P < 0.05).Conclusion Observation on A wave and PVI of pulmonary vein can be used as an indicator for prenatal screening of CHD.It is important to select one fixed pulmonary vein for measuring blood flow in pulmonary veins.