实时三维超声心动图评价中晚孕期正常胎儿右心室功能

目的应用全容积实时三维超声心动图评价正常胎儿右心室功能。方法对109例孕妇的正常胎儿进行超声心动图检查．应用Shimazaki法、双平面Simpson法以及全容积实时三维超声心动图方法（RT-3DE）来评估胎儿右室舒张末期容积（EDV）、收缩末期容积（ESV）、每搏输出量（SV）、射血分数（EF）及心输出量（CO），并比较三种方法获得的数值结果。结果三种方法比较，EDV、ESV、SV、CO值的差异均有统计学意义（F=31．22、23．30、31．67、32．61。P均〈0．05），EF值的差异无统计学意义（F=1．56，P〉0．05）。RT-3DE法、双平面Simpson法与Shimazaki法比较，除EF值外，胎儿EDV、ESV、SV、CO值的差异均有统计学意义（t分别=6．57、5．64、6．66、6．76；7．10、6．25、7．11、7．21，P均〈0．05）；RT-3DE法与Simpson法比较，胎儿EDV、ESV、SV、CO的差异无统计学意义（t分别=0．53、0．61、0．44、0．45．P均〉0．05）。两个观察者一致性检验，RT-3DE法的Kappa值要高ff-Simpson法的Kappa值。结论全容积实时三维超声心动图能够全面、整体地评价胎儿右心室心功能。

Full-volume real-time three-dimensional echocardiographic assessment on right ventricular function of fetuses in the second and third trimester

Objective To evaluate the fetal right ventricular function by using full volume real-time three-dimensional eehoeardiography（RT-3DE）. Methods The fetal right ventricular volumes of 109 normal fetuses were outlined and calcu- lated by Shimanaki rule, Simpson＇s method and full-volume RT-3DE. The right ventricular end-diastolic volume （EDV）, end- systolic volume （ESV）, stroke volume （SV）, ejection fraction （EF） and cardiac output （CO） measured by three different methods were compared. Results The EDV,ESV,SV,CO were significantly different among three methods（F=31.22,23.30, 31.67,32.61, P〈0.05） except the EF（F=l.56,P〉0.05） . EDV, ESV, SV, CO were significantly different except EF between Shimanaki and Simpson method as well as between Shimanaki and RT-3DE（t=6.57, 5.64, 6.66, 6.76; 7.10, 6.25, 7.11, 7.21, P〈0.05）. Compared with RT-3DE, the EDV, ESV, SV, CO, EF of Simpson were not significantly different （t=0.53,0.61,0.44,0.45, 0.52, P〉0.05）. The Kappa value of RT-3DE was higher than that of the Simpson. Conclusions RT-3DE is an accurate and reliable method to make a comprehensive, holistic evaluation of fetal right ventricular function.