CAJ | 학술논문

目的应用组织多普勒(tissue Doppler imaging,TDI)心肌运动速度梯度(myocardial velocity gradient,MVG)评价胎儿左、右心室心肌动力学.方法对孕龄22～40周的30例正常胎儿取横位四腔心切面进行组织多普勒成像,采集3个心动周期的动态图像,获得心肌速度分布图.测量左、右心室游离壁基底段心内膜和心外膜收缩期及舒张期峰值速度及心肌厚度,计算MVG.分析左、右心室心肌收缩期及舒张期心内膜、心外膜速度及MVG与孕周的关系.结果剔除图像质量较差的3例后,共有27例胎儿纳入分析.收缩期及舒张期左、右心室心内膜运动峰值速度均高于心外膜运动峰值速度(P<0.01).收缩期及舒张期左室游离壁、右室游离壁心肌运动速度与孕周呈正相关,而左室游离壁、右室游离壁MVG与孕周呈负相关.结论 TDI技术测量MVG能够用于评价胎儿心室心肌动力学,可以了解胎儿心室壁运动速度在中、晚孕期的生理变化特点及规律,有助于更加准确可靠地评估胎儿心功能的相应变化.
목적 응용조직다보륵(tissue Doppler imaging,TDI)심기운동속도제도(myocardial velocity gradient,MVG)평개태인좌、우심실심기동역학.방법 대잉령22～40주적30례정상태인취횡위사강심절면진행조직다보륵성상,채집3개심동주기적동태도상,획득심기속도분포도.측량좌、우심실유리벽기저단심내막화심외막수축기급서장기봉치속도급심기후도,계산MVG.분석좌、우심실심기수축기급서장기심내막、심외막속도급MVG여잉주적관계.결과 척제도상질량교차적3례후,공유27례태인납입분석.수축기급서장기좌、우심실심내막운동봉치속도균고우심외막운동봉치속도(P<0.01).수축기급서장기좌실유리벽、우실유리벽심기운동속도여잉주정정상관,이좌실유리벽、우실유리벽MVG여잉주정부상관.결론 TDI기술측량MVG능구용우평개태인심실심기동역학,가이료해태인심실벽운동속도재중、만잉기적생리변화특점급규률,유조우경가준학가고지평고태인심공능적상응변화.
Objective To evaluate the fetal myocardial dynamics by tissue Doppler imaging(TDI)myocardial velocity gradient(MVG).Methods Thirty normal fetuses with a gestational age ranging from 22 to 40weeks were studied.Two-dimensional color-TDI was superimposed on a transverse four-chamber view of the fetal heart and three cardiac cycles captured in cine-loop format.Generation of the subepicardial and subendocardial myocardial velocity curves was realized by sampling two-dimensional color-TDI imaging,and myocardial thickness was calculated,subsequently the corresponding MVG were derived.The disparities between right and left subendocardial and subepicardial myocardial velocities in systole and diastole,and the relationship between fetal myocardial velocities,MVG and gestational weeks were correlated.Results Echocardiographic images from a total of 30 normal fetuses were analyzed for inclusion in this study,TDI velocities and MVG data from both the left and right ventricular free walls from 27 of them were of sufficient quality to make quantitative evaluation,3 fetuses with poor echocardiographic images were excluded.Fetal subendocardial myocardial velocities were higher than that of subepicardial myocardium throughout the cardiac cycle in both ventricular free walls.Right and left subendocardial and subepicardial myocardial velocities in systole and diastole showed a positive correlation with advancing gestational age.Right and left MVG in systole and diastole showed a negative correlation with advancing gestational age.Conclusions Tissue Doppler MVG evaluation of the fetal myocardial dynamics is feasible,illustration the relationship between fetal myocardial velocity,MVG and gestational weeks may offer a useful approach for better understanding the characteristic of fetal myocardial properties during fetal heart development.