CAJ | 학술논문

目的探讨时间-空间相关成像技术(spatiotemporal image correlation,STIC)在定量胎儿左心室容积中的价值.方法通过三维容积探头获得162例孕龄22～38周胎儿的心脏三维数据,应用STIC对容积数据处理并获得胎儿心脏形态结构评估要求的多个切面.通过VOCALⅡ功能进行左室三维重建,对胎儿左室功能进行评估,获得左室舒张末期容积(EDV)、收缩末期容积(ESV),并与M型Teichholz法、二维超声心动图简化Simpson法测定的结果进行比较.结果剔除图像质量较差的26例、双胎2例,共有134例正常胎儿纳入分析,三种方法两两比较,STIC VOCALⅡ法与二维超声心动图简化Simpson法所测EDV、ESV相关性最好,r分别为0.968和0.956,Bland-Altman分析两者一致性最好,存在最小偏倚,EDV为0.282 ml、ESV为0.117ml.采用Bland-Altman分析三种测量方法,STICVOCAIⅡ法的重复性最好,观察者间EDV的偏倚为0.190 ml,ESV的偏倚为0.028ml；观察者内EDV的偏倚为0.076ml,ESV的偏倚为0.053 ml.M型Teichholz法与STIC VOCALⅡ法、2DE Simpson法所测得左室容积比较差异均有统计学意义,STIC VOCALⅡ法与2DE Simpson法所测左室容积比较差异无统计学意义.结论 STIC VOCALⅡ法和二维超声心动图简化Simpson法测量左室容积有良好的一致性,且STICVOCALⅡ法所测左室容积观察者间及观察者内重复性均较其他两种方法好.STIC能够更准确地定量正常胎儿的左室容积,三维重建更合理准确地评估心室收缩功能,有助于深入了解发育中的胎儿心脏结构和功能.
목적 탐토시간-공간상관성상기술(spatiotemporal image correlation,STIC)재정량태인좌심실용적중적개치.방법 통과삼유용적탐두획득162례잉령22～38주태인적심장삼유수거,응용STIC대용적수거처리병획득태인심장형태결구평고요구적다개절면.통과VOCALⅡ공능진행좌실삼유중건,대태인좌실공능진행평고,획득좌실서장말기용적(EDV)、수축말기용적(ESV),병여M형Teichholz법、이유초성심동도간화Simpson법측정적결과진행비교.결과 척제도상질량교차적26례、쌍태2례,공유134례정상태인납입분석,삼충방법량량비교,STIC VOCALⅡ법여이유초성심동도간화Simpson법소측EDV、ESV상관성최호,r분별위0.968화0.956,Bland-Altman분석량자일치성최호,존재최소편의,EDV위0.282 ml、ESV위0.117ml.채용Bland-Altman분석삼충측량방법,STICVOCAIⅡ법적중복성최호,관찰자간EDV적편의위0.190 ml,ESV적편의위0.028ml；관찰자내EDV적편의위0.076ml,ESV적편의위0.053 ml.M형Teichholz법여STIC VOCALⅡ법、2DE Simpson법소측득좌실용적비교차이균유통계학의의,STIC VOCALⅡ법여2DE Simpson법소측좌실용적비교차이무통계학의의.결론 STIC VOCALⅡ법화이유초성심동도간화Simpson법측량좌실용적유량호적일치성,차STICVOCALⅡ법소측좌실용적관찰자간급관찰자내중복성균교기타량충방법호.STIC능구경준학지정량정상태인적좌실용적,삼유중건경합리준학지평고심실수축공능,유조우심입료해발육중적태인심장결구화공능.
Objective To investigate the feasibility of spatiotemporal image correlation(STIC)to assess left ventricular volume in normal fetuses.Methods The volume data acquisition of 162 normal fetuses ranging between 22 and 38 weeks of gestation was achieved by automatic sweep scan.The virtual organ computer-aided analysis(VOCAL Ⅱ)was then used to evaluate end-systolic and end-diastolic volumes of left ventricle and compared with that obtained by M-mode Teichholz formula and 2D biplane Simpson's method.Results Twenty-six fetuses with poor STIC image and 2 twin pregnancies were excluded,the study subjects consisted of 134 singleton fetuses.The highest concordance correlation(r =0.968,for EDV,r =0.956 for ESV;P =0.000)was noted between 2D biplane Simpson' s and STIC VOCAL Ⅱ values with a small bias(0.282 ml for EDV,0.117 ml for ESV).The Bland-Altman analysis showed that STIC VOCAL Ⅱ had the best agreement than M-mode Teichholz formula and 2D biplane Simpson's method.The result showed that there were significant difference between Mmode Teichholz formula and Simpson's method in EDV and ESV(P＜0.05).There were significant differences between M-mode Teichholz formula and STIC VOCAL Ⅱ(P＜0.05).There were no significant differences between STIC VOCAL Ⅱ and Simpson' s method in EDV and ESV.Conclusions There is a good agreement between left ventricular volumes measured either by STIC VOCAL Ⅱ or by 2D biplane Simpson's method.STIC is a novel technique that can be more accurate than conventional Methods in quantification of fetal left ventricular volumes.All the volume data acquisition is achieved by postprocessing facilities.STIC promises to become a new method for left ventricular volume quantification.