CAJ | 학술논문

目的：评价时间-空间关联成像（ STIC）技术在胎儿右心室双出口畸形检查中的临床应用价值。方法回顾性分析自2010年10月至2013年8月在商丘市第一人民医院超声科行中孕期超声检查的孕妇942例，使用GE voluson 730 Expert series彩色多普勒超声仪和实时4D容积探头对孕龄在18～38周孕妇的胎儿进行心脏和胸部的自动扫查，观察指标包括胎儿心脏四腔心、五腔心及各血管长轴切面，并加用彩色多普勒观察二、三尖瓣和各房室血流情况，结合彩色血流成像，对获得容积数据进行分析，根据右心室双出口的诊断标准进行定性观察。结果28例因羊水相对不足、受胎儿胎位影响或胎儿孕周较大（大于30周）、脊柱及肋骨声影遮挡，未能采集满意的容积数据。通过STIC技术914例胎儿均获得了满意显示一系列相互垂直的三维平面图像的容积数据，满意率97．0％，超声诊断符合率100．0％。检出右心室双出口6例，其中1例合并三尖瓣下移畸形，1例伴有法洛四联症。6例患儿均经过手术证实。主动脉瓣下缺损和双瓣下缺损患儿3例行将人工血管片修补室间隔缺损；2例行大动脉调转术＋室间隔缺损修补术；1例采用Rastelli手术。结论 STIC技术比常规二维胎儿超声心动图检查能更快地提供更多的心脏解剖结构及与之相邻的信息，减少了胎儿心脏检查中对检查者经验的依赖。但STIC技术在获得数据时同样受检查声窗的影响，包括胎儿体位、羊水等因素。
목적：평개시간-공간관련성상（ STIC）기술재태인우심실쌍출구기형검사중적림상응용개치。방법회고성분석자2010년10월지2013년8월재상구시제일인민의원초성과행중잉기초성검사적잉부942례，사용GE voluson 730 Expert series채색다보륵초성의화실시4D용적탐두대잉령재18～38주잉부적태인진행심장화흉부적자동소사，관찰지표포괄태인심장사강심、오강심급각혈관장축절면，병가용채색다보륵관찰이、삼첨판화각방실혈류정황，결합채색혈류성상，대획득용적수거진행분석，근거우심실쌍출구적진단표준진행정성관찰。결과28례인양수상대불족、수태인태위영향혹태인잉주교대（대우30주）、척주급륵골성영차당，미능채집만의적용적수거。통과STIC기술914례태인균획득료만의현시일계렬상호수직적삼유평면도상적용적수거，만의솔97．0％，초성진단부합솔100．0％。검출우심실쌍출구6례，기중1례합병삼첨판하이기형，1례반유법락사련증。6례환인균경과수술증실。주동맥판하결손화쌍판하결손환인3례행장인공혈관편수보실간격결손；2례행대동맥조전술＋실간격결손수보술；1례채용Rastelli수술。결론 STIC기술비상규이유태인초성심동도검사능경쾌지제공경다적심장해부결구급여지상린적신식，감소료태인심장검사중대검사자경험적의뢰。단STIC기술재획득수거시동양수검사성창적영향，포괄태인체위、양수등인소。
Objective To estimate the value of spatio-temporal image correlation for evaluation of double outlet right ventricle .Methods Nine hundred and forty-two pregnant women were tested with spatio-temporal im-age correlation from October 2011 to August 2013 , at the First People′s Hospital in Shangqiu city .The GE voluson 730 expert series color Doppler ultrasound and the volume of the probe were used in the clinical examination of fe -tus in 18-38 weeks of gestation age .The four/five heart′s cavity or blood vessels and long axis plane were observed with some emphasis;the volume data were later treated with GE 4D-viewer 6.2 software.The diagnosis of double outlets of right ventricle was observed according to the standard .Results Totally 28 cases did not attain satisfac-tory volume data due to relatively insufficient amniotic fluid and so on .The volume data of a series of three-dimen-sional imaging in 914 fetus achieved satisfied volume data of perpendicular three-dimensional graphic images through STIC technology ,and the rate of satisfaction was 97.0%, with double outlet right ventricle of six patients , one case with downward displacement of tricuspid valve and one case accompanying with tetralogy of fallot .The correct rate of color Doppler ultrasound in diagnosis of DORV was 100.0%.All the cases had operation .Ventricu-lar septal defect compared with artificial blood vessels slice were used in three cases;arterial switch operation +ventricular septal defect repair were used in two cases and one case had rastelli operation .Conclusion Compared with routine two-dimensional fetal echocardiography , spatio-temporal image correlation can more clearly show the minute anatomy of heart malformation and display the double outlet right ventricle .