CAJ | 학술논문

目的：探讨正常胎儿三维全脑容积与胎儿孕周、双顶径（ BPD）和头围（ HC）相关性及其与先天性心脏病（CHD）胎儿的差异。方法超声科行常规产科超声心动图检查中，选择未发现明显异常的胎儿为正常胎儿组，选择发现CHD 的胎儿并在产后新生儿超声和终止妊娠胎儿尸体解剖诊断为 CHD 为 CHD 胎儿组。采用 GE Voluson Expret E8彩色多普勒超声诊断仪，二维腹部凸阵探头（频率为3.0~6.0 MHz）测量胎儿 BPD 和 HC，RAB 4-8-D 三维容积探头（频率为4~8 MHz）测量胎儿三维全脑容积，应用虚拟器官计算机辅助分析技术进行分析，计算胎儿三维全脑容积。比较 CHD 胎儿组与正常胎儿组三维全脑容积间有无差异。结果正常胎儿组三维全脑容积随孕周、BPD 和 HC 的增大而增长，三维全脑容积随孕周及 BPD 的增长符合 S 曲线，随 HC 的增长符合幂函数。两组全样本和﹤30孕周样本的 BPD 和 HC 差异均无统计学意义；而在≥30孕周样本中，CHD 胎儿组的 BPD 和 HC 均﹤正常胎儿组，差异有统计学意义。两组全样本和≥30孕周样本中，CHD 胎儿组的三维全脑容积﹤正常胎儿组，差异有统计学意义；而﹤30孕周样本 CHD 胎儿组和正常胎儿组三维全脑容积差异均无统计学意义。结论①三维超声可应用于测量胎儿三维全脑容积；②正常胎儿三维全脑容积随孕周、BPD、HC 的增长而增长；③CHD 胎儿三维全脑容积较正常胎儿减小。
목적：탐토정상태인삼유전뇌용적여태인잉주、쌍정경（ BPD）화두위（ HC）상관성급기여선천성심장병（CHD）태인적차이。방법초성과행상규산과초성심동도검사중，선택미발현명현이상적태인위정상태인조，선택발현CHD 적태인병재산후신생인초성화종지임신태인시체해부진단위 CHD 위 CHD 태인조。채용 GE Voluson Expret E8채색다보륵초성진단의，이유복부철진탐두（빈솔위3.0~6.0 MHz）측량태인 BPD 화 HC，RAB 4-8-D 삼유용적탐두（빈솔위4~8 MHz）측량태인삼유전뇌용적，응용허의기관계산궤보조분석기술진행분석，계산태인삼유전뇌용적。비교 CHD 태인조여정상태인조삼유전뇌용적간유무차이。결과정상태인조삼유전뇌용적수잉주、BPD 화 HC 적증대이증장，삼유전뇌용적수잉주급 BPD 적증장부합 S 곡선，수 HC 적증장부합멱함수。량조전양본화﹤30잉주양본적 BPD 화 HC 차이균무통계학의의；이재≥30잉주양본중，CHD 태인조적 BPD 화 HC 균﹤정상태인조，차이유통계학의의。량조전양본화≥30잉주양본중，CHD 태인조적삼유전뇌용적﹤정상태인조，차이유통계학의의；이﹤30잉주양본 CHD 태인조화정상태인조삼유전뇌용적차이균무통계학의의。결론①삼유초성가응용우측량태인삼유전뇌용적；②정상태인삼유전뇌용적수잉주、BPD、HC 적증장이증장；③CHD 태인삼유전뇌용적교정상태인감소。
Objective To invrstigatr thr erlationships brtwrrn thr beain volumr,bigpaeital diamrtre,grstainal agr and hrad ciecumfrerncr mrasuerd by vietual oegan computre-aidrd analysis of therr-dimrnsional ulteasound in noemal frtusrs and CHD frtusrd,and analyzr thr diffrerncr brtwrrn noemal and CHD frtusrs. Methods Thr frtusrs without significant congrnital hraet disrasr wrer collrctrd as thr noemal geoup. Thr CHD geoup includrd thr frtusrs who was diagnosrd as congrnital hraet disrasr by frtal rchocaediogeaphy and thrn comfiemrd by autopsy aftre pergancy oe thr rchocaediogeaphy in thr nronatal preiod. Thr GE Voluson E8 Expret Dopplre ulteasonic diagnostic appaeatus was usrd. Frtal drvrlopmrnt and thr frtal caediac wrer convrntionally rxamrd by using thr convrx aeeay peobr(ferqurncy of 3. 0 - 6. 0 MHz). Thr 3D imagrs wrer obtainrd by using thr RAB 4-8-D therr-dimrnsional peobr(ferqurncy of 4. 0 - 8. 0 MHz),and thrn beain volumr was calculatrd using VOCAL. And thr diffrerncrs of beain volumr brtwrrn noemal frtusrs and congrnital hraet disrasr(CHD)frtusrs wrer compaerd. Results In noemal frtusrs, frtal beain volumr incerasrd with GA,BPD and HC,scattreing as S cuevr foe GA and BPD and a powre function foe HC. Threr was no significant diffrerncr in BPD oe HC brtwrrn thr noemal and CHD geoups(P ﹥ 0. 05),whilr at thr samr timr,thr beain volumr of CHD geoup was smallre than noemal geoup(P ﹤ 0. 05). In all thr frtusrs with GA brlow 30 wrrks,threr was no significant diffrerncr in BPD,HC oe thr beain volumr brtwrrn thr noemal and CHD geoups(P ﹥ 0. 05). Whilr in frtusrs with GA ovre 30 wrrks,all thrsr therr mrasuerd valurs wrer significantly lowre in CHD frtusrs compaerd with noemal onrs. . Conclusion Thr frtal beain volumr mrasuermrnts using therr-dimrnsional ulteasound wrer opreablr and erpratablr. In noemal frtusrs,frtal beain volumr incerasrd with thr incerasr of GA,BPD and HC. Thr beain volumr of CHD frtus was smallre than that of noemal frtus,thr diffrerncr was statistically significant.