组织多普勒成像技术分析先天性膈疝胎儿心室舒张功能变化

Analysis of diastolic function of fetal heart with congenital diaphragmatic hernia with Doppler tissue imaging

目的运用组织多普勒成像(DTI)技术分析先天性膈疝(CDH)胎儿心室舒张功能变化。方法采用DTI技术记录22例先天性膈疝胎儿和151名正常胎儿心室心肌的最大运动速度,然后用脉冲多普勒技术记录心室流入道的血流速度峰值。计算舒张早期的最大血流速度(E)和最大心肌运动速度(Ea)之比(E/Ea)。结果经过孕周配比后,在舒张早期,与正常胎儿相比,CDH胎儿舒张早期Ea值明显降低,而心房的E值与心室心肌的Ea值之比(E/Ea)未见明显变化。结论CDH胎儿的心室舒张功能无明显改变;E/Ea可作为一个定量评价胎儿心室充盈压力的指标。

Objective To assess the value of Doppler tissue imaging （DTI） in evaluating diastolic function of fetal heart with congenital diaphragmatic hernia （CDH）. Methods A total of 22 fetuses with CDH and 151 normal fetuses were studied with DTI. Maximum velocity of ventricle myocardium was recorded, and then peak velocity of ventricular inflowing tract was assessed with pulsed-wave Doppler. Ratio of early diastolic peak velocity and maximum velocity of ventricle myocardium （E/Ea） was calculated. Results Early diastole Ea value of fetus with CDH decreased significantly than that of gestational age-matched normal fetus while E/Ea ratio did not change obviously. Conclusion Ventricle diastolic function of CDH fetus doesn＇t change obviously. E/Ea ratio can be used as a quantitative index for evaluating the filling pressure of the ventricles.