胎儿房室瓣畸形的三维表面成像

Application of three-dimensional surface imaging in fetal atrioventricular valve malformations

目的应用三维表面成像观察胎儿房室瓣畸形的立体形态结构,分析其三维图像特征。方法分别获取58胎中晚孕期房室瓣畸形及97胎中晚孕期正常胎儿的心脏容积数据;房室瓣畸形胎儿中,完全型或部分型房室间隔缺损26胎,单心室共同房室瓣15胎,三尖瓣下移畸形2胎,瓣膜闭锁15胎。应用表面成像模式进行成像分析,对比观察房室瓣畸形及正常胎儿房室瓣的三维图像特征。结果①表面成像显示房室瓣畸形胎儿瓣环与正常胎儿相比存在明显不同。②表面成像模式可显示房室瓣畸形的立体形态,如完全型房室间隔缺损时,其共同房室瓣有5个瓣叶:前、后桥瓣,左、右壁瓣以及右前上瓣,开放时呈花瓣状。结论三维表面成像能够逼真显示胎儿房室瓣畸形时的立体形态和活动特征,弥补二维超声观察胎儿房室瓣视野不足的缺点。

Objective To observe the steric morphological constructions of fetal atrioventricular valve malformations with three-dimensional surface imaging, in order to analyze the features of three-dimensional imaging. Methods Heart volume datasets of 58 fetus with atrioventricular valve pathology and 97 normal fetus were acquired with spatio-temporal image correlation （STIC） in the second and third trimester. Complete atrioventricular septal defect （AVSD） or partial AVSD was found in 26 fetuses, single atrium and single ventricles in 15, Ebstein＇s anomaly in 2 and ventricle dysplasia in 15 fetuses. The volume datasets were evaluated, and the image characteristics were compared between normal and abnormal fetal atrio ventricular valve. Results Three-dimensional surface imaging showed obvious difference between normal and abnormal atrioventricular valve ring. Surface imaging demonstrated the three-dimensional spatial shape of abnormal atrioventricular valve. In fetuses of complete AVSD, the atrioventricular valve had five leaflets： Anterosuperior and posteroinferior bridg ing leaflets, amural leaflets, posterior and anterior leaflets, just like a flower. Conclusion Three-dimensional surface imaging can vividly display the morphology and activity characteristics of abnormal fetal atrioventricular valve, thus it can make up the inadequacy of the traditional ultrasound in observing atrioventricular valve malformations.