应用智能时间-空间相关成像技术评估正常胎儿左心室容积的可行性和可重复性

Feasibility and reproducibility of intelligent spatiotemporal image correlation for evaluation of left ventricular volume in normal fetuses

目的探讨应用智能时间-空间相关成像（iSTIC）技术评估正常胎儿左心室容积的可行性和可重复性。方法对76名孕妇（共76胎）应用iSTIC技术行胎儿心脏实时三维成像检查,测量正常胎儿左心室舒张末期容积（EDV）和收缩末期容积（ESV）,计算左心室每搏输出量（SV）。各指标由2名观察者采用盲法分别进行测算,并由同一观察者在间隔2周后再次采用盲法进行测算。对观察者内及观察者间的可重复性进行统计学分析。结果同一观察者前后两次测量EDV的ICC为0.980（95%CI：0.969-0.988）,测量ESV的ICC为0.988（95%CI：0.981-0.992）,计算SV的的ICC为0.927（95%CI：0.887-0.953）。2名观察者间测量EDV的ICC为0.987（95%CI：0.980-0.992）,测量ESV的ICC为0.979（95%CI：0.967-0.987）,计算SV的ICC为0.948（95%CI：0.919-0.967）。Bland-Altman分析显示,观察者内及观察者间对SV的测值点均位于一致性界限之内。结论应用iSTIC技术可准确评估正常胎儿左心室容积,且简便可行、重复性较好。

Objective To explore the feasibility and reproducibility of intelligent spatiotemporal image correlation（iSTIC）technique for evaluation of left ventricular volume in normal fetuses.Methods A total of 76 pregnant women（76 fetuses）underwent fetal cardiac real-time three-dimensional acquisition using iSTIC technique.The left ventricular end-diastolic volume（EDV） and end-systolic volume（ESV） were measured and the stroke volume（SV） was calculated.All parameters were measured by two observers with blinded method independently.And the same observer repeated the measurements after two weeks.The statistical analysis was performed to evaluate the reproducibility of interobserver and intraobserver.Results For intraobserver analysis,the intraclass correlation coefficient（ICC） of EDV,ESV and SV was 0.980（95%CI0.969—0.988）,0.988（95%CI0.981—0.992） and 0.927（95%CI0.887—0.953）,respectively.For interobserver analysis,the ICC of EDV,ESV and SV was 0.987（95%CI 0.980—0.992）,0.979（95%CI0.967—0.987） and 0.948（95%CI0.919—0.967）.The Bland-Altman analysis showed all data points of stroke volume（SV） from intraobserver and interobserver consistency were located within the limits of consistency.Conclusion iSTIC technique is a simple and feasible modality for evaluation of fetal Left ventricular volumes in normal fetuses with good accuracy and reproducibility.