三维容积超声结合彩色多普勒技术在正常胎儿主动脉弓和头臂血管发出检查中的应用

Application of Three-dimensional Sonography with Color Doppler in Detection of Normal Fetal Aortic Arch and Brachiocephalic Arteries

目的探讨二维及三维容积超声结合彩色多普勒技术在显示正常胎儿主动脉弓及头臂血管发出中的价值。方法随机选择2014年9月至2015年9月于中国医科大学附属盛京医院门诊进行常规产科超声检查的150例孕妇（150例正常胎儿）为研究对象。将胎儿按孕周分为19～22周、23～26周、27～30周、31～34周4组。胎儿矢状面连续超声检查,观察并计数主动脉弓及头臂血管;胎儿矢状面采集心脏三维容积数据,同时开启彩色多普勒功能。利用图像后处理软件对容积数据分析重建,获取胎儿主动脉弓及头臂血管的三维图像,观察并计数主动脉弓及头臂血管。比较两种方法显示主动脉弓及头臂血管情况。结果孕〈31周胎儿三维容积超声较二维超声能够显示更多的头臂血管;而孕≥31周胎儿二维超声明显优于三维容积超声。结论利用二维超声心动图对胎儿矢状面行连续超声检查可有效显示胎儿主动脉弓及头臂血管的发出。在孕周较小时,利用三维容积超声结合彩色多普勒技术可更好地显示胎儿主动脉弓及头臂血管的发出,且三维重建图像直观、立体,有助于理解心脏大血管的空间立体结构。

Objective To evaluate the clinical significance of traditional two-dimensional echocardiography and three-dimensional volume sonography combined with color doppler in the detection of normal fetal aortic arch and the brachiocephalic arteries. Methods A total of 150 normal fetuses were enrolled in the prospective study from September 2014 to September 2015 for routine obstetrical ultrasound.The fetuses were divided into four subgroups according to gestational weeks 19 to 22,23 to 26,27 to 30,and 31 to 34. Sagittal scans were used to detect aortic arch and its branches. three-dimensional volume datasets were acquired at the sagittal view when opening color doppler function. Three-dimensional volume post-analysis was performed to obtain the rendered images of aortic arch and the branches. The number of vessels were recorded by both two-dimensional and three-dimensional methods. Comparisons were made between these two methods in the visualization number of aortic arch and the brachiocephalic arteries. Results The three-dimensional modality was better than traditional two-dimensional method in visualization of more vessels before 31 gestational weeks,while the two-dimensional method did a better work in the late pregnancy. Conclusion It is possible and simple to identify fetal aortic arch and brachiocephalic arteries by sagittal scans with two-dimensional echocardiography. However,three-dimensional volume sonography combined with color doppler is better in displaying more vessels than two-dimensional method in early pregnancies. The beautiful three-dimensional images are helpful in understanding the spatial relationships of the great arteries for obstetric sonographers.