高分辨血流成像结合三维超声对胎儿主动脉弓及头臂动脉显示

Three-dimensional sonography combined with high definition flow imaging in the detection of normal fetal aortic arch and its branches

目的探讨高分辨血流成像（HD-flow）及三维容积超声结合HD-flow技术对正常胎儿主动脉弓及头臂动脉显示效果方法。方法前瞻性收集180例正常胎儿超声资料。常规横断面扫查除外各种胎儿先心病。矢状面扫查获取主动脉弓切面,开启HD-flow,检测主动脉弓及头臂血管的发出。在矢状面上采集胎儿心脏的三维容积数据,同时开启HD-flow功能,记录3D-HD法检测主动脉弓及头臂血管的数目。两种方法进行比较。结果所有胎儿分为17-20、21-24、25-28、29-32、33-36周5个时间段进行分析。在孕29周之前,3D-HD法是检出血管数目最多的一种方法 ,而在后两个时间段（即29周以后）其效果明显减低,而HD-flow法是最佳检查方法。结论结合HD-flow技术于矢状面连续扫查可有效显示胎儿主动脉弓及头臂动脉的发出,三维容积超声结合HD-flow技术可更加直观立体的显示心脏大动脉的走行、发出及空间关系,是传统二维法的有效补充。

Objective To assess the value of high-definition flow imaging （HD-flow） as well as three-dimensional （3D） sonography （US） combined with HD-flow technique （3D-HD） in the detection of normal fetal aortic arch and the brachiocephalic arteries. Methods Sagittal US scans with 3D-HD were performed on 180 normal fetuses to evaluate the aortic arch and its branches. The 3D volume data were post-processed to obtain the volume rendered images of the aortic arch and its branches. The number of the vessels recorded by the HD-flow and the 3D-HD methods were compared. Results 3D-HD modality was best for demonstrating more vessels before 29 gestational weeks, whereas HD-flow was the best modality in later gestation. Conclusion Fetal aortic arch and the brachiocephalic arteries are well visualized on sagittal US with HD-flow. 3D US combined with HD-flow technique can generate high-definition 3D images with improved visualization of the course, branching, and spatial relationships of the great arteries.