心肌超声速度向量成像技术对法洛四联症胎儿右心功能的初步研究

A preliminary study on the right heart function of fetal tetralogy of Fallot by ultrasonic velocity vector imaging technology

目的:应用速度向量成像(VVI)技术评价法洛四联症(TOF)胎儿右心室整体及局部心肌功能。方法:选取2010年8月至2015年11月,在我院产前行胎儿超声心动图检查并诊断为TOF的胎儿24例,平均孕周(24.9±2.7)周。应用常规超声参数三尖瓣环收缩期位移(TAPSE)、右心室面积变化分数(RVFAC)测量右心室整体功能,应用VVI技术测量右心室纵向整体及节段心肌(右心室侧壁基底段、中间段、心尖段及室间隔侧基底段、中间段、心尖段)的收缩期峰值应变(S)及应变率(SR),结果与同孕周的48例正常胎儿进行比较。结果:TOF胎儿组TAPSE、RVFAC与正常胎儿组比较无明显变化,差异无统计学意义(P均>0.05);TOF组胎儿右心室壁整体及节段心肌应变及应变率较正常对照组均明显减低,差异有统计学意义(P均<0.05)。结论:TOF患儿右心功能在胎儿期即出现明显减低。VVI技术可定量评价TOF胎儿右心室整体及局部心肌功能。

Objective： To evaluate the right ventricular function of fetus with tetralogy of Fallot（ TOF）by velocity vector imaging（ VVI）. Methods： Twenty-four fetus with TOF were recruited in the study,mean gestational age was（ 24. 9 ± 2. 7） week. The conventional parameters,such as tricuspid annular plane systolic excursion（ TAPSE） and right ventricular fractional area change（ RVFAC） were measured. The global and segmental longitudinal strain（ S） and strain rate（ SR） of right ventricular free wall and ventricular septum were traced and analyzed by VVI. The result were compared with 48 normal fetus of the same gestational age. Results： TAPSE and RVFAC had no significant changes in TOF fetus compared with normal fetus. But the strain and strain rate of the right ventricular myocardium in TOF group were significantly lower than those in the normal control group（ all P〈0. 05）. Conclusion： The right ventricular function of TOF decreased significantly in the fetal period. VVI technology can be used as an indicator of quantitative evaluation of cardiac function for such patients.