二维斑点追踪成像联合组织多普勒成像对胎儿先天性心脏病的评估价值

Evaluation Value of Two-Dimensional Speckle Tracking Imaging Combined with Tissue Doppler Imaging in Fetal Congenital Heart Disease

目的探讨二维斑点追踪成像(2D-STI)联合组织多普勒成像(TDI)对胎儿先天性心脏病(CHD)的评估价值。方法收集2020年5月至2021年5月灵宝市第一人民医院确诊的40例胎儿存在CHD孕妇的临床资料,将其纳入CHD组,另收集同期经医院筛查的40例胎儿不存在CHD孕妇的临床资料,将其纳入非CHD组。所有孕妇均接受2D-STI及TDI联合检查。比较两组2D-STI[左室整体纵向应变(GLS)、平均左心室收缩期左心房峰值应变率(mSRs)、平均左心室舒张晚期左心房峰值应变值(mSRa)]及TDI[二尖瓣环运动Ea峰速度(Ea)、二尖瓣环运动Aa峰速(Aa)、心肌做功指数(Tei指数)、二尖瓣口血流舒张期E峰/A峰(E/A)]定量参数,并分析二者联合对胎儿CHD的评估价值。结果CHD组GLS、mSRs低于非CHD组(P<0.05),两组mSRa差异无统计学意义(P>0.05)。CHD组Ea、Aa低于非CHD组(P<0.05);两组Tei指数、E/A比较,差异无统计学意义(P>0.05)。受试者操作特征(ROC)曲线显示,GLS、mSRs、EA、SAa单独及联合检查对胎儿CHD评估价值曲线下面积(AUC)均>0.7,其中联合检测评估价值最高。结论2D-STI联合TDI在胎儿CHD的评估中具有一定应用价值。

Objective To investigate the evaluation value of two-dimensional speckle tracking imaging(2D-STI)combined with tissue Doppler imaging(TDI)in fetal congenital heart disease(CHD).Methods The clinical data of 40 pregnant women with CHD diagnosed in the First People’s Hospital of Lingbao from May 2020 to May 2021 were collected and included in the CHD group.The clinical data of 40 pregnant women without CHD who were screened by the hospital during the same period were collected and included in the non-CHD group.All pregnant women received 2D-STI and TDI combined examination.Comparison of 2D-STI[global longitudinal strain of left ventricle(GLS),mean peak left atrial strain rate in left ventricular systole(mSRs),mean peak left atrial strain in late diastole of left ventricle(mSRa)]and TDI[mitral valve]between the two groups.Quantitative Parameters.The evaluation value of the combination of the two in fetal CHD was analyzed.Results GLS and mSRs in CHD group were lower than those in non-CHD group(P<0.05).There was no significant difference in mSRa between the two groups(P>0.05).Ea and Aa in CHD group were lower than those in non-CHD group(P<0.05).There was no significant difference in Tei index and E/A between the two groups(P>0.05).The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of GLS,mSRs,EA,and SAa alone and in combination in evaluating fetal CHD were all>0.7,and the combined detection had the highest evaluation value.Conclusion 2D-STI combined with TDI has certain application value in the evaluation of fetal CHD.