时间-空间关联成像联合高分辨率血流显像在胎儿先天性血管环诊断中的应用价值

Application value of spatio-temporal image correlation combined with high definition flow imaging in the diagnosis of fetal congenital vascular ring

目的探讨空间-时间关联成像(STIC)联合高分辨率血流显像(HDF)在胎儿先天性血管环诊断中的价值。方法对89例产前胎儿超声心动图检查诊断为先天性血管环胎儿分别进行HDF显像及STIC数据采集,并与产后超声心动图、CT血管三维重建(CTA)进行对照分析。结果89例胎儿先天性血管环中,完全性血管环58例,不完全性血管环31例;其中77例获得动态三维重建图像容积数据,12例未能取得完整容积数据。二维及彩色多普勒超声对主动脉弓及动脉导管弓相对气管位置异常显示率为100%,主动脉弓分支显示率为76.4%(68/89);HDF-STIC对主动脉弓及动脉导管弓相对气管位置异常显示率为100%,主动脉弓分支显示率为84.3%(75/89)。75例继续妊娠者产后经超声心动图或CTA证实,产前HDF-STIC诊断准确率为98.7%。结论HDF-STIC可提供常规超声心动图无法获得的空间结构信息,清晰显示主动脉弓分支并对其分型,提高胎儿先天性血管环诊断准确率。

Objective definition flow imaging(HDF)in the diagnosis of fetal congenital vascular ring.Methods were collected from 89 fetuses diagnosed as congenital vascular ring by prenatal echocardiography.The results were compared with those of postpartum echocardiography and CT three-dimensional vascular reconstruction(CTA).ResultsAmong 89 cases of fetal congenital vascular rings,58 cases were complete vascular rings and 31 cases were incomplete vascular rings.Among them,77 cases obtained dynamic 3D reconstruction image volume data,and 12 cases failed to obtain complete volume data.The visualization rate of abnormal position of aortic arch and ductal arch relative to trachea were 100%by two-dimensional and color Doppler imaging,the visualization rate of the branches of aortic arch was 76.4%(68/89).The visualization rate of abnormal position of aortic arch and ductus arteriosus was 100%by HDF-STIC,the visualization rate of the branches of aortic arch was84.3%(75/89).The accuracy of prenatal HDF-STIC diagnosis was 98.7%confirmed by postpartum echocardiography or CTA in75 patients with continued pregnancy.ConclusionHDF-STIC can provide spatial structure information that cannot be obtained by conventional echocardiography,clearly display and classify the branches of aortic arch,and improve the diagnostic accuracy of fetal congenital vascular ring.