斑点追踪成像技术对胎儿圆锥动脉干畸形心功能的研究

Study on cardiac function of fetal trunk conus artery malformation by STI

目的:探讨斑点追踪成像技术对胎儿圆锥动脉干畸形心功能的相关性。方法:选择2018年5月—2021年7月胎儿圆锥动脉干畸形孕妇31例,均给予斑点追踪成像技术检查,出生后以新生儿超声心动图结果为依据,探讨斑点追踪成像技术在胎儿圆锥动脉干畸形心功能中的应用;记录并比较圆锥动脉干畸形胎儿与正常胎儿的心肌应变及应变率参数差异,并进行相关性分析。结果:胎儿圆锥动脉干畸形检出法洛四联症15例,右心室双出口10例,肺动脉瓣缺如6例,其中出生后新生儿超声心动图结果证实25例,4例病理解剖证实诊断,2例失访问;圆锥动脉干畸形胎儿左室整体长轴应变(LV-GLS)、右室整体长轴应变(RV-GLS)、收缩期应变率(GLSr)及舒张晚期应变率(GLAr)均低于正常胎儿,有统计意义(P<0.05);圆锥动脉干畸形胎儿RV-GLS参数低于LV-GLS参数(P<0.05);相关性分析结果显示:与左室舒张早期应变率(LV-GLEr)呈负相关性(P<0.05);与GLAr、RV-GLS、GLSr呈正相关性(P<0.05)。结论:斑点追踪成像技术在胎儿圆锥动脉干畸形的左、右心室收缩和舒张功能参数评估与心功能存在相关性。

Objective: To investigate the application of speckle tracing imaging in the cardiac function of fetal conus artery malformation. Methods: From May 2018 to July 2021, 31 pregnant women with fetal trunk conus artery malformation were enrolled. All were examined by speckle tracking imaging. The results of neonatal echocardiography were determined after birth. The myocardial strain and strain rate parameters of the conus trunk ma lformation fetus and the normal fetus were recorded and compared. Correlation analysis was conducted. Results: Tetralogy of Fallot(TOF) was detected in 15 cases of fetal trunk conus artery malformation. Right ventricular double outlet(DORV) was detected in 10 cases and pulmonary valve absence in 6 cases. Twenty-five cases were confirmed by postnatal echocardiography. The diagnosis was confirmed by pathological dissection in 4 cases, while 2 cases lost access. Global longitudinal strain of the left ventricle(LV-GLS). Global longitudinal strain of the right ventricle(RV-GLS), systolic strain rate(GLSr) and late diastolic strain rate(GLAr) were significantly lower than those of the normal fetus(P<0.05). RV-GLS was lower than LV-GLS(P<0.05). Correlation analysis results showed negative correlation with the left ventricular early diastolic strain rate(LV-GLEr)(P<0.05) and positive correlation with GLAr, RV-GLS and peak GLSr. Conclusion: Speckle tracing imaging was associated with cardiac function in the evaluation of systolic and diastolic function parameters of left and right ventricles in fetal conus artery malformation.