三维超声时间-空间关联成像联合定向能量多普勒技术在胎儿肺静脉异位引流产前超声诊断中的研究

Study on the application of 3D ultrasound STIC combined with HD-Flow technique in prenatal ultrasound diagnosis of fetal APVC

目的:探讨三维超声时间-空间关联成像(STIC)联合定向能量多普勒(HD-Flow)技术在胎儿肺静脉异位引流(APVC)产前超声诊断中的应用价值。方法:选取医院收治的120例APVC孕妇,均行二维彩超及STIC联合HD-Flow技术两种检查,并对重点切面进行实时三维数据采集,比较5年以下及10年以上不同工作经验超声医生两种检查方法对胎儿肺部各静脉的诊断显示率,以及对APVC肺静脉连接显示的准确性。结果:有5年以下及10年以上不同经验的超声医师采用二维彩超技术以及STIC联合HD-Flow技术,对胎儿左上肺静脉及右上肺静脉的显示率均为100%;而有5年以下经验超声医师采用二维彩超技术对左下静脉和右下静脉的显示率均低于有10年以上经验超声医师,差异有统计学意义(x^(2)=8.620、x^(2)=7.624;P<0.05);但STIC联合HD-Flow技术下,不同工作年限医生对胎儿肺部各静脉的诊断显示率差异无统计学意义(x^(2)=2.626,x^(2)=1.520;P>0.05)。STIC联合HD-Flow检查对所有肺静脉连接的正确显示好于二维超声检查,差异有统计学意义(x^(2)=37.029,P<0.05)。结论:STIC联合HD-Flow技术对APVC有较高的诊断准确性,且对操作者技术的依赖性较低。

Objective:To investigate the application value of three-dimensional(3D)ultrasound spatio-temporal image correlation(STIC)combined with high definition flow(HD-Flow)in prenatal ultrasound diagnosis of fetal anomalous pulmonary vein connection(APVC).Methods:A total of 120 pregnant women with APVC admitted to hospital were selected,and all of them underwent two-dimensional(2D)color ultrasound and STIC combined with HD-flow technique.Real-time 3D data were collected on key sections.The display rates of diagnosis of two kinds of examination methods of physicians with work experiences under 5 years and who with work experiences above 10years were compared on each vein of fetal pulmonary.And the accuracies of them on the display of the connection of APVC pulmonary vein were also compared.Results:The display rates of physicians with experience under 5 years and physicians with experience above 10 years used 2D color ultrasound technique and STIC combined with HD-Flow technique were 100%on the fetal upper left pulmonary vein and upper right pulmonary vein,respectively.For lower left vein and lower right vein,the display rates of physicians with experience under 5 years used 2D color ultrasound were significantly lower than those of physicians with experience above 10 years used that(x^(2)=8.620,x^(2)=7.624,P0.05).The accurate display of STIC combined with HD-Flow examination was significantly better than that of 2D ultrasound examination on the connections of all pulmonary veins(x^(2)=37.029,P<0.05).Conclusion:STIC combined with HD-Flow technique has higher diagnostic accuracy for APVC,and it has less dependency on the technique of operator.