时间-空间相关成像结合Vocal模式、M型超声模式对辅助生殖胎儿右心功能的评估作用

Assessment effect of spatio-temporal image correlation combined with Vocal mode and M-type ultrasound mode on right heart function in fetuses conceived by assisted reproductive technology

目的探讨时间-空间关联成像(STIC)结合Vocal模式、M型模式对辅助生殖技术(ART)受孕胎儿右心功能的评估作用。方法选择2015年1月至2021年5月于赣州市人民医院超声科进行产前超声检查的孕22^(+0)周至26^(+5)周的ART单胎儿51例,自然受孕胎儿(SP)59例,运用多普勒及STICVocal、STIC-M测得三尖瓣E峰、A峰、E/A值、右心室舒张末期容积(RVEDV),右心室收缩末期容积(RVESV),右心室每搏输出量(RVSV),右心室射血分数(RVEF),三尖瓣环位移(TAPSE),并进行重复性检验,比较两组差异及分析ART心功能与孕周、体重的关系。结果ART胎儿RVSV、RVEF、TAPSE明显低于SP胎儿(P<0.05),而RVEDV、RVESV、三尖瓣E峰、A峰、E/A值两者之间无明显差异(P>0.05)。ART胎儿RVEDV、RVSV、TAPSE与孕周具有相关性(P<0.05),RVEDV、RVSV与体重具有相关性(P<0.05),SP胎儿RVEF、TAPSE与孕周具有相关性(P<0.05),呈正相关。STIC Vocal模式、M型模式下RVEDV、RVESV、TAPSE均具有较高的重复性(P<0.05),且TPASE更为显著。结论STIC技术联合Vocal模式、M超模式可客观的反映ART胎儿右心功能的情况(尤其是TAPSE),可靠、重复性强,可作为评估ART胎儿右心功能的新方法,为临床早期发现ART胎儿右心功能异常提供依据。

Objective To discuss the assessment effect of patio-temporal image correlation(STIC)combined with Vocal mode(STIC-Vocal mode)and M-type ultrasound mode(STIC-M mode)on right heart function in fetuses conceived by assisted reproductive technology(ART).Methods ART fetuses(ART group,n=51)conceived from 22^(+0) weeks to 26^(+5) weeks and fetuses of spontaneous pregnancy(SP group,n=59)with prenatal ultrasonographic examination were chosen from Department of Ultrasound in People’s Hospital of Ganzhou City from Jan.2015 to May 2021.The indexes of tricuspid peak E,peak A and ratio of peak E to peak A(E/A),right ventricular enddiastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),right ventricular stroke volume(RVSV),right ventricular ejection fraction(RVEF)and tricuspid annulus plane systolic excursion(TAPSE)were detected by using color Doppler echocardiogram,STIC-Vocal mode and STIC-M mode.A repeatability test was conducted,and differences were compared between 2 groups.The relationship among heart function of ART fetuses,gestational weeks and body weight was analyzed.Results The indexes of RVSV,RVEF and TAPSE were significantly lower(P<0.05)in ART group than those in SP group,and RVEDV,RVESV,and tricuspid peak E,peak A and E/A had no significant differences(P>0.05)between 2 groups.RVEDV,RVSV and TAPSE were correlated to gestational weeks(P<0.05)and RVEDV and RVSV were correlated to body weight(P<0.05)in ART group,and RVEF and APSE were correlated to gestational weeks in SP group(P<0.05).RVEDV,RVESV and TAPSE had higher repeatability in STIC-Vocal mode and STIC-M mode(P<0.05),and TPASE repeatability was more significant.Conclusion STICVocal mode and STIC-M mode can objectively reflect the right heart function(especially TAPSE)in ART fetuses and they are reliable with a higher repeatability,and they can be used as a new method to review right heart function in ART fetuses and provide evidence for early clinical detection of abnormal right heart function.