微血管血流联合LumiFlow成像技术获取早中孕期胎儿心脏标准切面中的应用

Application of Micro-Blood-Flow Combined with LumiFlow Imaging Technology in Obtaining the Standard Views of Fetal Heart in Early and Second Trimester

目的探讨微血管血流(MV-Flow)联合LumiFlow成像技术在获取11~17^(+6)周胎儿心脏标准切面中的应用价值。资料与方法回顾性收集2022年7月-2023年8月在解放军总医院第一医学中心接受胎儿超声心动图检查的正常早中孕期孕妇63例,行胎儿超声心动图彩色多普勒血流显像(CDFI)及MV-Flow联合LumiFlow检查,分别获取国际妇产科超声学会推荐的8个诊断切面,对不同模式下各标准切面图的血流要素进行评分,比较CDFI及MV-Flow联合LumiFlow在各诊断切面的显示成功率及评分。结果63例孕妇共进行66次胎儿超声心动图检查,MV-Flow联合LumiFlow在上腹横切面、四腔心切面、主动脉弓切面显示成功率分别为98.48%、98.48%、96.97%,高于CDFI(χ^(2)=5.143、8.100、6.125,P<0.05),在三血管气管切面和左心室流出道切面显示成功率分别为39.40%和43.94%,显著低于CDFI(χ^(2)=13.885、7.579,P<0.05)。MV-Flow联合LumiFlow及CDFI两者在动脉导管弓切面、上下腔静脉长轴切面及所有切面总体评分差异无统计学意义(Z/t=-1.56、-1.77、-0.41,P>0.05);在上腹横切面、四腔心切面及主弓脉弓切面,MV-Flow联合LumiFlow评分显著高于传统CDFI(t=-5.14、-6.08、-6.63,P<0.001),左、右心室流出道切面及三血管气管切面CDFI评分显著高于MV-Flow联合LumiFlow(Z=-4.00、-2.93、-4.61,P<0.05)。结论MV-Flow联合LumiFlow在上腹横切面、四腔心切面与主弓脉弓切面的显示较CDFI更具优势,可以作为早期胎心筛查中血流显像技术的有效补充。

Purpose To explore the application value of micro-blood flow imaging(MV-Flow)combined with LumiFlow in obtaining the standard views of fetal heart at 11-17^(+6) weeks.Materials and Methods A total of 63 normal pregnant women in first and second trimesters who underwent fetal echocardiography in the PLA General Hospital from July 2022 to August 2023 were retrospectively examined by color Doppler flow imaging(CDFI)and MV-Flow combined with LumiFlow to obtain 8 diagnostic views recommended by the International Society of Ultrasound in Obstetrics and Gynecology,and researchers A and B scored diagnostic elements displayed in each section of different modes.The mean value of each diagnostic section element score was calculated to analyze the success rate of all diagnostic sections from the two different pattern diagrams,and to compare the success rate and scores of the two different modes,respectively.Results A total of 63 pregnant women were examined by fetal echocardiography for 66 times,and the success rates of MV-Flow combined with LumiFlow in upper abdomen view,four chamber view and aortic arch view respectively were 98.48%,98.48%and 96.97%,which was significantly higher than those of CDFI(χ^(2)=5.143,8.100,6.125,P<0.05),and the success rates of three-vessel trachea view and left ventricular outflow tract view were 39.40%and 43.94%,which were significantly lower than those of CDFI(χ^(2)=13.885,7.579,P<0.05).There was no difference between MV-Flow combined with LumiFlow and CDFI in the overall score of ductal arch view,vena cave view and all sections(Z/t=-1.56,-1.77,-04.1,P>0.05).The scores of MV-Flow combined with LumiFlow were significantly higher than those of CDFI in upper abdomen view,four chamber view and aortic arch view(t=-5.14,-6.08,-6.63,P<0.001),and were significantly lower than those of CDFI in left and right ventricular outflow tract view and three-vessel trachea view(Z=-4.61,-2.93,-4.06,P<0.001).Conclusion MV-Flow combined with LumiFlow has more advantages than CDFI only in the display of upper abdomen view,four chamber view and aortic arch view,which can be used as an effective supplement to blood flow imaging technology in early fetal heart screening.