三维能量多普勒超声联合频谱多普勒超声对孕晚期胎儿生长受限的预测价值

Prediction Value of Three-dimensional Energy Doppler UltrasoundCombined with Spectral Doppler Ultrasound for Fetal GrowthRestriction in the Third Trimester

目的:探究三维能量多普勒超声联合频谱多普勒超声对孕晚期胎儿生长受限(FGR)的预测价值。方法:回顾性连续纳入2020年6月至2023年5月于本院进行产前检查并于分娩后确诊为FGR的孕晚期产妇46例,设为FGR组,按照1∶1的比例纳入同期的非FGR孕晚期产妇46例,设为非FGR组。比较两组孕妇临床资料、胎盘及新生儿指标。Cox比例风险模型分析超声参数与FGR发生之间的关系。采用受试者操作特征(ROC)曲线分析超声参数对FGR的预测效能。结果:FGR组新生儿体质量、胎盘血管化指数(VI)、血管化-血流指数(VFI)显著低于非FGR组,血管搏动指数(PI)、阻力指数(RI)和收缩期血流速度峰值/舒张期血流速度峰值(S/D)显著高于非FGR组(P<0.05)。随着VI、VFI水平的降低,S/D、PI、RI水平的升高,与FGR事件的关联效应也更强。ROC曲线分析结果显示,VI、VFI、S/D、PI、RI单独及联合检测诊断FGR均有预测价值,且联合预测价值最高。结论:三维能量多普勒超声联合频谱多普勒超声对孕晚期孕妇FGR的预测效果较好,临床应用价值较高。

Objective:To explore the predictive value of 3D energy Doppler ultrasound combined with spectral Doppler ultrasound for fetal growth restriction(FGR)in late pregnancy.Methods:A total of 46 women in the third trimester who underwent prenatal examination in our hospital and were diagnosed with FGR after delivery from June 2020 to May 2023 were retrospectively included as the FGR group,and 46 women in the third trimester who were not FGR during the same period were included as the non-FGR group in a 1∶1 ratio.The clinical data,placenta and newborn indexes were compared between the two groups.Cox proportional risk model was used to analyze the relationship between ultrasonic parameters and the occurrence of FGR.Receiver operator characteristics(ROC)curve was used to analyze the predictive efficiency of ultrasonic parameters to FGR.Results:Neonatal weight,placental vascularization index(VI)and vascularization blood flow index(VFI)of the FGR group were significantly lower than those of the non-FGR group. And pulse index (PI), resistance index (RI) and systolic peak blood flow velocity/diastolic peak blood flow velocity (S/D) were significantly higher than those in non-FGR group ( P <0.05). With the decrease of VI and VFI levels and the increase of S/D, PI and RI levels, the correlation effect with FGR events was stronger. ROC curve analysis results showed that VI, VFI, S/D, PI and RI had predictive value in the diagnosis of FGR alone and in combination, and the combined prediction value was the highest. Conclusion: Three-dimensional energy Doppler ultrasound combined with spectral Doppler ultrasound has a better prediction effect on FGR in pregnant women in the third trimester, and has high clinical application value.