时间-空间相关成像联合组织多普勒技术评估妊娠期高血压状态下胎儿右心室功能

Evaluation of fetuses right ventricular function with spatiotemporal image correlation and tissue Doppler imaging in gestational hypertension condition

目的探讨时间-空间相关成像(STIC)技术联合组织多普勒技术(TDI)评价妊娠期高血压疾病状态下胎儿右心功能的临床价值。方法选取于我院接受超声心动图检查的75例妊娠期高血压孕妇(高血压组),根据高血压严重程度将其分为I亚组(40例)和Ⅱ亚组(35例),另选同期接受常规胎儿产检正常的50名孕妇作为对照组。以STIC采集2组胎儿心动周期图像,获取右室舒张期末容积(RVEDV)、右室收缩期末容积(RVESV),计算右室每搏心输出量(RVSV)、右室射血分数(RVEF)及右室心输出量(RVCO);采用TDI技术分别测量2组三尖瓣舒张早期峰值(Ea)、舒张晚期峰值(Aa)、收缩期峰值(Sa),并计算Ea/Aa值,比较2组的各参数。结果与对照组相比,高血压I亚组RVEDV、RVESV、RVSV、RVEF、RVCO及Sa值差异均无统计学意义(P均>0.05),而Ea、Aa、Ea/Aa值均减小(P均<0.05);高血压Ⅱ亚组较对照组RVEDV及RVESV增大,RVSV、RVEF、RVCO、Ea、Aa、Ea/Aa及Sa峰值均减小(P均<0.05)。结论STIC技术联合TDI可全面、客观评估妊娠期高血压疾病状态下胎儿右心室的收缩和舒张功能。

Objective To investigate the value of spatio-temporal image correlation(STIC)and tissue doppleri maging(TDI)in evaluating fetal right heart function in pregnancy induced hypertension syndrome(PIHS).Methods Seventy-five fetuses of pregnant women with PIHS(hypertensive group)were divided into I subgroup andⅡsubgroup according to the severity of hypertension,and 50 pregnant women with normal fetal examination were selected as control group.Images of fetal cardiac cycle in 2 groups were collected with STIC technique to obtain right ventricular end-diastolic volume(RVEDV)and right ventricular end-systolic volume(RVESV).Right ventricular stroke volume output(RVSV),right ventricular ejection fraction(RVEF)and right ventricular output(RVCO)were calculated.Tricuspid valve early diastolic peak(Ea),late diastolic peak(Aa)and systolic peak(Sa)were measured with TDI,and the Ea/Aa value was calculated.The parameters of two groups were compared.Results There were no significant differences in RVEDV,RVESV,RVSV,RVEF,RVCO and Sa between I subgroup and control group(all P>0.05),while the values of Ea,Aa and Ea/Aa were all decreased(All P<0.05),The RVEDV and RVESV inⅡsubgroup were higher than those in control group,while the RVSV,RVEF,RVCO,Ea,Aa,Ea/Aa and Sa were all decreased(all P<0.05).Conclusion STIC combined with TDI can comprehensively and objectively assess the systolic and diastolic function of fetal right ventricle in gestational hypertension.