目的：探讨iSTIC技术在评价正常胎儿右心室容积及收缩功能方面的应用价值。方法：选择2014年10月—2015年9月我院行产前超声检查的正常单胎妊娠孕妇167例，应用iSTIC技术采集胎儿整个心动周期的容积数据，采集完成后存储于机器内置硬盘中，QLAB软件进行脱机分析。根据房室瓣的开闭定义心脏收缩末期、舒张末期两个时相，手动勾勒出两个时相胎儿右心室容积，记录右心室收缩末期容积（RESV）及舒张末期容积（REDV），计算出右心每搏输出量（RSV）、右心输出量（RCO）及右心射血分数（REF）。分析上述各项指标值随孕周（GA）的变化关系。随机抽取30例，由两名独立的观察者分别测量右心室容积进行观察者间的可重复性检验，同一观察者分别测量两次进行观察者内的可重复性检验。结果：167例胎儿，140例应用iSTIC技术采集图像清晰用于后期分析，采集成功率为83.8%，REDV从孕22周的（0.99±0.34） mL增加到35周+6的（3.70±0.35） mL；RESV从孕22周的（0.43±0.18） mL增加到35周+6的（1.37±0.21） mL；RSV从孕22周的（0.62±0.29） mL增加到35周+6的（2.32±0.19） mL；RCO从孕22周的（92.23±40.67） mL/min增加到35周+6的（337.21±29.02） mL/min；REDV、RESV、RSV、RCO随孕周的增长而增加，与孕周呈线性相关关系（P<0.001）。REF不随孕周的增长而变化，在整个孕期相对恒定，与孕周无明显相关性（P>0.05）。结论：应用iSTIC技术可以定量测量胎儿右心室容积，操作相对简单，重复性较好，iSTIC技术有望为临床评价胎儿心功能提供新方法。
Abstract
Objective: To investigate the value of intelligent spatiotemporal image correlation(iSTIC) in researching normal fetal right heart ventricular volume and systolic function. Methods: From October 2014 to September 2015 in our prenatal ultrasound examinations of normal pregnancy, 167 cases of pregnant women were included. The application of iSTIC technology was to acquire the whole fetal cardiac volume data and the QLAB software was for off-line analysis. We defined cardiac systolic and diastolic phase by atrioventricular valve open and following atrioventricular value closure. Two phases of volumetric data were measured by manual tracting and summation of multiple slices, recording the right ventricular end-systolic volume(RESV) and the right ventricular end-diastolic volume(REDV). These volumes were used to calculate the right stroke volume(RSV), the right cardiac output(RCO) and the right ejection fraction(REF). Analysis of the relationship between the above-mentioned index changing with the gestational age(GA). In 30 randomly selected cases the right ventricular volume were measured by the same sonographer twice and the intraobserver agreement measurements were calculated. Results: Among 167 cases of fetal, 140 cases of application of iSTIC technology acquisition images clarity for later analysis, the successful rate was 83.8%.The mean REDV increased from (0.99±0.34) at 22 weeks to (3.70±0.35) at 35 weeks+6; the mean RESV increased from (0.43±0.18) at 22 weeks to (1.37±0.21) at 35 weeks+6; the mean RSV increased from (0.62±0.29) at 22 weeks to (2.32±0.19) at 35 weeks+6; the mean RCO increased from (92.23±40.67) at 22 weeks to (337.21±29.02) at 35 weeks+6. REDV, RESV, RSV, RCO were increased with the gestational age, there are linear correlation with gestational age(P<0.001). REF had no obvious correlation with GA(P>0.05). Conclusion: Application of iSTIC technology can quantitatively measure the fetal right ventricular volume, relatively simple operation, and high repeatability. iSTIC technology is expected to provide a new method for clinical evaluation of the fetal cardiac function.
关键词
心室功能 /
右 /
胎儿 /
超声检查 /
产前
Key words
Ventricular function, right /
Fetus /
Ultrasonography, prenatal
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参考文献
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基金
辽宁省科技厅科学技术计划项目（2012225019）
