目的：探讨iSTIC技术评估正常胎儿左心室室壁体积的可行性。方法：对124例孕20～36 w正常胎儿进行超声心动图检查，应用Phillips iU22G4超声诊断仪采集实时三维图像，采用QLAB软件Stacked contours方法，脱机手动描记测量左心室舒张末期左心室整体体积和左心室容积数据，左心室整体体积减去左心室容积就得到舒张末期左心室室壁体积数据，应用相关与回归方法分析左心室室壁体积数据与孕周的关系，并采用组内相关系数（Intraclass correlation coefficient，ICC）分析观察者内和观察者间的一致性。结果：去除图像质量较差的16例，共有108例正常单胎胎儿纳入分析，胎儿左心室室壁体积数值与孕周之间有明显曲线相关关系（P<0.05），随孕周增长而增加。ICC评价观察者内的和观察者间的重复性均较好（观察者内的ICC为0.978，95%可信区间0.947～0.991，观察者间的ICC为0.927，95%可信区间0.825～0.970）。结论：iSTIC技术能够准确地评估正常胎儿的左心室室壁体积，方法简单可行、重复性较好，成为评估胎儿心脏发育的一种新方法。
Abstract
Objective: To explore the feasibility of iSTIC in evaluation of left ventricular wall volumes in normal fetuses. Methods: Real Time three-dimensional echocardiography were performed in 124 normal fetuses from 20 to 36 weeks gestation with Phillips iU22G4 ultrasonic diagnostic instrument. The images were analyzed by QLAB software with Stacked contours method for measuring left ventricular end-diastolic interior volume and peripheral volume. The different value between interior volume and peripheral volume was the left ventricular wall volume. The correlation between fetal left ventricular wall volume and gestational age was analyzed. The intraclass correlation coefficient(ICC) was used to evaluate the agreement of inter-observer and intra-observer. Results: The iSTIC volumes of 16 fetuses were excluded from the study because of the poor image quality. There was a significant correlation between left ventricular wall volume and gestational age(P<0.05). The reproducibility of intra-observer and inter-observer evaluated by ICC were better(ICC of intraobserver was 0.978, 95% CI: 0.947~0.991, ICC of interobserver was 0.927, 95% CI: 0.825~0.970). Conclusion: The iSTIC technique is a simple and feasible modality to determine the fetal left ventricular wall volumes in normal fetuses. This method may become a new way for evaluating fetal heart development.
关键词
心室 /
超声检查 /
多普勒 /
彩色 /
超声检查 /
产前
Key words
Heart ventricles /
Ultrasonography, Doppler, color /
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）。
