本文關(guān)鍵詞： 彩色多普勒 法洛氏四聯(lián)癥 高分辨率血流顯像技術(shù)　出處：《中南大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 應(yīng)用HDF與傳統(tǒng)彩色多普勒分別在胎兒法洛氏四聯(lián)癥中室間隔缺損、主動(dòng)脈騎跨、肺動(dòng)脈狹窄處血流顯示情況,并通過兩者在血流顯示上差異性,提高對(duì)室間隔小缺損及法洛氏四聯(lián)癥的檢出率。 對(duì)象與方法： 采集2011年1月～2013年12月期間于瀏陽(yáng)市婦幼保健院的門診和住院孕婦近2.96萬(wàn)人次于行系統(tǒng)超聲檢查,室間隔缺損152例,其中最終確診法洛氏四聯(lián)癥者22例,孕26.3±3.5周(23～35周)。其中胎兒入選標(biāo)準(zhǔn)：可疑室間隔缺損并主動(dòng)脈騎跨患者。 采用飛利浦IU22和GE voluson E8彩色超聲診斷儀,常規(guī)系統(tǒng)檢查每例胎兒,測(cè)量胎兒雙頂、小腦橫徑,頭圍、腹圍、股骨、肱骨、胎盤及羊水等基本情況,估測(cè)胎兒體重；選用胎兒心臟模式,八步法排除常見的先天性心臟畸形如：?jiǎn)涡姆俊涡氖�、大�?dòng)脈轉(zhuǎn)位、永存動(dòng)脈干等。取樣容積置于室間隔缺損,聲束垂直于室間隔,調(diào)節(jié)至最佳頻譜狀態(tài),保存最佳圖像,記錄室間隔缺損大小,2-3.9mm定義為室間隔小缺損,≥4mm為大缺損。在提高室間隔缺損的檢出率基礎(chǔ)上,篩查主動(dòng)脈騎跨,監(jiān)測(cè)左右心室的血流同時(shí)進(jìn)入主動(dòng)脈內(nèi),進(jìn)而查看有無(wú)主肺動(dòng)脈狹窄及右心室肥厚。 結(jié)果： 1.在疑有室間隔缺損中,≥4mm的室間隔缺損,HDF及傳統(tǒng)彩色多普勒檢查陽(yáng)性率相近,無(wú)明顯統(tǒng)計(jì)學(xué)差異(P0.05)；2-3.9mm的室間隔缺損,HDF及傳統(tǒng)彩色多普勒檢查陽(yáng)性率有差別,HDF顯示血流更敏感,其差異有顯著性意義(P0.05)。 2.在疑有室間隔缺損中,4mm的室間隔缺損并主動(dòng)脈騎跨時(shí),HDF及傳統(tǒng)彩色多普勒檢查無(wú)明顯特異性(P0.05),2～3.9mm的室間隔缺損并主動(dòng)脈騎跨時(shí),HDF及傳統(tǒng)彩色多普勒檢查無(wú)明顯特異性(P0.05)。 3.比較傳統(tǒng)的四腔心切面與四個(gè)切面掃查(四腔心+左、右室流出道+三血管-氣管)、胎兒心臟系統(tǒng)八切面掃查,連續(xù)動(dòng)態(tài)掃查明顯提高法洛氏四聯(lián)癥的檢出率。 結(jié)論： 1.HDF作為一種無(wú)創(chuàng)、經(jīng)濟(jì)、便捷的檢查技術(shù)應(yīng)用于胎兒法洛氏四聯(lián)癥的檢查,可更敏感、更準(zhǔn)確地提高檢出率。 2.比較傳統(tǒng)的四腔心切面與四個(gè)切面掃查(四腔心+左、右室流出道+三血管-氣管)、胎兒心臟系統(tǒng)八切面,胎兒心臟系統(tǒng)八切面連續(xù)動(dòng)態(tài)掃查明顯提高法洛氏四聯(lián)癥的檢出率。
[Abstract]:Objective:. HDF and traditional color Doppler were used to display ventricular septal defect (VSD), aortic straddle and pulmonary artery stenosis in fetal tetralogy of Fallot, respectively. To improve the detection rate of ventricular septal defect and tetralogy of Fallot. Objects and methods:. From January 2011 to December 2013, nearly 29,600 pregnant women in Liuyang Maternal and Child Health Hospital were examined with systemic ultrasound and ventricular septal defect (VSD). Among them, 22 cases were diagnosed as tetralogy of Fallot. Gestation was 26.3 鹵3.5 weeks and 2335 weeks after pregnancy. Fetal inclusion criteria: suspected ventricular septal defect (VSD) with aortic straddle. Using Philips IU22 and GE voluson E8 color ultrasound diagnostic instrument, routine system was used to examine each fetus, to measure the fetal diapause, transverse diameter of cerebellum, head circumference, abdominal circumference, femur, humerus, placenta and amniotic fluid, and to estimate fetal weight. The fetal heart model was selected to exclude common congenital heart malformations such as single atrium, single ventricle, transposition of great artery, trunk of persistent artery, etc. The sampling volume was placed in ventricular septal defect, and the sound beam was perpendicular to the ventricular septum. The size of ventricular septal defect (VSD) was defined as small ventricular septal defect (VSD) and large ventricular septal defect (VSD). On the basis of improving the detection rate of VSD, aortic straddle was screened. The left and right ventricle flow into the aorta at the same time to see if there are pulmonary artery stenosis and right ventricular hypertrophy. Results:. 1. In the suspected ventricular septal defect, the positive rate of HDF in the ventricular septal defect 鈮，

本文編號(hào)：1501358