本文選題：三維超聲　切入點：MPR技術(shù)　出處：《泰山醫(yī)學院》2014年碩士論文

【摘要】：目的:為了提高檢查成功率,縮短檢查時間,進而為臨床診斷胎兒心臟發(fā)育異常提供依據(jù),本研究通過比較三維超聲和二維超聲對胎兒心臟標準切面的顯示率,分析探討三維超聲MPR技術(shù)在中孕期胎兒心臟檢查中的應用技巧和優(yōu)勢。材料與方法:1.研究對象:回顧性分析2011年10月至2013年12月在泰山醫(yī)學院附屬聊城市第二人民醫(yī)院建檔,并在超聲科行常規(guī)產(chǎn)前超聲檢查的正常單胎孕婦52例。2.儀器設備:應用西門子SC2000心臟超聲診斷儀,配置有二維成人心臟探頭4V1c、實時三維超聲成像技術(shù)及三維成像探頭4Z1c,頻率為1~3 MHz,并自帶三維容積數(shù)據(jù)分析軟件。3.檢查方法:入選病例仰臥于檢查床上,操作者運用SC2000心臟超聲診斷儀,選用4V1c探頭,調(diào)節(jié)相關(guān)參數(shù),顯示胎兒心臟7個標準切面。然后選用三維成像4Z1c探頭,首先在二維模式下調(diào)整清晰圖像,轉(zhuǎn)換為三維容積模式,調(diào)整各項參數(shù),分別顯示胎兒心臟不同的三個初始切面(標準心尖四腔心切面、大動脈短軸切面及主動脈弓長軸切面)。儲存三個切面所得到的三維容積數(shù)據(jù)。4.三維容積數(shù)據(jù)分組及數(shù)據(jù)分析:各個數(shù)據(jù)根據(jù)心臟不同的三個初始切面分為三組:A組:標準心尖四腔心組;B組:大動脈短軸組;C組:主動脈弓長軸組。應用西門子SC2000心臟超聲診斷儀所配備的三維超聲圖像工作站進行圖像處理,在多平面重建(MPR)模式下調(diào)整出三組原始參考平面,調(diào)整X、Y、Z三個空間坐標軸,顯示胎兒心臟7個標準切面,觀察分析標準切面圖像顯示的結(jié)構(gòu)。根據(jù)標準評價各個標準切面的圖像質(zhì)量:應顯示的解剖結(jié)構(gòu)顯示者為清晰,不能顯示應顯示的解剖結(jié)構(gòu)者為模糊。5.數(shù)據(jù)統(tǒng)計分析:應用SPSS 13.0統(tǒng)計學軟件進行統(tǒng)計分析。胎兒心臟各標準切面的顯示率采用R×C卡方檢驗分析,P0.05認為差異有統(tǒng)計學意義;當三組數(shù)據(jù)進行兩兩比較時,P0.017時差異具有統(tǒng)計學意義。結(jié)果:1.基本情況:52例正常單胎作為研究對象,胎兒心臟結(jié)構(gòu)和心律均正常。孕周20~24周,平均22.6±3.2周。孕婦年齡21~35歲,平均28.2±3.7歲。雙頂徑41~64mm,平均53±11.2mm。心胸比0.29~0.35,平均0.33±0.15。胎心率131~160次/分,平均147±18次/分。三維超聲共獲得113個容積數(shù)據(jù),A組42個(37.2%)、B組39個(34.5%)、C組32個(28.3%)。2.二維超聲和三維超聲對胎兒心臟切面的顯示率比較:二維超聲檢查對胎兒心臟7個標準切面的顯示率為75.5%(275/364),三維超聲檢查顯示率為85.6%(677/791)。兩組比較差異具有統(tǒng)計學意義(P0.05)。3.三組容積數(shù)據(jù)對心臟7個標準切面的顯示情況:A組對LAV-Ao A及LAV-DA顯示率較低,對其它切面顯示率高,總顯示率87.8%(258/294);B組對7個標準切面的顯示率均較高,總顯示率93.0%(254/273);C組對LAV-Ao A及LAV-DA顯示率較高,對其它切面顯示率較低,總顯示率73.7%(165/224)。C組與A、B組比較差異有統(tǒng)計學意義(P0.05)。LAV-Ao A與LAV-DA在C組中顯示率最高,分別為100%(32/32)及96.9%(31/32);A組中顯示率最低,分別為64.3%(27/42)及59.5%(25/42);B組中顯示率為87.2%(34/39)。三組顯示率差異具有統(tǒng)計學意義(PA-B-C0.017)。結(jié)論:三維超聲對胎兒心臟標準切面的顯示率明顯優(yōu)于二維超聲。以胎兒心臟不同的三個初始切面(4CV、SAV及LAV-Ao A)獲取的三維容積數(shù)據(jù)可影響其顯示胎兒心臟各標準切面的能力。因此,應該根據(jù)胎兒心臟不同的三個初始切面的容積數(shù)據(jù)綜合分析評價,以相互補充圖像信息。
[Abstract]:Objective: to improve the success rate, shorten the inspection time, and for the clinical diagnosis of fetal cardiac abnormalities provide the basis for this study by comparing the three-dimensional ultrasound and two-dimensional ultrasound for fetal heart rate display standard section, analysis of 3D ultrasound MPR technology in fetal heart screening skills and advantages. Materials and methods: 1. research subjects: a retrospective analysis from October 2011 to December 2013 in the second people's Hospital Affiliated to Taishan Medical University Liaocheng city building, and in the routine prenatal ultrasound examination of Department of ultrasound for normal singleton pregnant women in 52 cases of.2. equipment: application of SIEMENS SC2000 heart ultrasound diagnostic apparatus, equipped with two-dimensional adult cardiac probe 4V1c, real-time three-dimensional ultrasound imaging and 3D imaging the 4Z1c probe, the frequency is 1~3 and MHz, with 3D volume data analysis software.3. examination methods cases supine on the examination bed, The operator uses the SC2000 cardiac ultrasound diagnostic apparatus using 4V1c probe, adjust relevant parameters, display the fetal heart 7 standard sections. Then using 3D 4Z1c imaging probe, first adjust the clear image in the two-dimensional mode, converted to three-dimensional volume model, adjust the parameters, respectively, show three different initial planes of fetal heart (apical four chamberview, great artery short axis view and long axis view of aortic arch). The three-dimensional data storage.4. three-dimensional volume data packet and data analysis of the three section are: all data according to three different initial sections of heart were divided into three groups: group A: standard apical four chamber group; B group: arterial short axis group; group C: aortic arch axis group. Three dimensional ultrasound image workstation application SIEMENS SC2000 heart ultrasound diagnostic apparatus equipped with image processing, the multi planar reconstruction (MPR) mode adjustment three The original reference plane, X, Y, Z three space axes, display fetal heart 7 standard sections, observe and analyze the standard section image display structure. The image quality evaluation standard according to the standards of each section: anatomy should display is not clear, display should show the anatomical structure analysis for fuzzy.5. statistics: Using SPSS 13 statistical software for statistical analysis. The standard section shows the fetal heart rate was analyzed by chi square test of R * C, P0.05 believes that the difference was statistically significant; when the data of the three groups were compared at 22 P0.017, the difference was statistically significant. Results: 1. basic conditions: 52 normal singleton as the research object, structure and rhythm of fetal heart were normal. The gestational age of 20~24 weeks, average 22.6 + 3.2 weeks. Pregnant women aged 21~35 years old, average 28.2 + 3.7 years. Biparietal diameter 41~64mm, average 53 + 11.2mm. cardiothoracic ratio 0.29~0.35 ,騫沖潎0.33鹵0.15.鑳庡績鐜，

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