本文選題：時間-空間相關(guān)成像技術(shù)(STIC) + 胎兒心臟　； 參考：《浙江大學(xué)》2014年碩士論文

【摘要】：三維胎兒超聲心動圖(Fetal Echocardiography)是近幾年發(fā)展起來的一門新的超聲心動圖技術(shù),隨著彩色多普勒技術(shù)和圍產(chǎn)醫(yī)學(xué)的發(fā)展,以及胎兒期先天性心血管畸形介入治療技術(shù)的進步,這一影像技術(shù)在胎兒心臟形態(tài)結(jié)構(gòu)和左室收縮功能的產(chǎn)前診斷中發(fā)揮著愈來愈加重要的作用。本研究采用一種新的三維胎兒超聲心動圖技術(shù)時間-空間相關(guān)成像技術(shù)(STIC, spatiotemporal image correlation),主要對胎兒心臟形態(tài)結(jié)構(gòu)和左室收縮功能進行評估,并與二維常規(guī)胎兒超聲心動圖檢查進行比較。 資料與方法 一、研究對象 本研究中研究對象為26例孕婦,年齡23～35歲,平均(28±2.9)歲,孕齡16周～41周,平均(31±7.4)周。所有研究對象均符合以下條件：常規(guī)產(chǎn)科超聲檢查未見明顯異常,二維胎兒超聲心動圖檢查未見明顯的心血管畸形。 二、方法 使用GE Voluson730Expert型彩色多普勒超聲診斷儀,采用S3二維探頭(頻率2.5～3.5MHZ)和三維容積探頭(頻率3.5-5.0MHz)。應(yīng)用Fetal Echo軟件及四維處理軟件(4D View)。 對每一研究對象由同一操作者進行平均20～40min的胎兒心臟二維超聲掃查和10～20min的胎兒心臟、胸部三維超聲掃查,以獲得數(shù)據(jù)并存儲。 胎兒心臟形態(tài)結(jié)構(gòu)評估要求獲得心尖四腔心切面、左室流出道長軸切面或心尖五腔心切面、右室流出道長軸、三血管切面、主動脈弓長軸切面,觀察心腔大小、瓣膜形態(tài)結(jié)構(gòu)、室壁厚度、四個瓣口血流、動脈導(dǎo)管血流、主動脈和肺動脈起源、關(guān)系、內(nèi)徑、走行、主動脈弓血流、卵圓瓣活動。 胎兒心臟左室功能評估,二維胎兒超聲心動圖采用簡化Simpson法測定左室射血分?jǐn)?shù)(LVEF)值；STIC采用4D View工作站中的VOCAL II(容積計算)功能進行左室三維重建,獲得左室舒張末期容積(LVEDV)和收縮末期容積(LVESV),并根據(jù)公式LVEF=(LVEDV-LVESV)/LVEDV計算LVEF值 結(jié)果 一、共對26例孕婦進行了二維和三維胎兒超聲心動圖檢查各26次,皆一次性成功獲得滿意二維和三維四腔心切面的圖像。胎兒心臟形態(tài)結(jié)構(gòu)及心律均正常25例,胎兒心律不規(guī)則1例,均在正常范圍(120～180次／min)。 二、對26例胎兒通過STIC技術(shù)獲得的體積數(shù)據(jù)應(yīng)用4D View工作站進行進一步的三維處理,主要包括TUI(Tomographic Ultrasound Imaging,斷層超聲顯像)、Niche、Render(表面三維重建)、VOCAL II(容積計算),獲得比常規(guī)二維胎兒超聲心動圖檢查更多的切面及信息。 三、對22例胎兒進行了心臟左室收縮功能評估。簡化Simpson法測定左室舒張末期容積(LVEDV)平均(1.99±2.38)ml,左室收縮末期容積(LVESV)平均(0.62±0.48)ml；每搏量(SV)平均(1.37±2.00)ml,左室射血分?jǐn)?shù)(LVEF)平均(63.0±8.4)%; STIC的VOCAL II(容積計算)左室三維重建后,得LVEDV平均(1.90±1.21)ml,LVESV平均(0.71±0.41)ml；每搏量(SV)平均(1.20±0.87)ml,左室射血分?jǐn)?shù)(LVEF)平均(61.4±7.0)%。兩種測量方法EDV、ESV、SV、EF比較差異均無顯著性意義。 結(jié)論 STIC具有多種快速空間成像技術(shù)和三維重建功能,對胎兒心臟內(nèi)部結(jié)構(gòu)的觀察和分析更準(zhǔn)確仔細(xì),使胎兒超聲檢查受檢查者經(jīng)驗、胎兒胎位等因素影響較小,并顯著減少了檢查時間,更合理準(zhǔn)確地評估心室收縮功能,明顯優(yōu)于常規(guī)二維胎兒超聲心動圖技術(shù),其臨床應(yīng)用必然有助于胎兒產(chǎn)前診斷的確立和療效評價。
[Abstract]:Three-dimensional fetal echocardiography (Fetal Echocardiography) is a new echocardiographic technique developed in recent years. With the development of color Doppler and perinatal medicine and the advances in fetal congenital cardiovascular malformation, this imaging technique is in the form of fetal heart structure and left ventricular systolic function. In this study, a new three-dimensional fetal echocardiography (STIC, spatiotemporal image correlation) was used in this study to evaluate the fetal cardiac structure and left ventricular systolic function and to check with two-dimensional conventional fetal echocardiography. Compare.
Information and methods
First, the research object
In this study, the subjects were 26 pregnant women, aged 23~35 years, average (28 + 2.9) years of age and 16 weeks to 41 weeks of pregnancy, with an average of (31 + 7.4) weeks. All the subjects were in accordance with the following conditions: conventional obstetric ultrasound showed no obvious abnormalities, and two dimensional fetal echocardiography did not see obvious cardiovascular malformations.
Two, method
The GE Voluson730Expert color Doppler ultrasonic diagnostic instrument was used, the S3 two-dimensional probe (frequency 2.5 ~ 3.5MHZ) and the three-dimensional volume probe (frequency 3.5-5.0MHz) were used. The Fetal Echo software and the four dimensional processing software (4D View) were applied.
The fetal heart of 20 to 40min of the same operator was examined by the same operator for two dimensional ultrasound scan and 10 to 20min of the fetal heart. The three-dimensional ultrasound scan of the chest was used to obtain data and store.
The fetal heart morphological structure evaluation required the apical four cavities, the long axis of the left ventricular outflow tract or the five cavities of the apex, the long axis of the right ventricular outflow tract, the three vessels, the long axis of the aortic arch, the size of the heart cavity, the valve shape, the thickness of the ventricular wall, the blood flow of the four valves, the artery and the origin of the aorta and pulmonary artery. System, internal diameter, walking, aortic arch blood flow, oval valve activity.
Left ventricular function assessment, two-dimensional fetal echocardiography using simplified Simpson method to determine left ventricular ejection fraction (LVEF) value; STIC using VOCAL II (volume calculation) function in 4D View workstation to reconstruct left ventricle (LVEDV) and end systolic volume (LVESV) by the function of 4D View workstation, and according to formula LVEF= (LVEDV-LVESV) ) /LVEDV calculates the LVEF value
Result
A total of 26 pregnant women were examined 26 times by two-dimensional and three-dimensional fetal echocardiography. The images of satisfactory two-dimensional and three-dimensional four cavities were successfully obtained. 25 cases of fetal heart structure and rhythm were normal, and 1 cases of fetal arrhythmia were in normal range (120~180 times / min).
Two, the volume data obtained by STIC technology in 26 fetuses was applied to the 4D View workstation for further three-dimensional processing, including TUI (Tomographic Ultrasound Imaging, fault ultrasonography), Niche, Render (surface 3D reconstruction), VOCAL II (volume calculation), to obtain more sections than conventional two-dimensional fetal echocardiography. Information.
Three, the left ventricular systolic function was evaluated in 22 fetuses. The mean left ventricular end diastolic volume (LVEDV) was measured by the simplified Simpson method (1.99 + 2.38) ml, the mean left ventricular end systolic volume (LVESV) was (0.62 + 0.48) ml; the mean (SV) average (1.37 + 2) ml, the mean left ventricular ejection fraction (63 + 8.4)%, and STIC's VOCAL II (volume calculation) left ventricle After three-dimensional reconstruction, the average LVEDV (1.90 + 1.21) ml, LVESV average (0.71 + 0.41) ml, SV (1.20 + 0.87) ml, and left ventricular ejection fraction (LVEF) averaged (61.4 + 7)%. There were no significant differences in the two measurement methods EDV, ESV, SV, EF.
conclusion
STIC has a variety of rapid spatial imaging techniques and three-dimensional reconstruction functions. The observation and analysis of the internal structure of the fetal heart is more accurate and careful. The factors such as fetal ultrasound examination experience, fetal fetal position and other factors are less affected, and the examination time is reduced significantly, and the ventricular systolic function is more reasonable and accurate than the conventional two-dimensional fetus. The clinical application of echocardiography is bound to contribute to the establishment and evaluation of fetal prenatal diagnosis.

【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.1;R714.5

【共引文獻】

相關(guān)碩士學(xué)位論文 前1條

1 黃艷華;智能時間空間相關(guān)成像技術(shù)（iSTIC）及胎兒心臟導(dǎo)航（FHN）定量評價孕中晚期正常胎兒動脈導(dǎo)管內(nèi)徑的研究[D];浙江大學(xué);2014年

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本文編號：1789682