本文選題：胎兒 + 先天性心臟病�。� 參考：《中南大學》2014年碩士論文

【摘要】：目的：應用三維超聲結合虛擬器官計算機輔助技術(virtual organ computer-aided analysis,VOCAL)對正常胎兒及患有先天性心臟病的胎兒的全腦容積進行測量。探討正常胎兒全腦容積與孕周、雙頂徑以及頭圍變化的關系,比較先心病胎兒與正常胎兒全腦容積間有無差異。 研究對象與方法：本研究采集2013年2月至2014年2月間在本院進行產(chǎn)前常規(guī)超聲檢測的孕婦共241例,其中正常胎兒組168例,孕齡20-36周,平均孕齡為27.76±4.5周；產(chǎn)前超聲診斷為先天性心臟病的胎兒73例,孕齡20-36周,平均孕齡為27.75±4.1周。采用GE Voluson Expert E8彩色多普勒超聲診斷儀,常規(guī)檢查胎兒整體生長發(fā)育情況及心臟情況后,使用三維容積探頭獲取胎兒顱腦的三維圖像使用VOCAL技術進行分析,計算胎兒全腦容積。分析胎兒全腦容積與胎兒孕周、雙頂徑及頭圍間的關系,將正常組與先心病組胎兒全腦容積進行比較。 結果：在正常胎兒組中,胎兒全腦容積隨孕周、雙頂徑、頭圍的增長而增長。胎兒全腦容積隨孕周及雙頂徑的增長符合S曲線,隨頭圍的增長符合冪函數(shù)。正常胎兒組與先心病胎兒組的頭圍及雙頂徑間的差異無統(tǒng)計學意義(P0.05)。但將其分為小于30周組及大于等于30周組后,結果顯示小于30孕周組胎兒中,先心病組與正常組相比頭圍及雙頂徑間的差異無統(tǒng)計學意義(P0.05)；而在大于等于30孕周組中,先心病組的頭圍及雙頂徑小于正常組,兩者間的差異具有統(tǒng)計學意義(P0.05)；先心病胎兒組的全腦容積小于正常胎兒組的全腦容積,兩者間的差異具有統(tǒng)計學意義,將兩組胎兒分別分為小于30孕周組與大于等于30孕周組后,小于30孕周組胎兒中,先心病組與正常組胎兒全腦容積間的差異無統(tǒng)計學意義(P0.05)；而在大于等于30孕周組中,先心病組的全腦容積小于正常組,兩者間的差異具有統(tǒng)計學意義(P0.05)。 結論： 1.三維超聲可應用于測量胎兒全腦容積,具有可操作性及可重復性。 2.正常胎兒三維全腦容積隨孕周、雙頂徑、頭圍的增長而增長。 3.先天性心臟病胎兒三維全腦容積較正常胎兒三維全腦容積減小,兩者間差異有統(tǒng)計學意義。
[Abstract]:Objective: to measure the global brain volume of normal fetus and fetus with congenital heart disease by using three-dimensional ultrasound and virtual organ computer aided technique (virtual organ computer-aided analysis Vacal). To explore the relationship between the whole brain volume of normal fetus and the changes of gestational week, biparietal diameter and head circumference, and to compare the difference between fetal whole brain volume of congenital heart disease and that of normal fetus. Subjects and methods: a total of 241 pregnant women with normal prenatal ultrasound were collected from February 2013 to February 2014 in our hospital. 168 normal fetuses were enrolled. The gestational age ranged from 20 to 36 weeks with an average gestational age of 27.76 鹵4.5 weeks. There were 73 cases of congenital heart disease diagnosed by prenatal ultrasound. The gestational age was 20-36 weeks, and the average gestational age was 27.75 鹵4.1 weeks. GE Voluson expert E8 color Doppler ultrasound was used to detect the whole fetal growth and development and the heart condition. The three-dimensional image of fetal brain was obtained by using three-dimensional volume probe and the volume of fetal whole brain was calculated by VOCAL technique. The relationship between fetal whole brain volume and fetal gestational week, biparietal diameter and head circumference was analyzed, and the fetal whole brain volume was compared between normal group and congenital heart disease group. Results: in normal fetal group, fetal whole brain volume increased with gestational week, biparietal diameter and head circumference. The increase of fetal whole brain volume with gestational week and biparietal diameter accords with S curve, and with the increase of head circumference, it accords with power function. There was no significant difference in head circumference and biparietal diameter between normal fetal group and congenital heart disease group (P0.05). The results showed that there was no significant difference in head circumference and biparietal diameter between the CHD group and the normal group (P0.05), but in the group greater than 30 weeks of gestation, there was no significant difference in the head circumference and biparietal diameter between the CHD group and the normal group (P0.05). The head circumference and biparietal diameter of congenital heart disease group were smaller than that of normal group, the difference between them was statistically significant (P0.05), the whole brain volume of congenital heart disease group was smaller than that of normal fetus group, and the difference between them was statistically significant. There was no significant difference in the fetal brain volume between the CHD group and the normal group after the two groups were divided into three groups: the gestational age group was less than 30 weeks and the gestational age group was greater than 30 gestational weeks group (P0.05), while in the group greater than 30 weeks of gestational age, there was no significant difference in the fetal brain volume between the heart disease group and the normal group (P0.05). The whole brain volume of CHD group was smaller than that of normal group, the difference between them was statistically significant (P0.05). Conclusion: 1. Three-dimensional ultrasound can be used to measure fetal whole brain volume, which is operable and repeatable. 2. 2. The three-dimensional global brain volume of normal fetus increased with the increase of gestational age, biparietal diameter and head circumference. The fetal global brain volume of congenital heart disease was significantly lower than that of normal fetus.
【學位授予單位】：中南大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R714.5;R445.1

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