本文選題：先天性心臟病 + 胎兒心臟��； 參考：《中南大學(xué)》2014年碩士論文

【摘要】：目的通過研究聯(lián)合利用STIC技術(shù)和OmniView技術(shù)在正常和異常胎兒心臟中的聲像特點(diǎn),探討STIC-OmniView技術(shù)在胎兒心臟產(chǎn)前檢查中的臨床應(yīng)用價(jià)值。 方法選擇孕周為20-40周的130例心臟正常胎兒和孕周為21-32周41例已行二維超聲心動(dòng)圖擬診為先天性心血管畸形的異常胎兒,應(yīng)用STIC技術(shù)采集心臟容積數(shù)據(jù),存盤后進(jìn)行脫機(jī)研究及分析,獲取心臟檢查所需的8個(gè)常規(guī)診斷切面,比較正常組胎兒心臟圖像質(zhì)量顯示滿意率的差異有無統(tǒng)計(jì)學(xué)差異,以及比較CHD胎兒STIC-OmniView技術(shù)診斷的結(jié)果與產(chǎn)前二維超聲、產(chǎn)后新生兒心動(dòng)圖或引產(chǎn)兒尸檢結(jié)果,評價(jià)STIC-OmniView技術(shù)在胎兒心臟產(chǎn)前篩查及先天性心臟病胎兒產(chǎn)前診斷的臨床價(jià)值。 結(jié)果正常組130例胎兒心臟超聲檢查均獲得滿意的容積數(shù)據(jù)。130例正常胎兒心臟通過STIC-OmniView技術(shù)獲得的四腔心、五腔心、右室流出道、左室流出道、三血管—?dú)夤堋⒅鲃?dòng)脈弓和導(dǎo)管動(dòng)脈弓切面圖像的顯示合格率與常規(guī)二維超聲檢查顯示相應(yīng)切面圖像合格率的差異均無統(tǒng)計(jì)學(xué)意義(x2=0.50,2.25,0.50,0.001,1.33,2.25,0.50,P0.05)；胃泡切面與常規(guī)二維超聲檢查顯示相應(yīng)切面圖像合格率比較差異有統(tǒng)計(jì)學(xué)意義(x2=12.00,P=0.0005),聯(lián)合使用二維超聲和STIC-OmniView技術(shù)顯示8個(gè)常規(guī)診斷切面的滿意率為100%。使用自由解剖平面技術(shù)對41例先天性心臟病胎兒容積數(shù)據(jù)進(jìn)行后處理,結(jié)果如下：38例樣本與產(chǎn)前二維超聲心動(dòng)圖及產(chǎn)后新生兒超聲心動(dòng)圖或尸檢結(jié)果相符,1例二維超聲診斷為主動(dòng)脈離斷,STIC-OmniView技術(shù)診斷為主動(dòng)脈弓縮窄,胎兒引產(chǎn)后病檢結(jié)果為主動(dòng)脈弓縮窄。1例二維超聲診斷為正常心臟胎兒,STIC-OmniView技術(shù)診斷為室間隔缺損,新生兒產(chǎn)后超聲心動(dòng)圖為室間隔缺損。1例二維超聲診斷為右室雙出口,STIC-OmniView技術(shù)診斷為完全性大動(dòng)脈轉(zhuǎn)位,胎兒引產(chǎn)后病檢結(jié)果為完全性大動(dòng)脈轉(zhuǎn)位。 結(jié)論STIC-OmniView技術(shù)能清晰顯示常規(guī)胎兒心臟檢查的標(biāo)準(zhǔn)切面,將其應(yīng)用于胎兒心臟的產(chǎn)前篩查是可行的,并有助于胎兒先天性心臟病的產(chǎn)前診斷研究,也有利于胎兒先天性心臟病的醫(yī)學(xué)教學(xué)和遠(yuǎn)程醫(yī)療。但目前STIC-OmniView技術(shù)只能作為二維超聲心動(dòng)圖的有力補(bǔ)充,無法取代。
[Abstract]:Objective to study the ultrasonographic characteristics of STIC and OmniView in normal and abnormal fetal heart, and to explore the clinical value of STIC-OmniView in prenatal examination of fetal heart. Methods 130 normal fetuses aged 20-40 weeks and 41 abnormal fetuses aged 21-32 weeks were selected. Cardiac volume data were collected by STIC technique. Off-line study and analysis were carried out after storage to obtain 8 routine diagnostic sections needed for cardiac examination, and to compare the difference of satisfactory rate of fetal heart image quality in normal group with or without statistical difference. The diagnostic results of CHD fetal STIC-OmniView were compared with the results of two dimensional prenatal echocardiography, postpartum cardiogram or fetal autopsy. The clinical value of STIC-OmniView technique in prenatal screening of fetal heart and fetal prenatal diagnosis of congenital heart disease was evaluated. Results satisfactory volume data were obtained in 130 cases of normal fetal heart by echocardiography. Four chamber heart, five chamber heart, right ventricular outflow tract, left ventricular outflow tract, three vessels trachea were obtained by STIC-OmniView technique in 130 normal fetal hearts. There was no statistical difference between the eligible rate of aortic arch and ductal arterial arch section image and that of conventional two-dimensional ultrasound examination. There was no significant difference between the two dimensional ultrasound examination and the corresponding section image was found by conventional two-dimensional ultrasound. There was no statistical significance between the two dimensional ultrasound examination and the corresponding cross section of gastric vesicle section was shown by conventional two-dimensional ultrasound examination and gastric alveolar section was not significantly different from that of conventional two-dimensional ultrasound examination on the sectional image of aortic arch and ductal arterial arch, and there was no statistically significant difference between conventional two-dimensional ultrasound and conventional two-dimensional ultrasound. The difference of image qualified rate was statistically significant. The satisfactory rate of using two-dimensional ultrasound and STIC-OmniView to display 8 conventional diagnostic sections was 100. 5%. The fetal volume data of 41 cases of congenital heart disease were postprocessed by the technique of free anatomical plane. Results the following 38 samples were consistent with the results of prenatal echocardiography and postpartum echocardiography or autopsy. One patient was diagnosed as aortic arch constriction by STIC-OmniView technique. After induced labor, 1 cases of aortic arch constriction were diagnosed as ventricular septal defect (VSD) by STIC-OmniView technique. Postpartum echocardiography showed ventricular septal defect (VSD) in 1 cases. STIC-OmniView technique was used to diagnose complete transposition of great arteries. Conclusion STIC-OmniView can clearly display the standard section of routine fetal heart examination, and it is feasible to apply it to prenatal screening of fetal heart, and it is helpful for prenatal diagnosis of fetal congenital heart disease. Also conducive to fetal congenital heart disease medical teaching and telemedicine. But at present, STIC-OmniView technique can only be used as a powerful supplement of two-dimensional echocardiography.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.1;R714.5

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