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目的探讨三维超声时空关联成像-断层超声显像(STIC-TUI)技术对法洛四联症(TOF)胎儿心脏标准切面和重要解剖结构成像的应用价值。方法 150例胎儿经尸检、产后超声心动图及手术确诊为TOF,其中孕妇年龄24~38岁,平均年龄29.8岁;孕周20~36周,平均孕周31.9周。回顾性分析心脏容积数据,根据孕周分组。利用该技术结合五步分析法分析容积数据,获取标准切面并统计分析各切面和具有诊断价值的解剖征象的成像率。结果各切面总成像率由高到低依次为左心室流出道切面(97.33%)>四腔心切面(96.00%)>动脉导管弓切面(89.33%)>三血管切面(86.00%)。四腔心切面和左心室流出道切面均可观察室间隔缺损,左心室流出道切面上成像率达100%,高于四腔心切面(46%)。动脉导管弓切面和三血管切面均可观察肺动脉狭窄,其中三血管切面成像率为86.67%,高于动脉导管弓切面(82.00%)(χ~2=4.61,P<0.05)。86.67%例在三血管切面上观察到主动脉/肺动脉>1。主动脉骑跨征象总成像率97.33%。结论 STIC-TUI技术可对TOF胎儿心脏标准切面和解剖结构成像,为先天性心脏病产前超声诊断提供了技术支持。
Objective To explore the value of three-dimensional ultrasound-SPECT-TUI in the imaging of standard and important anatomical structures of tetralogy of Fallot (TOF). Methods 150 fetuses were diagnosed as TOF by autopsy, postpartum echocardiography and operation. The pregnant women were 24 to 38 years old with mean age of 29.8 years. The gestational age ranged from 20 to 36 weeks, with an average gestational age of 31.9 weeks. Cardiac volume data were retrospectively analyzed and grouped according to gestational age. Volumetric data were analyzed using this technique combined with five-step analysis to obtain standard sections and to statistically analyze the imaging rates of the various sections and anatomic features of diagnostic value. Results The total imaging rate of each section was descending order of left ventricular outflow tract (97.33%), four-chamber (96.00%), arteriotomy (89.33%), and three-vessel section (86.00%). Ventricular septal defect was observed in the four-chamber and left-ventricular outflow tract sections, and imaging rate was 100% in the left ventricular outflow tract section, which was higher than that in the four-chamber heart section (46%). Pulmonary arterial stenosis was observed on the section of the patent ductus arteriosus and the three-vessel section. The imaging rate of the three-vessel section was 86.67%, which was higher than that of the ductus arteriosus (82.00%) (χ ~ 2 = 4.61, P <0.05). Aortic / pulmonary arteries> 1 were observed on the three-vessel view in 86.67% of cases. Aortic cross-riding imaging total imaging rate of 97.33%. Conclusion The STIC-TUI technique can image TOF fetal heart sections and anatomical structures and provide technical support for prenatal ultrasound diagnosis of congenital heart disease.