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目的探讨三维超声在胎儿肺容积生理测值中的应用价值,并评价其可行性、重复性。方法对402例孕20～32周正常胎儿肺脏行三维超声容积扫描,应用体积自动测量技术(virtual organ computer-aided analysis,VOCAL)分别测量胎儿左肺(LLV)、右肺(RLV)、总肺容积(TotFLV)。随机抽取45例,运用Bland-Altman分析评价操作者内及操作者间测值的一致性。结果胎儿LLV、RLV、TotFLV均与孕周呈正相关,相关系数分别为0.851,0.852,0.854(P均<0.001)。以孕周(GA)为自变量,三者预测值回归方程分别为:LLV=-13.041+0.481GA+0.019GA2,RLV=2.898-1.033GA+0.06GA2,TotFLV=-10.143-0.552GA+0.08GA2。重复性分析中,操作者内及操作者间于孕20～21周、26～27周、31～32周测值的偏倚及95%一致性界限均较小。结论三维超声VOCAL技术测量胎儿肺容积的可行性及可重复性较好。初步得到了402例孕20～32周正常胎儿肺容积的超声测值。
Objective To investigate the value of three-dimensional ultrasound in the measurement of fetal lung volume and to evaluate its feasibility and repeatability. Methods 402 cases of normal fetuses from 20 to 32 weeks of gestation were subjected to three-dimensional ultrasound volume scanning. The left lung (LLV), right lung (RLV), total lung Volume (TotFLV). Forty-five patients were randomly selected, and Bland-Altman analysis was used to evaluate the consistency of the measurements among the operators and between the operators. Results Fetal LLV, RLV, TotFLV were positively correlated with gestational age, the correlation coefficients were 0.851,0.852,0.854 (P <0.001). The gestational age (GA) as an independent variable, the regression equation of the three predicted values were: LLV = -13.041 + 0.481GA + 0.019GA2, RLV = 2.898-1.033GA + 0.06GA2, TotFLV = -10.143-0.552GA +0.08GA2 . In the repeatability analysis, the bias and the 95% agreement margin between the 20 to 21 weeks, the 26 to 27 weeks, the 31 to 32 weeks among the operators and the operators were small. Conclusion The feasibility and repeatability of three-dimensional ultrasonic VOCAL technique in measuring fetal lung volume are good. Obtained 402 cases of normal pregnancy 20 to 32 weeks of fetal lung ultrasound measurements.