Chaoui R, Kalache K D, Hartung J
Department of Obstetrics and Gynecology, Charite Hospital CCM, Schumannstr. 20/12, D-10098, Berlin, Germany.
Ultrasound Obstet Gynecol. 2001 Jan;17(1):22-9. doi: 10.1046/j.1469-0705.2001.00305.x.
To assess the fetal cardiovascular system using three-dimensional power Doppler ultrasound (3D-PDU) in normal and abnormal conditions during the second half of gestation.
Forty-five normal fetuses and 87 selected pregnancies with different abnormalities involving the vascular system were examined.
The following regions of interest were assessed: placental, umbilical, abdominal, renal, pulmonary and intracranial vessels together with the heart and great arteries. Equipment used was a commercially available HDI-3000 and 5000 ultrasound system with integrated 3D-Color Power Angio software. Data acquisition was performed by the free-hand technique. Images were reconstructed online. In pathological cases, a maximum of three attempts of 3D reconstruction was allowed to obtain the information needed.
Satisfactory visualization of the fetal vascular system using 3D-PDU could be achieved in normal pregnancies. The main difficulty during the learning curve was the optimization of the power Doppler image prior to 3D data acquisition. Despite good visualization conditions, the reconstruction of satisfactory images was only possible in 56 out of the 87 (64%) pregnancies with abnormal vascular anatomy. These were abnormalities of placenta and umbilical vessels (n = 26), intra-abdominal and intrathoracic anomalies (n = 12), renal malformations (n = 9), central nervous system (n = 4) and cardiac defects (n = 5). The main reasons for the lack of information were fetal position and movements, overlapping with signals from neighboring vessels as well as technical limitations of the online system. Details and figures of the potential field of interest in prenatal diagnosis are presented.
运用三维能量多普勒超声（3D-PDU）评估妊娠晚期正常及异常情况下的胎儿心血管系统。
对45例正常胎儿以及87例选取的伴有不同血管系统异常的妊娠进行检查。
评估以下感兴趣区域：胎盘、脐、腹、肾、肺及颅内血管，以及心脏和大动脉。使用的设备是市售的配备集成三维彩色能量血管造影软件的HDI-3000和5000超声系统。采用徒手技术进行数据采集。图像在线重建。在病理情况下，最多允许进行三次三维重建尝试以获取所需信息。
在正常妊娠中使用3D-PDU可实现胎儿血管系统的满意可视化。学习曲线期间的主要困难是在三维数据采集之前优化能量多普勒图像。尽管可视化条件良好，但在87例血管解剖异常的妊娠中，只有56例（64%）能够重建出满意的图像。这些异常包括胎盘和脐血管异常（n = 26）、腹内和胸内异常（n = 12）、肾畸形（n = 9）、中枢神经系统异常（n = 4）和心脏缺陷（n = 5）。缺乏信息的主要原因是胎儿位置和活动、与相邻血管信号重叠以及在线系统的技术限制。展示了产前诊断中潜在感兴趣区域的详细信息和图像。
