Chang Chiung-Hsin, Yu Chen-Hsiang, Ko Huei-Chen, Chang Fong-Ming, Chen Hsi-Yao
Department of Obstetrics and Gynecology, National Cheng Kung University Medical College, Tainan, Taiwan.
Ultrasound Med Biol. 2003 Jul;29(7):943-9. doi: 10.1016/s0301-5629(03)00909-8.
Fetal liver blood flow is very important for fetal hemodynamics. To assess the development of fetal liver vascularization and blood flow in normal gestation, we measured the fetal liver vascularization and blood flow in normal fetuses using the three-dimensional (3-D) power Doppler ultrasound (US) and quantitative 3-D power Doppler histogram analysis. This study was undertaken with a prospective, cross-sectional design. In total, 196 normal singletons with gestational age between 20 and 40 weeks were included. The 3-D power Doppler US and the quantitative histogram analysis were used to assess the fetal liver vascularization index (VI), flow index (FI), vascularization-flow index (VFI) and mean greyness in each case. Our results showed that all the fetal liver VI, FI and VFI increased significantly with gestational age (GA), whereas, fetal liver mean greyness decreased with GA. Using GA as the independent variable, the linear regression equations for fetal liver VI, FI, VFI and mean greyness were VI = 0.5746 x GA - 5.8264 (r = 0.86, p < 0.0001), FI = 0.3291 x GA + 35.624 (r = 0.35, p < 0.001), VFI = 0.2905 x GA - 3.4871 (r = 0.82, p < 0.0001) and mean greyness = -0.2034 x GA + 42.315 (r = -0.20, p < 0.0001). In addition, fetal liver VI, FI, VFI and nean greyness were all significantly correlated with common fetal growth indexes, such as biparietal diameter, occipitofrontal diameter, head circumference, abdominal circumference, femur length and estimated fetal weight. Our study indicates that normal fetal liver vascularization and blood flow change significantly with the advancement of GA as well as fetal growth indexes. We believe our data may serve as a reference for further studies of fetal liver blood flow in abnormal conditions.
胎儿肝脏血流对胎儿血液动力学非常重要。为了评估正常妊娠中胎儿肝脏血管形成和血流的发育情况，我们使用三维（3-D）能量多普勒超声（US）和定量三维能量多普勒直方图分析，测量了正常胎儿的肝脏血管形成和血流情况。本研究采用前瞻性横断面设计。总共纳入了196例孕龄在20至40周之间的正常单胎妊娠。使用三维能量多普勒超声和定量直方图分析来评估每例胎儿的肝脏血管化指数（VI）、血流指数（FI）、血管化-血流指数（VFI）和平均灰度。我们的结果显示，所有胎儿肝脏的VI、FI和VFI均随孕周（GA）显著增加，而胎儿肝脏平均灰度随孕周下降。以GA作为自变量，胎儿肝脏VI、FI、VFI和平均灰度的线性回归方程分别为VI = 0.5746×GA - 5.8264（r = 0.86，p < 0.0001），FI = 0.3291×GA + 35.624（r = 0.35，p < 0.001），VFI = 0.2905×GA - 3.4871（r = 0.82，p < 0.0001）和平均灰度 = -0.2034×GA + 42.315（r = -0.20，p < 0.0001）。此外，胎儿肝脏的VI、FI、VFI和平均灰度均与常见的胎儿生长指标显著相关，如双顶径、枕额径、头围、腹围、股骨长度和估计胎儿体重。我们的研究表明，正常胎儿肝脏血管形成和血流会随着孕周的增加以及胎儿生长指标的变化而发生显著改变。我们相信我们的数据可为进一步研究异常情况下的胎儿肝脏血流提供参考。
