彩色多普勒电影环与传统频谱多普勒测量脐静脉最大流速和血流量的比较。

Gerada M, Struijk P C, Stewart P A, Guerriero S, Melis G B, Wladimiroff J W

Department of Obstetrics and Gynaecology, Erasmus Medical Centre, Rotterdam, The Netherlands.

Ultrasound Obstet Gynecol. 2006 Aug;28(2):156-61. doi: 10.1002/uog.2729.

OBJECTIVE

To compare the umbilical venous flow velocity derived from color Doppler cineloop recordings with that derived from conventional spectral Doppler in normal pregnancies.

METHOD

In 18 uncomplicated pregnancies between 19 and 39 weeks' gestation, color Doppler was used to find the maximum velocity in the cross-sectional vessel area of a free-floating loop of the umbilical vein. The maximum velocity was determined using the software tool HDI_Lab (Philips Medical Systems) after tracing the vessel area of interest. Conventional spectral Doppler was then used to determine the maximum velocity with the High-Q machine option. The cross-sectional area of the umbilical vein was determined using B-mode imaging and was subsequently used to determine the umbilical volume flow from both Doppler methods. Assuming a parabolic flow profile in the umbilical vein, the mean velocity is equal to half the maximum velocity. The fetal weight was estimated from fetal biometry using the four-parameter Hadlock formula.

RESULTS

Maximum velocity was significantly (P = 0.003) higher with color Doppler cineloop (14.3 +/- 2.5 cm/s) compared with spectral Doppler (12.7 +/- 3.2 cm/s). Therefore, using the same cross-sectional area for both methods, the umbilical blood flow was significantly higher (P = 0.001) with color Doppler cineloop (127.9 +/- 59.0 mL/min) than it was with spectral Doppler (112.8 +/- 54.1 mL/min). The umbilical blood flow expressed as volume flow per kg fetal weight was significantly (P = 0.01) higher with color Doppler cineloop (126.0 +/- 57.0 mL/min/kg) than it was with spectral Doppler (115.0 +/- 53.0 mL/min/kg).

CONCLUSIONS

Umbilical venous flow velocity derived from color Doppler cineloops is approximately 10% higher than that derived from spectral Doppler-derived velocity. The reduced angle dependence of the color Doppler cineloop technique and the large sampling area of the cross-sectional vessel should allow better determination of the correct maximum velocity in the umbilical vein.

目的

比较彩色多普勒电影环记录所得的脐静脉血流速度与正常妊娠中传统频谱多普勒所得的脐静脉血流速度。

方法

对18例妊娠19至39周的无并发症孕妇，使用彩色多普勒在脐静脉自由漂浮环的横截面积血管区域内寻找最大速度。在描绘感兴趣的血管区域后，使用软件工具HDI_Lab（飞利浦医疗系统）确定最大速度。然后使用传统频谱多普勒通过高Q机器选项确定最大速度。使用B超成像确定脐静脉的横截面积，随后用于通过两种多普勒方法确定脐血流量。假设脐静脉内血流呈抛物线分布，平均速度等于最大速度的一半。使用四参数哈德洛克公式通过胎儿生物测量法估计胎儿体重。

结果

彩色多普勒电影环测得的最大速度（14.3±2.5 cm/s）显著高于频谱多普勒（12.7±3.2 cm/s）（P = 0.003）。因此，两种方法使用相同的横截面积时，彩色多普勒电影环测得的脐血流量（127.9±59.0 mL/min）显著高于频谱多普勒（112.8±54.1 mL/min）（P = 0.001）。以每千克胎儿体重的血流量表示时，彩色多普勒电影环测得的脐血流量（12±57.0 mL/min/kg）显著高于频谱多普勒（115.0±53.0 mL/min/kg）（P = 0.01）。