Wu Ying, Liu Tao, Xiong Yi, Zang Ling
Department of Ultrasound, Shenzhen People's Hospital, Second Affiliated Hospital of Jinan University, Shenzhen, Guangdong 518020, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2008 Feb;30(1):75-9.
To explore the clinical application of real-time three-dimensional ultrasonography in the routine scanning of normal fetal heart.
A total of 110 volume datasets of normal fetal hearts in the second trimester were acquired by spatio-temporal image correlation (STIC). An off-line analysis of acquired volume datasets was performed to examine each segment of fetal heart with tomographic ultrasound imaging (TUI) and dynamic multi-planar mode (MP). The re-slice images of four-chamber view, ventricular outflow tract views, and the three vessels plane were viewed with TUI. The quality of images obtained from TUI was compared with the conventional 2D imaging mode. The volume datasets were displayed interactively with MP as a series of three-orthogonal planes. The dynamic loops of one cardiac cycle were preformed by navigating the pivot point and rotational axis and shifting each re-slice image plane inside the volume datasets.
Satisfactory gray-scale volume acquisitions were accomplished in 110 cases. The average STIC scanning time of fetal heart was (55 +/- 15) s. An offline analysis showed that four standard planes of 2D routine screening for fetal hearts were easily obtained by TUI. The quality of the images derived from volume datasets were comparable to that directly obtained from 2D echocardiography. The visualization rate had no significant difference between TUI and routine 2D screening (P > 0.05). In MP mode, 39 cases with the starting plan of apical four-chamber view were obtained. Each segment of fetal heart was almost visualized off line, both in a frozen state and with heart in motion to fulfill sequential segmental analysis in fetal cardiac anatomy. The 72% - 100% main features of atria, ventricles, aorta, and the junction segments were viewed with MP by adjusting the three dimensional volume datasets, whose quality and contents met the expectations of off-line segmental analysis of normal fetal heart. A sagittal section of ventricular septum was obtained in the offline analysis, which was an unconventional view in 2D echocardiography.
Real-time three-dimensional ultrasonography can be applied for off-line segmental analysis of normal fetal hearts in the second trimester.
探讨实时三维超声心动图在正常胎儿心脏常规扫查中的临床应用价值。
应用时空关联成像(STIC)技术采集110例孕中期正常胎儿心脏容积数据,对采集的容积数据进行脱机分析,采用断层超声显像(TUI)及动态多平面模式(MP)观察胎儿心脏各节段。应用TUI观察四腔心切面、心室流出道切面及三血管平面的重切片图像,并与传统二维成像模式比较图像质量。应用MP模式将容积数据以一系列相互垂直的平面交互式显示,通过调整容积数据中的旋转点、旋转轴及各重切片图像平面,获得一个心动周期的动态环。
110例均成功获得满意的灰阶容积数据,胎儿心脏平均STIC扫描时间为(55±15)s。脱机分析显示,应用TUI可清晰获得胎儿心脏二维常规扫查的四个标准切面,容积数据图像质量与二维超声心动图直接采集的图像相当,TUI与二维常规扫查的图像显示率差异无统计学意义(P>0.05)。MP模式下,以心尖四腔心切面为起始平面,共获得39例,可对胎儿心脏各节段进行几乎完全的脱机观察,包括心脏静止和运动状态,以完成胎儿心脏解剖结构的节段分析。通过调整三维容积数据,应用MP模式可观察到72%~100%的心房、心室、主动脉及连接节段的主要特征,其图像质量及内容符合正常胎儿心脏脱机节段分析的要求。脱机分析还可获得二维超声心动图难以显示的室间隔矢状切面。
实时三维超声心动图可应用于孕中期正常胎儿心脏的脱机节段分析。