Grzyb A, Skrzypecki J, Koleśnik A, Niszczota C S
Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland.
Folia Morphol (Warsz). 2012 May;71(2):86-92.
Abnormal diameters of foetal vessels are common findings in congenital heart defects. However, it is difficult for pathologist to assess whether the diameters of the vessels are normal or not and to compare with echocardiographic data. The Z-score is a dimensionless quantity representing the distance between the raw score and population mean in standard deviation units. Using Z-score, we can compare single cases to average standards in the population.
To compare diameters of great arteries measured in specimens fixed in 10% formalin solution to normal values obtained on echocardiography using Z-scores.
The study was performed on 43 formalin-fixed normal foetal hearts aged from 19 to 40 weeks of gestation. Each specimen was dissected and the following diameters were measured: aortic valve (AoV), ascending aorta (AAo), descending aorta (DAo), aortic isthmus (AoI), ductus arteriosus (DA), pulmonary trunk valve (PV), and pulmonary arteries (RPA and LPA). Z-score parameters were calculated for all structures using the Foetal Echo Z-score Calculator.
Z-score values of all measured foetuses were mostly found to fit within the echocardiographic norms, although the most reliable results were obtained for foetuses aged 23 weeks. This group was represented by the highest number of specimens. The minimal and maximal Z-score values were, respectively: AoV -3.45, 1.4; AAo -4.24, -0.11; DAo -2.12, 1.29; PV -3.21, 0.69; RPA -3.4, 0.84; LPA -2.25, 0.31; AoI -1.97, 0.96; DA -3.56, -1.52.
The diameters of great arteries measured on autopsy are comparable to the results obtained from echocardiographic measurement. Z-score values for foetal echocardiography can be applied to post-mortem examination.
胎儿血管直径异常是先天性心脏缺陷的常见表现。然而，病理学家很难评估血管直径是否正常，也难以与超声心动图数据进行比较。Z分数是一个无量纲量，它表示原始分数与总体均值之间以标准差为单位的距离。使用Z分数，我们可以将单个病例与总体中的平均标准进行比较。
使用Z分数比较在10%福尔马林溶液中固定的标本中测量的大动脉直径与超声心动图获得的正常值。
对43例妊娠19至40周的福尔马林固定正常胎儿心脏进行研究。解剖每个标本并测量以下直径：主动脉瓣（AoV）、升主动脉（AAo）、降主动脉（DAo）、主动脉峡部（AoI）、动脉导管（DA）、肺动脉干瓣（PV）以及肺动脉（右肺动脉和左肺动脉）。使用胎儿超声心动图Z分数计算器为所有结构计算Z分数参数。
尽管23周龄胎儿获得的结果最可靠，且该组标本数量最多，但所有测量胎儿的Z分数值大多符合超声心动图标准。最小和最大Z分数值分别为：主动脉瓣-3.45，1.4；升主动脉-4.24，-0.11；降主动脉-2.12，1.29；肺动脉干瓣-3.21，0.69；右肺动脉-3.4，0.84；左肺动脉-2.25，0.31；主动脉峡部-1.97，0.96；动脉导管-3.56，-1.52。
尸检时测量的大动脉直径与超声心动图测量结果具有可比性。胎儿超声心动图的Z分数值可应用于尸检。
