Department of Ultrasound, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Rd, 210002 Nanjing, Jiangsu, China.
J Ultrasound Med. 2014 Feb;33(2):349-54. doi: 10.7863/ultra.33.2.349.
Fetal cardiac examination is an important part of fetal malformation screening. The purposes of this study were to describe the left ventricular (LV) mass in the second and third trimesters by 2-dimensional echocardiography using area-length calculation methods and to examine the clinical usefulness of this procedure in evaluation of gestational age (GA)- and fetal weight-related LV mass changes.
Five hundred healthy fetuses were divided into 2 groups (250 participants per group): second- and third-trimester groups. The estimated fetal weight (EFW) was computed according to the Hadlock formula (Radiology 1984; 150:535-540). The LV mass at end diastole (LVd mass) and LV mass at end systole (LVs mass) were measured, and the difference between the LVd mass and LVs mass [LV(d-s) mass], LVd mass/EFW ratio, and LVs mass/EFW ratio were calculated.
The EFW, LVd mass, LVs mass, and LV(d-s) mass were all significantly greater in the third-trimester group than the second-trimester group (P < .05), whereas the LVd mass/EFW and LVs mass/EFW ratios did not differ between the groups (P > .05). The LVd mass, LVs mass, and LV(d-s) mass all significantly correlated with GA and weight (P< .001), but the LVd mass/EFW and LVs mass/EFW ratios did not (P > .05).
Two-dimensional echocardiography using area-length calculation methods can effectively provide measurements for LV mass and can sensitively indicate fetal weight- and GA -related changes in LV mass. Fetal cardiac mass measurement is a useful parameter for evaluation of fetal heart development.
胎儿心脏检查是胎儿畸形筛查的重要组成部分。本研究的目的是通过二维超声心动图的面积-长度计算方法描述第二和第三孕期的左心室(LV)质量,并检查该方法在评估与胎龄(GA)和胎儿体重相关的 LV 质量变化方面的临床应用价值。
将 500 例健康胎儿分为 2 组(每组 250 例):第二和第三孕期组。根据 Hadlock 公式(Radiology 1984;150:535-540)计算估计胎儿体重(EFW)。测量舒张末期左心室质量(LVd mass)和收缩末期左心室质量(LVs mass),并计算 LVd mass 和 LVs mass 之间的差值[LV(d-s) mass]、LVd mass/EFW 比值和 LVs mass/EFW 比值。
第三孕期组的 EFW、LVd mass、LVs mass 和 LV(d-s) mass 均明显大于第二孕期组(P<.05),而 LVd mass/EFW 和 LVs mass/EFW 比值在两组之间无差异(P>.05)。LVd mass、LVs mass 和 LV(d-s) mass 均与 GA 和体重显著相关(P<.001),但 LVd mass/EFW 和 LVs mass/EFW 比值与 GA 和体重无相关性(P>.05)。
二维超声心动图的面积-长度计算方法可有效提供 LV 质量测量值,并能敏感地反映与胎儿体重和 GA 相关的 LV 质量变化。胎儿心脏质量测量是评估胎儿心脏发育的有用参数。