Maheshwari Priya, Henry Amanda, Welsh Alec W
Faculty of Medicine, School of Women's & Children's Health, University of New South Wales, Sydney, NSW 2052, Australia.
Faculty of Medicine, School of Women's & Children's Health, University of New South Wales, Sydney, NSW 2052, Australia ; Department of Maternal-Fetal Medicine, Royal Hospital for Women, Locked Bag 2000, Barker Street, Randwick, NSW 2031, Australia ; Women's and Children's Health, St George Hospital, Kogarah, NSW 2217, Australia ; Australian Centre for Perinatal Science, University of New South Wales, Sydney, NSW 2052, Australia.
Biomed Res Int. 2015;2015:215910. doi: 10.1155/2015/215910. Epub 2015 Jun 22.
The fetal modified myocardial performance index (Mod-MPI) is a noninvasive, pulsed-wave Doppler-derived measure of global myocardial function. This review assesses the progress in technical refinements of its measurement and the potential for automation to be the crucial next step. The Mod-MPI is a ratio of isovolumetric to ejection time cardiac time intervals, and the potential for the left ventricular Mod-MPI as a tool to clinically assess fetal cardiac function is well-established. However, there are wide variations in published reference ranges, as (1) a standardised method of selecting cardiac time intervals used in Mod-MPI calculation has not been established; (2) cardiac time interval measurement currently requires manual, inherently subjective placement of callipers on Doppler ultrasound waveforms; and (3) ultrasound machine settings and ultrasound system type have been found to affect Mod-MPI measurement. Collectively these factors create potential for significant inter- and intraobserver measurement variability. Automated measurement of the Mod-MPI may be the next key development which propels the Mod-MPI into routine clinical use. A novel automated system of Mod-MPI measurement is briefly presented and its implications for the future of the Mod-MPI in fetal cardiology are discussed.
胎儿改良心肌性能指数（Mod-MPI）是一种通过脉冲波多普勒获得的无创性整体心肌功能测量指标。本综述评估了其测量技术改进方面的进展以及自动化成为关键下一步的潜力。Mod-MPI是等容时间与射血时间的心脏时间间隔之比，左心室Mod-MPI作为临床评估胎儿心脏功能工具的潜力已得到充分证实。然而，已发表的参考范围存在很大差异，原因如下：（1）尚未建立用于计算Mod-MPI的心脏时间间隔的标准化选择方法；（2）目前心脏时间间隔测量需要在多普勒超声波形上手动放置卡尺，这本质上是主观的；（3）已发现超声机器设置和超声系统类型会影响Mod-MPI测量。这些因素共同导致观察者间和观察者内测量存在显著差异的可能性。Mod-MPI的自动化测量可能是推动Mod-MPI进入常规临床应用的下一个关键发展。本文简要介绍了一种新型的Mod-MPI自动化测量系统，并讨论了其对胎儿心脏病学中Mod-MPI未来发展的影响。
