Liu Lin, He Yihua, Li Zhian, Gu Xiaoyan, Zhang Ye, Zhang Lianzhong
Department of Ultrasound, Henan Province Hospital, Zhengzhou, 450002, China.
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
J Med Ultrason (2001). 2014 Jul;41(3):333-8. doi: 10.1007/s10396-014-0520-5. Epub 2014 Feb 6.
The use of low-frequency high-definition power Doppler in assessing and defining pulmonary venous connections was investigated.
Study A included 260 fetuses at gestational ages ranging from 18 to 36 weeks. Pulmonary veins were assessed by performing two-dimensional B-mode imaging, color Doppler flow imaging (CDFI), and low-frequency high-definition power Doppler. A score of 1 was assigned if one pulmonary vein was visualized, 2 if two pulmonary veins were visualized, 3 if three pulmonary veins were visualized, and 4 if four pulmonary veins were visualized. The detection rate between Exam-1 and Exam-2 (intra-observer variability) and between Exam-1 and Exam-3 (inter-observer variability) was compared. In study B, five cases with abnormal pulmonary venous connection were diagnosed and compared to their anatomical examination.
In study A, there was a significant difference between CDFI and low-frequency high-definition power Doppler for the four pulmonary veins observed (P < 0.05). The detection rate of each pulmonary vein when employing low-frequency high-definition power Doppler was higher than that when employing two-dimensional B-mode imaging or CDFI. There was no significant difference between the intra- and inter-observer variabilities using low-frequency high-definition power Doppler display of pulmonary veins (P > 0.05). The coefficient correlation between Exam-1 and Exam-2 was 0.844, and the coefficient correlation between Exam-1 and Exam-3 was 0.821. In study B, one case of total anomalous pulmonary venous return and four cases of partial anomalous pulmonary venous return were diagnosed by low-frequency high-definition power Doppler and confirmed by autopsy.
The assessment of pulmonary venous connections by low-frequency high-definition power Doppler is advantageous. Pulmonary venous anatomy can and should be monitored during fetal heart examination.
研究低频高清功率多普勒在评估和确定肺静脉连接中的应用。
研究A纳入了260例孕龄在18至36周的胎儿。通过二维B型成像、彩色多普勒血流成像（CDFI）和低频高清功率多普勒对肺静脉进行评估。若观察到一条肺静脉则评分为1分，两条肺静脉为2分，三条肺静脉为3分，四条肺静脉为4分。比较检查1与检查2之间（观察者内变异性）以及检查1与检查3之间（观察者间变异性）的检出率。在研究B中，诊断了5例肺静脉连接异常的病例，并与解剖检查结果进行比较。
在研究A中，对于观察到的四条肺静脉，CDFI与低频高清功率多普勒之间存在显著差异（P<0.05）。采用低频高清功率多普勒时每条肺静脉的检出率高于采用二维B型成像或CDFI时。使用低频高清功率多普勒显示肺静脉时，观察者内和观察者间变异性之间无显著差异（P>0.05）。检查1与检查2之间的相关系数为0.844，检查1与检查3之间的相关系数为0.821。在研究B中，低频高清功率多普勒诊断出1例完全性肺静脉异位引流和4例部分性肺静脉异位引流，并经尸检证实。
低频高清功率多普勒评估肺静脉连接具有优势。在胎儿心脏检查期间可以且应该监测肺静脉解剖结构。
