Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Fetal Diagnostic Centers, Pasadena, Tarzana and Lancaster, CA, USA.
Ultrasound Obstet Gynecol. 2018 May;51(5):650-658. doi: 10.1002/uog.17505.
Because of parallel circulation in the fetus and the differential effect that various disease states may have on the shape of the right and left ventricles, this study was conducted to evaluate the sphericity index (SI) of 24 transverse segments distributed from the base to the apex of each of the ventricular chambers.
Two hundred control fetuses were examined between 20 and 40 weeks of gestation. The displacement of the ventricular endocardium during the cardiac cycle was computed using offline speckle-tracking software. From the ASCII output of the analysis, we analyzed 24 end-diastolic transverse segments, distributed from the base to the apex of each ventricle, as well as the end-diastolic mid-basal-apical length. The SI was computed for each of the 24 segments by dividing the mid-basal-apical length by the transverse length for each segment. Regression analysis was performed against biometric measurements and gestational age according to last menstrual period and ultrasound. Eight fetuses, in which the four-chamber view appeared subjectively to demonstrate chamber disproportion, were evaluated as examples to demonstrate the utility of this technology.
The SI for each segment was independent of gestational age and fetal biometric measurements. The SI of the right ventricle was significantly (P < 0.001) lower than that of the left ventricle for segments 1-18, suggesting that the right ventricle was more globular in shape than was the left ventricle at the base, mid and a portion of the apical segments of the chamber. Fetuses with various cardiac structural abnormalities and abnormal fetal growth had abnormal SI values that reflected either a more globular or a more flattened ventricular chamber.
Determination of SI for each of 24 segments of the fetal right and left ventricles provides a comprehensive method to examine the shape of the ventricular chambers. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
由于胎儿存在平行循环，并且各种疾病状态可能对左右心室的形态产生不同的影响，因此本研究旨在评估 24 个分布于心室基底至心尖的横断节段的球形指数（SI）。
对 20 至 40 孕周的 200 例正常胎儿进行检查。使用离线斑点追踪软件计算心动周期中心室心内膜的位移。从分析的 ASCII 输出中，我们分析了 24 个舒张末期的横断节段，分布于每个心室的基底至心尖，以及舒张末期的基底-中段-心尖长度。对于每个节段，通过将基底-中段-心尖长度除以每个节段的横断长度来计算 SI。根据末次月经和超声检查的生物测量值和胎龄进行回归分析。以 8 例四腔心视图主观上显示腔室比例失调的胎儿为例，评估该技术的实用性。
每个节段的 SI 与胎龄和胎儿生物测量值无关。右心室的 SI 显著低于左心室（P<0.001），提示右心室在基底、中段和部分心尖节段的球形程度大于左心室。存在各种心脏结构异常和胎儿生长异常的胎儿具有异常的 SI 值，反映出心室腔更呈球形或更扁平。
确定胎儿左右心室的 24 个节段的 SI 提供了一种全面的方法来检查心室腔的形状。版权所有©2017 ISUOG。由 John Wiley & Sons Ltd 出版。
