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三维多普勒超声评估胎儿宫内生长受限胎儿的肝血管化。

Three-dimensional Doppler ultrasonography for the assessment of fetal liver vascularization in fetuses with intrauterine growth restriction.

机构信息

Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Clínica Materno Infantil Colsubsidio, Bogotá, Colombia.

Department of Gynecology and Obstetrics, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia.

出版信息

Int J Gynaecol Obstet. 2019 Mar;144(3):260-264. doi: 10.1002/ijgo.12715. Epub 2018 Dec 5.

Abstract

OBJECTIVE

To demonstrate changes in hepatic volume and vascular indices in fetuses with intrauterine growth restriction (IUGR) compared with normal-growth fetuses, using a noninvasive method (three-dimensional power Doppler ultrasound).

METHODS

The present cross-sectional study was conducted between September 1 and November 30, 2014, at a maternal-fetal medicine unit in Bogotá, Colombia; it included consecutive women at 24-34 weeks of pregnancy. The fetal liver volume and indices of hepatic vascularization were determined with three-dimensional power Doppler ultrasonography and compared between fetuses with and without a diagnosis of IUGR. Results A total of 119 women met study inclusion criteria; 97 fetuses had no growth restriction, whereas 22 fetuses had IUGR. The latter group had decreased liver volume (57.85 ± 29.71 mL vs 86.99 ± 31.24 mL; P=0.010) and increased vascular indices (vascularization index, 47.92 ± 34.44 versus 22.46 ± 18.95; flow index, 71.39 ± 42.01 versus 41.11 ± 23.24; vascularization flow index, 47.94 ± 47.96 versus 13.67 ± 22.38; P=0.003 for all comparisons).

CONCLUSION

Liver volume was decreased and liver vascular indices values were increased in fetuses with IUGR. These findings imply that evaluation of hepatic vascularization with three-dimensional hepatic Doppler could be useful in the diagnosis of IUGR.

摘要

目的

使用非侵入性方法(三维能量多普勒超声),展示与正常生长胎儿相比,宫内生长受限(IUGR)胎儿的肝体积和血管指数的变化。

方法

本横断面研究于 2014 年 9 月 1 日至 11 月 30 日在哥伦比亚波哥大的一个母婴医学单位进行,纳入了连续 24-34 周妊娠的孕妇。使用三维能量多普勒超声测量胎儿肝体积和肝血管化指数,并比较有无 IUGR 诊断的胎儿之间的这些参数。

结果

共有 119 名符合研究纳入标准的女性;97 名胎儿无生长受限,而 22 名胎儿有 IUGR。后者组的肝体积减小(57.85±29.71 mL 与 86.99±31.24 mL;P=0.010),血管指数增加(血管化指数,47.92±34.44 与 22.46±18.95;血流指数,71.39±42.01 与 41.11±23.24;血管化血流指数,47.94±47.96 与 13.67±22.38;所有比较均 P=0.003)。

结论

IUGR 胎儿的肝体积减小,肝血管指数值增加。这些发现表明,使用三维肝多普勒评估肝血管化可能有助于 IUGR 的诊断。

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