Zanardini Cristina, D'Antonio Francesco, Hvingel Bodil, Vårtun Åse, Prefumo Federico, Flacco Maria E, Manzoli Lamberto, Acharya Ganesh
Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy.
Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Artic University of Norway, Tromsø, Norway.
J Obstet Gynaecol Res. 2019 Nov;45(11):2150-2157. doi: 10.1111/jog.14068. Epub 2019 Aug 23.
To evaluate the level of agreement between M-mode and pulsed-wave tissue Doppler imaging (PW-TDI) techniques in assessing fetal mitral annular plane systolic excursion (MAPSE), tricuspid annular plane systolic excursion (TAPSE) and septal annular plane systolic excursion (SAPSE) in a low-risk population.
This prospective longitudinal study included healthy fetuses assessed from 18 to 40 weeks of gestation. Tricuspid annular plane systolic excursion, MAPSE and SAPSE were measured using anatomical M-mode and PW-TDI. The agreement between the two diagnostic tests was assessed using Bland-Altman analysis.
Fifty fetuses were included in the final analysis. Mean values of TASPE were higher than that of MAPSE. There was a progressive increase of TAPSE, MAPSE and SAPSE values with advancing gestation. For each parameter assessed, there was an overall good agreement between the measurements obtained with M-mode and PW-TDI techniques. However, the measurements made with M-mode were slightly higher than those obtained with PW-TDI (mean differences: 0.03, 0.05 and 0.03 cm for TAPSE, MAPSE and SAPSE, respectively). When stratifying the analyses by gestational age, the mean values of TAPSE, MAPSE and SAPSE measured with M-Mode were higher compared to those obtained with PW-TDI, although the mean differences between the two techniques tended to narrow with increasing gestation. Tricuspid annular plane systolic excursion, MAPSE and SAPSE measurements were all significantly, positively associated with gestational age (all P < 0.001).
Fetal atrioventricular annular plane displacement can be assessed with M-mode technique, or with PW-TDI as the velocity-time integral of the myocardial systolic waveform. Atrioventricular annular plane displacement values obtained with M-mode technique are slightly higher than those obtained with PW-TDI.
评估M型和脉冲波组织多普勒成像（PW-TDI）技术在评估低风险人群胎儿二尖瓣环平面收缩期位移（MAPSE）、三尖瓣环平面收缩期位移（TAPSE）和间隔环平面收缩期位移（SAPSE）方面的一致性水平。
这项前瞻性纵向研究纳入了妊娠18至40周的健康胎儿。使用解剖M型和PW-TDI测量三尖瓣环平面收缩期位移、MAPSE和SAPSE。使用Bland-Altman分析评估两种诊断测试之间的一致性。
最终分析纳入了50例胎儿。TASPE的平均值高于MAPSE。随着孕周增加，TAPSE、MAPSE和SAPSE值逐渐升高。对于每个评估参数，M型和PW-TDI技术获得的测量值总体上具有良好的一致性。然而，M型测量值略高于PW-TDI测量值（TAPSE、MAPSE和SAPSE的平均差异分别为0.03、0.05和0.03 cm）。按孕周分层分析时，M型测量的TAPSE、MAPSE和SAPSE平均值高于PW-TDI测量值，尽管两种技术之间的平均差异随着孕周增加而趋于缩小。三尖瓣环平面收缩期位移、MAPSE和SAPSE测量值均与孕周显著正相关（均P < 0.001）。
胎儿房室环平面位移可用M型技术评估，或用PW-TDI作为心肌收缩波形的速度时间积分来评估。M型技术获得的房室环平面位移值略高于PW-TDI获得的值。
