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利用胎儿 HQ 评估先天性心脏病胎儿心脏形态的变化。

Evaluation of the changes in cardiac morphology of fetuses with congenital heart disease using fetalHQ.

机构信息

Department of Ultrasound, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China.

Clinical laboratory, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China.

出版信息

J Matern Fetal Neonatal Med. 2023 Dec;36(2):2285239. doi: 10.1080/14767058.2023.2285239. Epub 2023 Nov 27.

Abstract

To evaluate the changes in cardiac morphology of fetuses with congenital heart disease (CHD) using the fetal heart quantitative technique (fetalHQ). A total of 20 normal pregnant women (control group) and 20 pregnant women suspected of fetal CHD (case group) were included in this study. The dynamic images of the four-chamber view of the fetal heart were recorded and analyzed using fetalHQ. The global sphericity index (GSI) and 24-segment SI of the two groups were compared. The differences in the left and right ventricular 24-segment SI for each group were investigated. There was no statistically significant difference in the GSI between the two groups ( > 0.05). The difference in the SI values of left ventricular segments 1-2 between the case group and control group was statistically significant (all  < 0.05), while the intergroup difference in SI of left ventricular segments 3-24 was not significant (all  > 0.05). The SI of the 24 segments of the right ventricle showed no significant intergroup difference (all  > 0.05). The difference in the left and right ventricular 24-segment SI in the case group did not reach statistical significance (all  > 0.05). In the control group, the SI values between the left and right ventricles were significantly different in segments 18-24 (all  < 0.05), and no significant difference was found in segments 1-17 (all  > 0.05). There was a statistically significant intergroup difference in the percentage of unusual left ventricular SI, determined based on Z-score ( < 0.05), and the percentage of outliers for the right ventricle between the two groups showed no significant difference ( > 0.05). The fetalHQ is regarded as a straightforward and reliable approach for assessing the cardiac GSI and 24-segment SI of left and right ventricles in fetuses diagnosed with CHD. While CHD may not significantly impact the overall shape of the fetal heart or the geometric shape of the right ventricle, in this study, a notable increase in SI values for the left ventricular 1-2 segments was observed, indicating a more flattened ventricular chamber. Additionally, the morphological distinctions between the left and right ventricles in fetuses with CHD are no longer discernible.

摘要

利用胎儿心脏定量技术(fetalHQ)评估先天性心脏病(CHD)胎儿心脏形态的变化。本研究纳入 20 例正常孕妇(对照组)和 20 例疑似胎儿 CHD 孕妇(病例组)。记录并分析胎儿心脏四腔心切面的动态图像,使用 fetalHQ 比较两组的整体球形指数(GSI)和 24 节段 SI。比较两组左、右心室 24 节段 SI 的差异。两组 GSI 比较差异无统计学意义(>0.05)。病例组与对照组左心室 1-2 节段 SI 值比较差异有统计学意义(均<0.05),左心室 3-24 节段 SI 值比较差异无统计学意义(均>0.05)。右心室 24 节段 SI 比较差异无统计学意义(均>0.05)。病例组左右心室 24 节段 SI 比较差异无统计学意义(均>0.05)。对照组左、右心室 18-24 节段 SI 值比较差异有统计学意义(均<0.05),左、右心室 1-17 节段 SI 值比较差异无统计学意义(均>0.05)。根据 Z 评分判断左心室 SI 异常百分比有统计学差异(<0.05),两组右心室离群值百分比比较差异无统计学意义(>0.05)。胎儿 HQ 可用于评估 CHD 胎儿心脏 GSI 和左、右心室 24 节段 SI,操作简单、可靠。虽然 CHD 可能不会显著影响胎儿心脏的整体形态或右心室的几何形态,但本研究中发现左心室 1-2 节段 SI 值显著增加,表明心室腔更加扁平。此外,CHD 胎儿左、右心室的形态差异不再明显。

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