孕中期频谱多普勒超声联合彩色多普勒超声对胎儿生长受限的预测价值分析
Analysis of the predictive value of spectral Doppler ultrasound for fetal growth restriction
王梦瑶 1郭怡 1李瑞2
作者信息
- 1. 西北妇女儿童医院医学超声中心 陕西 西安 710061
- 2. 西安医学院第二附属医院超声科 陕西 西安 710043
- 折叠
摘要
目的 探讨孕中期频谱多普勒超声联合彩色多普勒超声对胎儿生长受限的预测价值.方法 选取2023年1月至6月在西北妇女儿童医院进行产检及生产的537例孕中期产妇进行回顾性分析,将产后及孕检确诊为胎儿生长受限的60例孕妇设为观察组,将其余分娩出健康新生儿的477名孕妇设为对照组.分析两组孕妇的彩色多普勒超声血流显像频谱数据[收缩期峰值(S)/舒张末期速度最低值(D)、搏动指数(PI)和阻力指数(RI)]及血流参数[收缩末反流流速(ESRV)、收缩期峰值血流速度(PSV)和PSV/ESRV值],并建立受试者操作特征(ROC)曲线分析血流频谱联合多普勒超声对胎儿生长受限的预测效能.结果 观察组患者孕妇子宫动脉舒张早期出现切迹的发生率81.67％,明显高于对照组(44.86％),且多以单侧切迹为主,差异有统计学意义(P＜0.05).观察组大脑中S/D、PI和RI分别为3.66±1.12、1.35±0.27、0.68±0.06,均低于对照组(4.68±0.87、1.73±0.44、0.87±0.09),差异均有统计学意义(P＜0.05).观察组脐动脉 S/D、PI、RI 分别为 3.46±0.43、1.36±0.21、0.78±0.13,均高于对照组(2.58±0.46、0.83±0.12、0.57±0.09),差异均有统计学意义(P＜0.05).观察组ESRV为36.43±5.63,高于对照组(22.52±4.52),观察组PSV/ES-RV 为3.06±0.63,低于对照组(4.75±0.64),差异均有统计学意义(P＜0.05).ROC曲线结果显示,血流频谱联合多普勒超声对胎儿生长受限的预测敏感度为71.57％,特异度为83.56％,联合预测明显高于单一指标(P＜0.05).结论 采用早孕期多普勒超声,观察其彩色多普勒血流参数大脑中动脉、脐动脉、主动脉弓峡部血流参数,并观察其频谱特征及舒张早期切迹可早期预测胎儿生长受限,可为胎儿早期生长受限的诊断及预测提供参考意见.
Abstract
Objective To explore the predictive value of early pregnancy spectral Doppler ultrasound combined with color Doppler ultra-sound for fetal growth restriction.Methods A retrospective analysis was conducted on 537 early pregnant women who underwent physical exami-nations and gave birth in Northwest Women's and Children's Hospital from January to June 2023.Sixty pregnant women diagnosed with fetal growth restriction during postpartum and prenatal examinations were divided into the observation group,while the remaining 477 pregnant women who gave birth to healthy newborns were divided into the control group.The spectral data of color Doppler ultrasound blood flow imaging[peak systolic(S)/minimum end-diastolic velocity(D),pulsatility index(PI)and resistance index(RI)]and blood flow parameters[end-systolic retrograde ve-locity(ESRV),peak systolic blood flow velocity(PSV)and PSV/ESRV value]of pregnant women in the two groups were analyzed,and the pre-dictive efficacy of blood flow spectrum combined with Doppler ultrasound for fetal growth restriction was analyzed by establishing a receiver operat-ing characteristic(ROC)curve.Results The incidence of incisions in the observation group was 81.67％,which was higher than that in the matched group(44.86％),and most of them were unilateral incisions,the difference was statistically significant(P＜0.05).The S/D,PI and RI in the brain of the observation group were 3.66±1.12,1.35±0.27 and 0.68±0.06,respectively,which were lower than those of the control group(4.68±0.87,1.73±0.44,0.87±0.09),and the differences were statistically significant(P＜0.05).The umbilical artery S/D,PI and RI in the observation group were 3.46±0.43,1.36±0.21 and 0.78±0.13,respectively,which were higher than those in the control group(2.58±0.46,0.83±0.12 and 0.57±0.09),and the differences were statistically significant(P＜0.05).The ESRV of the observation group was 36.43±5.63,which was higher than that of the control group(22.52±4.52),and the PSV/ESRV was 3.06±0.63,which was lower than that of the control group(4.75±0.64),the differences were statistically significant(P＜0.05).The ROC curve results showed that the sensi-tivity and specificity of the combination of blood flow spectrum and Doppler ultrasound for predicting fetal growth restriction were 71.57％and 83.56％,respectively.The combined prediction was significantly higher than a single indicator(P＜0.05).Conclusion Doppler ultrasound in early pregnancy is used to observe the blood flow parameters of the middle cerebral artery,umbilical artery and the aortic arch,and observe the spectral characteristics and early diastolic notch to predict fetal growth restriction early,and can provide reference for the diagnosis and prediction of early fetal growth restriction.
关键词
彩色多普勒超声/血流频谱/胎儿生长受限/大脑中动脉/脐动脉/主动脉弓峡部Key words
Color Doppler ultrasound/Blood flow spectrum/Fetal growth restriction/Middle cerebral artery/Umbilical artery/Isthmus of aortic arch引用本文复制引用
基金项目
陕西省自然科学基金项目(2023JC-QN-0924)
出版年
2024
NETL
NSTL
万方数据