摘要目的：探讨应用实时双平面成像（Bi-plane）技术显示胎儿完整室间隔的可行性及临床应用价值。方法：利用实时Bi-plane技术观察150例正常组及29例异常组的胎儿心脏（包括21例单纯性室间隔缺损及8例房室间隔缺损）。取胎儿心尖四腔心或心底四腔心切面，取样线通过室间隔，显示胎儿室间隔的全貌，评价室间隔完整性。此外，所有正常及异常胎儿另用时空影像关联（Spatiotemporal image correlation，STIC）技术采集胎心容积数据并行三维重建，获取室间隔影像。结果：实时Bi-plane技术与STIC技术相比，对胎儿完整室间隔的显示成功率显著提高（98.7% vs. 83.3%，P<0.01）；对异常组中室间隔缺损的显示率也显著提高（96.6% vs. 79.3%，P<0.01），而获取室间隔切面的时间显著缩短（（15.5±5.8） s vs. （58.1±13.3） s，P<0.01）。结论：实时Bi-plane技术可以显示胎儿室间隔的全貌，方法简单，操作方便，可作为常规二维超声心动图的辅助检查方法，具有重要的临床应用价值。
Abstract：Objective: To explore the feasibility and application value of real-time Bi-plane technique for the visualization of fetal interventricular septum(IVS). Methods: Using real-time Bi-plane technique to observe fetal IVS in 150 normal fetuses and 29 abnormal fetuses(including 21 cases of isolated VSD and 8 cases of AVSD). The fetal intact IVS can be demonstrated by displaying the apical four-chamber view or the bottom of four-chamber view, then putting the reference line across the IVS when using real-time Bi-plane technique. The integrity of IVS was then assessed. In addition, fetal cardiac volumes were acquired and analyzed by STIC technique to obtain the reconstructed image of IVS in all the normal and abnormal fetuses. Results: Compared with STIC modality, the Bi-plane technique showed a significantly higher visualization rate of IVS for the normal(98.7% vs. 83.3%, P<0.01) and abnormal fetuses (96.6% vs. 79.3%, P<0.01). At the same time, the time needed to obtain the plane for IVS of the Bi-plane technique was significantly shorter than STIC modality((15.5±5.8) s vs. (58.1±13.3) s, P<0.01). Conclusion: Real-time Bi-plane technique is a simple and time-saving method for the real-time assessment of the fetal intact IVS, which can be used as an important auxiliary examination of conventional two-dimensional fetal echocardiography and thus has important clinical value.
王 彧，孙 雪. 应用实时Bi-plane技术显示胎儿完整室间隔[J]. 中国临床医学影像杂志, 2020, 31(5): 354-357.
WANG Yu, SUN Xue. Application of real-time Bi-plane technique for the visualization of fetal interventricular septum. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(5): 354-357.
[1]Charafeddine F, Hachem A, Kibbi N, et al. The first Fetal Echocardiography experience for Prenatal diagnosis of Congenital Heart Disease in Lebanon: Successes and challenges[J]. J Saudi Heart Assoc, 2019, 31(3): 125-129.
[2]Svirsky R, Brabbing-Goldstein D, Rozovski U, et al. The genetic and clinical outcome of isolated fetal muscular ventricular septal defect(VSD)[J]. J Matern Fetal Neonatal Med, 2019, 32(17): 2837-2841.
[3]孙雪，张润，张颖，等. 实时双平面成像技术在胎儿心脏结构筛查中的应用[J]. 生物医学工程与临床，2017，21（5）：491-494.
[4]American Institute of Ultrasound in Medicine. AIUM practice guideline for the performance of fetal echocardiography[J]. J Ultrasound Med, 2013, 32(6): 1067-1082.
[5]任卫东，张玉奇，舒先红. 心血管畸形胚胎学基础与超声诊断[M]. 北京：人民卫生出版社，2015：11-18.
[6]王晓红，章海燕，陈华芳. 超声筛查胎儿室间隔缺损漏诊与误诊临床分析[J]. 浙江中西医结合杂志，2016，26（10）：938-939.
[7]贾赛玉，张小娟，滕玉凤. 彩色多普勒超声检查对诊断胎儿单纯室间隔缺损的研究[J]. 现代医学，2013，41（5）：348-350.
[8]孙雪，张颖. 实时双平面成像技术测量正常胎儿二尖瓣环面积的应用[J]. 中国介入影像与治疗学，2017，14（8）：476-479.
[9]Sun X, Zhang Y, Fan M, et al. Role of four-dimensional echocardiography with high-definition flow imaging and spatiotemporal image correlation in detecting fetal pulmonary veins[J]. Echocardiography, 2017, 34(6): 906-914.
[10]Wang Y, Fan M, Siddiqui FA, et al. Strategies for Accurate Diagnosis of Fetal Aortic Arch Anomalies: Benefits of Three-Dimensional Sonography with Spatiotemporal Image Correlation and a Novel Algorithm for Volume Analysis[J]. J Am Soc Echocardiogr, 2018, 31(11): 1238-1251.
[11]Liu J, Wang Y, Zhao H, et al. Spatio-Temporal Image Correlation Rendering Mode Visualizes the Specific Location and Surrounding Structure of Ventricular Septal Defect[J]. Clin Anat, 2019, 32(3): 408-420.
[12]贾立娟，王智培. 四维超声时间-空间关联成像对孕期胎儿室间隔缺损诊断的临床价值[J]. 中国医刊，2016，51（9）：85-88.
2020, Vol. 31 
