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目的探讨三维血管重建技术结合彩色多普勒超声评价胎儿宫内缺氧的价值。方法孕妇61例,孕14~43周。二维彩色多普勒超声检测胎心、脐动脉和胎儿大脑中动脉等血流参数异常,提示胎儿宫内缺氧;通过三维血管重建技术,观察脐带形态、走行及空间转向,同时利用实时三维成像观察胎儿活动状态及颜面表情。结果二维超声诊断胎盘和脐带异常的临床符合率为96.9%和89.3%,二维超声+三维/煊流技术检查诊断胎盘和脐带异常的临床符合率均为100%,二维超声+三维/煊流技术超声诊断的临床总符合率高于单纯二维超声(100%vs.93.1%)(P<0.05)。结论彩色多普勒超声结合三维血管重建技术能准确诊断胎儿宫内窘迫的原因和程度,为临床选择恰当的分娩方式提供重要参考依据。
Objective To evaluate the value of three-dimensional reconstruction of blood vessels and color Doppler ultrasound in evaluating intrauterine hypoxia. Methods 61 pregnant women, pregnant 14 to 43 weeks. Two-dimensional color Doppler ultrasound examination of fetal heart rate, umbilical artery and fetal middle cerebral artery blood flow parameters such as abnormal, suggesting fetal hypoxia; by three-dimensional vascular reconstruction technology, observation of umbilical cord morphology, walking and spatial steering, using real-time three-dimensional Imaging observation of fetal activity and facial expressions. Results The clinical coincidence rates of two-dimensional ultrasonography in diagnosing placenta and umbilical cord abnormalities were 96.9% and 89.3%, respectively. The two-dimensional ultrasound + 3D / The total clinical coincidence rate of ultrasonic diagnosis of popliteal flow was higher than pure two-dimensional ultrasound (100% vs 93.1%) (P <0.05). Conclusions Color Doppler ultrasound combined with three-dimensional reconstruction can accurately diagnose the cause and degree of fetal distress and provide an important reference for clinical choice of mode of delivery.