| 程一姗,周俊杰,董孝贞,等.超声微血管成像、三维能量多普勒超声评价胎盘灌注与胎儿生长受限的关系[J].安徽医药,2026,30(10):2040-2044. |
| 超声微血管成像、三维能量多普勒超声评价胎盘灌注与胎儿生长受限的关系 |
| Evaluation of the relationship between placental perfusion and fetal growth restriction using ultrasound microvascular imaging and three-dimensional power doppler ultrasound |
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| DOI：10.3969/j.issn.1009-6469.2026.10.025 |
| 中文关键词: 胎儿生长受限 胎盘灌注 超声微血管成像 三维能量多普勒超声 诊断 |
| 英文关键词: Fetal growth restriction Placental perfusion Ultrasound microvascular imaging Three dimensional energy Doppler ultrasound Diagnosis |
| 基金项目:河南省医学科技攻关计划联合共建和软科学项目( LHGJ20240936) |
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| 中文摘要: |
| 目的探讨超声微血管成像、三维能量多普勒超声评价胎盘灌注与胎儿生长受限( FGR)之间的关系。方法回顾性分析。选取 2022年 6月至 2024年 6月在郑州大学第三附属医院诊断为胎儿生长受限的孕妇 81例作为研究对象并纳入研究组，并选取同期妊娠正常胎儿孕妇 129例纳入对照组。比较两组孕妇的一般临床资料；收集所有孕妇的超声微血管成像参数［微血管指数( MVI)］、三维能量多普勒超声血流参数［血流指数( FI)、血管化指数( VI)、血管化 -血流指数( VFI)］评价胎盘灌注参数与 FGR的关系；采用 logistic回归分析筛选 FGR发生的影响因素；受试者操作特征曲线(ROC曲线)和曲线下面，积(AUC)用于评估超声微血管成像、三维能量多普勒超声对 FGR的诊断价值。结果与对照组孕妇相比较，研究组孕妇的胎膜早破、羊水过少、胎盘异常、胎粪污染、脐带异常人数占比升高(P<0.05)；与对照组孕妇相比，研究组孕妇的 MVI［(24.19±4.65)%比(30.64±6.77)%］、 FI(25.73±6.89比 33.16±7.75)、 VI(20.39±6.39比 27.59±7.15)、 VFI(8.56±2.54比 11.59±3.29)水平均降低( P<0.05)； lo-gistic回归分析结果显示，胎膜早破、羊水过少、胎盘异常、胎粪污染、脐带异常为 FGR发生的危险因素( P<0.05)，MVI、FI、VI、 VFI高水平为 FGR发生的保护因素( P<0.05)； ROC曲线结果显示， FI、VI、VFI、MVI及四者联合对 FGR的诊断的灵敏度分别为 83.95%、69.14%、81.48%、85.19%、91.36%，特异度分别为 58.14%、76.74%、54.26%、66.67%、80.62%，AUC分别为 0.76、0.78、0.71、0.80、0.92，且 FI、VI、VFI、MVI四者联合对 FGR的诊断价值高于各自单独诊断(均 P<0.001)。结论超声微血管成像、三维能量多普勒超声通过评价胎盘灌注对 FGR具有良好的诊断价值，且发生 FGR孕妇的 MVI、FI、VI、VFI水平均降低。 |
| 英文摘要: |
| Objective To investigate the relationship between placental perfusion and fetal growth restriction (FGR) evaluated by ul-trasound microvascular imaging and three-dimensional power Doppler ultrasound.Methods A total of 81 pregnant women diagnosedwith fetal growth restriction at the Third Affiliated Hospital of Zhengzhou University from June 2022 to June 2024 were selected asstudy subjects and included in the study group, while 129 pregnant women with normal fetal development during the same period wereenrolled in the control group. General clinical data were compared between the two groups. Ultrasound microvascular imaging parame-ters [microvascular index (MVI)] and three-dimensional power Doppler ultrasound blood flow parameters [flow index (FI), vasculariza-tion index (VI), vascularization-flow index (VFI)] were collected to assess the association between placental perfusion parameters and FGR. Logistic regression analysis was used to identify influencing factors for FGR. Receiver operating characteristic curves (ROCcurves) and the area under the curve (AUC) were employed to evaluate the diagnostic value of ultrasound microvascular imaging andthree-dimensional power Doppler ultrasound for FGR. Results Compared with the control group, the study group had significantlyhigher proportions of premature rupture of membranes, oligohydramnios, placental abnormalities, meconium contamination, and umbili-cal cord abnormalities (all P<0.05). Levels of MVI [(24.19±4.65)% vs. (30.64±6.77)%], FI (25.73±6.89 vs. 33.16±7.75), VI (20.39±6.39 vs. 27.59±7.15), and VFI (8.56±2.54 vs. 11.59±3.29) were significantly lower in the study group than those in the control group (all P< 0.05). Logistic regression analysis revealed that premature rupture of membranes, oligohydramnios, placental abnormalities, meconiumcontamination, and umbilical cord abnormalities were risk factors for FGR (P<0.05), whereas high levels of MVI, FI, VI, and VFI were protective factors against FGR (P<0.05). ROC curve analysis demonstrated that the sensitivity of FI, VI, VFI, MVI, and their combina-tion for diagnosing FGR was 83.95%, 69.14%, 81.48%, 85.19%, and 91.36%, respectively; the specificity was 58.14%, 76.74%,54.26%, 66.67%, and 80.62%, respectively; and the corresponding AUC values were 0.76, 0.78, 0.71, 0.80, and 0.92, respectively. Thecombined diagnostic efficacy of the four parameters was significantly higher than that of any single parameter alone (all P<0.001).Con. clusion Ultrasound microvascular imaging and three-dimensional power Doppler ultrasound demonstrate good diagnostic value forFGR by assessing placental perfusion, as evidenced by significantly reduced levels of MVI, FI, VI, and VFI in affected pregnancies. |
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