孕14-19+6周正常胎儿胼周动脉的超声评估

摘要 目的：探讨应用超声SlowflowHD（超低速血流成像）联合RadiantFlow（二维立体血流成像）技术评估孕14-19⁺⁶周正常胎儿胼周动脉的可行性,观察胎儿胼周动脉及分支走行,测量其长度和高度,并探讨二者与孕周及双顶径的关系。方法：纳入2022年5月-2023年3月来南京医科大学附属苏州医院进行常规超声检查的150例孕14-19⁺⁶周孕妇,在胎儿正中矢状切面上获取胎儿胼周动脉及分支的图像,测量其长度和高度,测量重复3次,取平均值,并观察胎儿胼周动脉及分支走行。所有孕妇均随访至中孕晚期（20-28周）或晚孕期行产前超声检查未见胼胝体异常及其他颅内结构异常。采用pearson相关分析和回归分析判断胎儿胼周动脉长度及高度与孕周及双顶径的关系。结果：胎儿胼周动脉长度及高度随着孕周及双顶径的增加而增加（P＜0.05）。胎儿胼周动脉长度与孕周、双顶径之间呈线性正相关,且胎儿胼周动高度与孕周、双顶径之间呈线性正相关（P＜0.05）。在孕14-19⁺⁶周中所有111病例均类"C"形走行,额前内侧动脉、额中内侧动脉、额后内侧动脉三者几乎与胎儿胼周动脉垂直,类"鸡冠",三者显示率100%;旁中央动脉在孕14-15⁺⁶周、16-17⁺⁶周、18-19⁺⁶周显示率分别约53.1%（17/32）、88.2%（45/51）、92.8%（26/28）;楔前动脉在孕14-15⁺⁶周、16-17⁺⁶周、18-19⁺⁶周显示率分别约3.1%（1/32）、35.2%（18/51）、78.5%（22/28）。结论：应用超声SlowflowHD（超低速血流成像）联合RadiantFlow（二维立体血流成像）技术显示孕14-19⁺⁶周正常胎儿胼周动脉及分支具有可行性,胎儿胼周动脉长度和高度与孕周及双顶径呈一定的线性相关。

Ultrasonographic Evaluation of Normal Fetal Pericallosal Arteries at 14-19+6 Weeks of Gestation

ABSTRACT Objective: To investigate the feasibility of applying ultrasound SlowflowHD (ultra-low-speed flow imaging) combined with RadiantFlow (two-dimensional stereological flow imaging) technique to evaluate normal fetal peri-callosal arteries at 14-19⁺⁶ weeks of gestation, to observe fetal peri-callosal arteries and branching courses, to measure their length and height, and to investigate the relationship between the two and gestational weeks and biparietal diameter. Methods: One hundred and fifty pregnant women who came to Suzhou Hospital Affiliated to Nanjing Medical University for routine ultrasound examination from May 2022 to March 2023 at 14-19⁺⁶ weeks of gestation were included, and images of the fetal peri-callosal artery and branches were obtained on the median sagittal section of the fetus, their length and height were measured, and the measurements were repeated three times and the mean value was taken, and the fetal peri-callosal artery and branches were observed to travel. All pregnant women were followed up until late mid-trimester (20-28 weeks) or late pregnancy without any callosal abnormalities or other intracranial structural abnormalities on prenatal ultrasonography. Pearsons correlation and regression analyses were used to determine the relationship between the length and height of the fetal pericallosal artery and the gestational weeks and biparietal diameter. Results: Fetal peri-callosal artery length and height increased with increasing gestational week and biparietal diameter(P<0.05). There was a linear correlation between the length of the fetal peri-callosal artery and the gestational week and biparietal diameter, and a linear correlation between the height of the fetal peri-callosal artery and the gestational week and biparietal diameter(P<0.05). In all 111 cases, the anterior medial frontal artery, medial middle frontal artery and posterior medial frontal artery were almost perpendicular to the fetal peri-callosal artery, and the rate of showing all three was 100%; the paracentral artery was 100%. The rate of the paracentral artery was about 53.1% (17/32), 88.2% (45/51) and 92.8% (26/28) at 14-15⁺⁶ weeks, 16-17⁺⁶ weeks and 18-19⁺⁶ weeks of gestation, respectively; the rate of the precuneus artery was about 3.1% (1/32), 35.2% (18/51) and 78.5%(18/51) at 14-15⁺⁶ weeks, 16-17⁺⁶ weeks and 18-19+6 weeks of gestation, respectively. /51), and 78.5% (22/28). Conclusion: It is feasible to use ultrasound SlowflowHD (ultra-low-speed flow imaging) combined with RadiantFlow (two-dimensional stereo flow imaging) technique to show normal fetal peri-callosal arteries and branches at 14-19⁺⁶ weeks of gestation, and the length and height of fetal peri-callosal arteries showed a linear correlation with gestational week and biparietal diameter.