A model for quantification technology of fetal right ventricular size and function and its application in the diagnosis of hypoplastic right heart syndrome
10.3760/cma.j.cn131148-20250115-00022
- VernacularTitle:胎儿右心室大小与功能定量分析模型及其在先天性心脏病诊断中的应用
- Author:
Zheng WANG
1
;
Jun LI
;
Minjuan ZHENG
;
Yiyu JIAO
;
Shengjun TUO
;
Ting ZHU
;
Dong WU
;
Yanting LI
;
Peng XU
;
Jiying GU
Author Information
1. 空军军医大学第一附属医院超声医学科 陕西省胎儿先天性心脏病超声诊断中心，西安 710032
- Publication Type:Journal Article
- Keywords:
Echocardiography;
Fetal;
Ventricular function，right;
Z-score;
Quantification technology
- From:
Chinese Journal of Ultrasonography
2025;34(7):616-622
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a normal data model of fetal right ventricular size and function using echocardiography，and to explore the clinical value of quantitative assessment of right ventricular size and function in the diagnosis of congenital heart diseases.Methods:（1）A simple random sampling method was employed to collect 1 004 pregnant women with normal singleton pregnancies at 24 to 32 +6 weeks of gestation who underwent fetal cardiac ultrasound examinations at the First Affiliated Hospital of Air Force Medical University from January 2021 to December 2023. Two-dimensional and M-mode echocardiography were used to measure the right ventricular end-diastolic diameter（RVEDD），right ventricular end-diastolic area（RVEDA），tricuspid annular plane systolic excursion（TAPSE）during systole，and the right ventricular fractional area change（RVFAC）was calculated. The correlations between the above parameters and ultrasound gestational age（USGA）were analyzed. Moreover，percentile growth curves for each parameter were plotted. With the above parameters as dependent variables and the USGA as the independent variable，a Z-score model was established through regression analysis.（2）A stratified sampling method was adopted to select 30 fetuses diagnosed with hypoplastic right heart syndrome（HRHS）and 30 fetuses diagnosed with pulmonary stenosis（PS）during the same period as the case group. The model was verified，and the morphological and functional characteristics of the right ventricle were analyzed. Results:The data of RVEDD，RVEDA，TAPSE，and RVFAC in normal fetuses showed a skewed distribution. Each parameter showed good linear correlations with USGA（ r=0.836，0.834，0.846，0.242；all P<0.001）. The constructed percentile curves for each parameter indicated that RVEDD，RVEDA and TAPSE increased significantly with the growth of USGA，while RVFAC showed a slow downward trend. All parameters in the HRHS group and TAPSE and RVFAC in the PS group deviated significantly from the normal reference range（all P<0.001）. Conclusions:By analyzing RVEDD，RVEDA，TAPSE and RVFAC of normal fetuses，the percentile and Z-score normal reference value models of multiple parameters of fetal right ventricular size and function have been established，providing corresponding standards for quantitative analysis.
