彩色多普勒超声检测胎儿脐动脉和大脑中动脉血流参数联合小脑横径测量在胎儿生长受限诊断中的应用OA

Objective To explore the clinical value of color Doppler ultrasound in detecting fetal umbilical artery(UA)blood flow parameters[including UA-resistance index(RI),UA-pulsatility index(PI),and UA-systolic/diastolic ratio(S/D)]and middle cerebral artery(MCA)blood flow parameters[including MCA-RI,MCA-PI,and MCA-S/D]combined with transverse cerebellar diameter(TCD)measurement in predicting fetal growth restriction(FGR).Methods A retrospective study was conducted,which enrolled 34 pregnant women with FGR who underwent prenatal ultrasonic screening and were confirmed at Beijing Tongzhou District Maternal and Child Health Hospital from May 2022 to May 2023 as the FGR group(n=34).Meanwhile,200 healthy pregnant women who received routine physical examinations in the same hospital during the same period were recruited as the control group(n=200).Color Doppler ultrasound was used to monitor the UA-RI,UA-PI,UA-S/D,MCA-RI,MCA-PI,and MCA-S/D in fetuses of both groups.Additionally,the fetal TCD was measured.The diagnostic value of the above indicators for FGR was evaluated by receiver operating characteristic(ROC)curve.Statistical analysis was performed using the independent samples t-test,χ² test.Results The fetal TCD in the FGR group was significantly shorter than that in the control group[(23.69±0.18)mm vs(25.71±0.24)mm,t=46.853,P<0.05].Additionally,the UA-RI,UA-PI,and UA-S/D in the FGR group were significantly higher than those in the control group(0.65±0.21 vs 0.56±0.07,1.02±0.22 vs 0.85±0.18,and 2.73±0.69 vs 2.49±0.31,t values were 4.740,4.921,and 3.982,respectively;all P<0.001).The MCA-RI,MCA-PI,and MCA-S/D in the FGR group were significantly lower than those in the control group(0.65±0.06 vs 0.73±0.07,1.50±0.16 vs 1.79±0.25,3.68±0.79 vs 4.61±0.99),respectively,t values were 6.280,6.533,and 5.200;all P<0.001).RIMCA/UA,PIMCA/UA,S/DMCA/UA in the FGR group were lower than those in the control group(0.97±0.25 vs 1.39±0.21,1.29±0.25 vs 2.08±0.50,1.09±0.35 vs 1.83±0.47,t values were 10.475,14.261,and 8.770,respectively;P<0.001).The diagnostic efficacy of PIMCA/UA for FGR was superior to that of UA and MCA alone[area under the curve(AUC)was 0.945,the sensitivity was 93.27%,the specificity was 87.89%],followed by TCD(AUC was 0.912,the sensitivity was 91.09%,the specificity was 90.57%).The combination of PIMCA/UA and TCD diagnostic approach demonstrated significantly higher efficacy than any single indicator(AUC was 0.969,the sensitivity was 96.59%,the specificity was 95.00%).Conclusion The combined evaluation of UA and MCA blood flow parameters with TCD measurements demonstrates high diagnostic efficacy for FGR.Color Doppler ultrasound assessment of UA and MCA blood flow parameters,along with TCD measurements,provides an effective basis for the clinical evaluation of FGR.