胎儿生长受限,彩色多普勒超声,脐动脉,大脑中动脉,小脑横径 ," /> 胎儿生长受限,彩色多普勒超声,脐动脉,大脑中动脉,小脑横径 ,"/> Fetal growth restriction,Color Doppler ultrasound,Umbilical artery,Middle cerebral artery,Transverse cerebellar diameter ,"/> <div> <span style="font-size:14px;line-height:2;">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</span> </div>
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发育医学电子杂志  2026, Vol. 14 Issue (2): 128-133    DOI: 10.3969/j.issn.2095-5340.2026.02.008
  生长发育   论著 |
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
宋玮 白子彤 刘艳 宗梦雅 朱毓
北京市通州区妇幼保健院 超声科,北京 101101
Application of color Doppler ultrasound in detecting fetal umbilical artery, middle cerebral artery blood flow parameters combined with transverse cerebellar diameter measurement in the diagnosis of fetal growth restriction
Song Wei, Bai Zitong, Liu Yan, Zong Mengya, Zhu Yu
Department of Ultrasound, Beijing Tongzhou District Maternal and Child Health Hospital, Beijing 101101, China
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摘要 
目的 探讨彩色多普勒超声检测胎儿脐动脉(umbilical artery,UA)血流参数 [UA- 阻力指数(resistance index,RI)、UA- 搏动指数(pulsatility index,PI)、UA- 收缩期 / 舒张期流速比(systolic/diastolic ratio,S/D)]、大脑中动脉(middle cerebral artery,MCA)血流参数 [MCA-RI、MCA-PI、MCA-S/D] 联合小脑横径(transverse cerebellar diameter,TCD)测量在预测胎儿生长受限(fetal growth restriction,FGR)中的临床价值。方法 采用回顾性研究方法,选取 2022 年 5 月至 2023 年 5 月在北京市通州区妇幼保健院行产前彩色多普勒超声筛查并确诊 FGR 的孕妇 34 例作为 FGR 组(n=34),纳入同期医院行常规体检的正常孕妇 200 例作为对照组(n=200)。应用彩色多普勒超声监测 2 组胎儿的 UA-RI、UA-PI、UA-S/D、MCA-RI、MCA-PI、MCA-S/D,并测量胎儿的 TCD。通过受试者工作特征(receiver operating characteristic,ROC)曲线来评估上述指标对 FGR 的诊断价值。统计学方法采用 t 检验,χ 2 检验。结果 FGR 组胎儿的 TCD 短于对照组 [(23.69±0.18) mm 与(25.71±0.24) mm,t 值为 46.853,P<0.05]。FGR组胎儿的 UA-RI、UA-PI、UA-S/D 均高于对照组(0.65±0.21 与 0.56±0.07,1.02±0.22 与 0.85±0.18,2.73±0.69 与 2.49±0.31,t 值分别为 4.740、4.921、3.982,P 值 均 <0.001)。FGR 组胎儿的 MCA-RI、MCA-PI、MCA-S/D 均 低 于 对 照 组(0.65±0.06 与 0.73±0.07,1.50±0.16 与 1.79±0.25,3.68±0.79 与4.61±0.99,t 值分别为 6.280、6.533、5.200,P 值均 <0.001)。FGR 组胎儿的 RIMCA/UA、PIMCA/UA、S/DMCA/UA均低于对照组(0.97±0.25 与 1.39±0.21,1.29±0.25 与 2.08±0.50,1.09±0.35 与 1.83±0.47,t 值分别为
10.475、14.261、8.770,P值均<0.001)。PIMCA/UA对FGR的诊断效能优于单一的UA、MCA[曲线下面积(area under the curve,AUC)为 0.945,敏感度为 93.27%,特异度为 87.89%] ;TCD 次之(AUC 为 0.912,敏感度为 91.09%,特异度为 90.57%)。UA、MAC 血流参数与 TCD 联合的诊断效能明显高于单一指标的诊断效能(AUC 为 0.969,敏感度为 96.59%,特异度为 95.00%)。结论 胎儿 UA、MCA 血流参数联合 TCD 测量对 FGR 的诊断效能较高,彩色多普勒超声检测 UA、MCA 血流参数及测量 TCD 可为临床评估 FGR提供有效依据。
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关键词:  胎儿生长受限')" href="#">    
Abstract: 

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.
Key words:  Fetal growth restriction')" href="#">
收稿日期:  2024-04-26                出版日期:  2026-03-30      发布日期:  2026-03-31      期的出版日期:  2026-03-30
基金资助: 
北京市通州区科技计划项目(KJ2022CX054)
通讯作者:  朱毓    E-mail:  zhuyumail78@sina.com
引用本文:    
宋玮 白子彤 刘艳 宗梦雅 朱毓.
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
[J]. 发育医学电子杂志, 2026, 14(2): 128-133.
Song Wei, Bai Zitong, Liu Yan, Zong Mengya, Zhu Yu.
Application of color Doppler ultrasound in detecting fetal umbilical artery, middle cerebral artery blood flow parameters combined with transverse cerebellar diameter measurement in the diagnosis of fetal growth restriction
. Journal of Developmental Medicine(Electronic Version), 2026, 14(2): 128-133.
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