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目的应用三维彩色能量多普勒超声成像(3D-CPA)评估妊娠13~41孕周乙型肝炎(乙肝)孕妇的肝脏灌注的价值。方法选取2012年2月-2013年6月孕检的13~41孕周孕妇117例,其中乙肝孕妇73例和健康孕妇44例。在孕妇肝右叶门静脉分支附近进行采样,通过虚拟组织计算机辅助分析软件(VOCAL)分析获得血管化指数(VI)、血流指数(FI)、血管化血流指数(VFI)。比较乙肝孕妇与健康孕妇的肝脏灌注差异。结果乙型肝炎病毒(HBV)-DNA病毒载量组和对照组之间由3D-CPA获得的肝脏血管指数差异有统计学意义(P<0.05),3个血管指数的临界值分别为:VI=8.760(P<3×10-4)、FI=22.180(P<6×10-7)、VFI=1.575(P<3×10-5)。结论应用3D-CPA评估肝脏灌注可以分辨感染HBV的孕妇与健康孕妇,在一定程度上为临床预防和治疗孕妇感染HBV提供帮助。
Objective To assess the value of hepatic perfusion in pregnant women with hepatitis B (HBV) during the third trimester of pregnancy by 3D-color Doppler sonography (3D-CPA). Methods A total of 117 pregnancies ranging from 13 to 41 weeks of gestation from February 2012 to June 2013 were selected, including 73 pregnant women with hepatitis B and 44 healthy pregnant women. Vaginal index (VI), blood flow index (FI) and vascularized blood flow index (VFI) were obtained by virtual tissue computer aided analysis software (VOCAL). Differences in liver perfusion between pregnant women and healthy pregnant women. Results The difference of hepatic vascularity index obtained by 3D-CPA between HBV-DNA viral load group and control group was statistically significant (P <0.05). The critical values of three vascular indices were VI = 8.760 (P <3 × 10-4), FI = 22.180 (P <6 × 10-7) and VFI = 1.575 (P <3 × 10-5). Conclusions The application of 3D-CPA to assess liver perfusion can distinguish pregnant women infected with HBV and healthy pregnant women, to some extent, to help prevent and treat pregnant women infected with HBV.