臨床婦人科産科71巻4号

2017年04月発行

増刊号 産婦人科画像診断トレーニング─この所見をどう読むか？ 周産期

症例：胎児血流計測➍

著者： 小澤克典¹

所属機関： ¹国立成育医療研究センター周産期・母性診療センター胎児診療科

ページ範囲：P.141 - P.146

この画像をどう読むか？

症例

妊娠20週6日，Quintero stage Ⅱの双胎間輸血症候群（twin-twin transfusion syndrome : TTTS）の受血児．左心室の心エコー図（パルス・ドプラ法）を図1に示す．

Q1　Tei Indexを計算せよ．

Q2　心機能は低下しているか？

解答，解説は次のぺージに☞

参考文献

1）Parasuraman R, et al : Gestation-specific reference intervals for fetal cardiac Doppler indices from 12 to 40 weeks of gestation. Open J Obstet Gynecol 3 : 97─104, 2013

2）Hernandez-Andrade E, et al : Gestational-age-adjusted reference values for the modified myocardial performance index for evaluation of fetal left cardiac function. Ultrasound Obstet Gynecol 29 : 321─325, 2007

3）Tei C, et al : New index of combined systolic and diastolic myocardial performance : a simple and reproducible measure of cardiac function - a study in normals and dilated cardiomyopathy. J Cardiol 26 : 357─366, 1995

4）Ichizuka K, et al : The Tei index for evaluation of fetal myocardial performance in sick fetuses. Early Hum Dev 81 : 273─279, 2005

5）Donofrio MT, et al : Diagnosis and treatment of fetal cardiac disease, a scientific statement from the American Heart Association. Circulation 129 : 2183─2242, 2014

6）Van Mieghem T, et al : Assessment of fetal cardiac function before and after therapy for twin-to-twin transfusion syndrome. Am J Obstet Gynecol 200 : 400. e1─400. e7, 2009

7）Villa CR, et al : Assessment of fetal cardiomyopathy in early-stage twin-twin transfusion syndrome : comparison between commonly reported cardiovascular assessment scores. Ultrasound Obstet gynecol 43 : 646─651, 2014

8）Hernandez-Andrade E, et al : Contribution of the myocardial performance index and aortic isthmus blood flow index to predicting mortality in preterm growth restricted fetuses. Ultrasound Obstet Gynecol 34 : 430─436, 2009

9）Cruz-Martinez R, et al : Sequence of changes in myocardial performance index in relation to aortic isthmus and ductus venosus Doppler in fetuses with early-onset intrauterine growth restriction. Ultrasound Obstet Gynecol 38 : 179─184, 2011

10）Hernandez-Andrade E, et al : A modified myocardial performance（Tei） index based on the use of valve clicks improves reproducibility of fetal left cardiac function assessment. Ultrasound Obstet Gynecol 26 : 227─232, 2005