VP34.07：在尼日利亚 ISUOG 认可的计划中对产科多普勒培训结果进行基于能力的评估,Ultrasound in Obstetrics & Gynecology

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VP34.07：在尼日利亚 ISUOG 认可的计划中对产科多普勒培训结果进行基于能力的评估
Ultrasound in Obstetrics & Gynecology ( IF 6.1 ) Pub Date : 2020-10-01 , DOI: 10.1002/uog.22840
I.O. Awowole ₁ , E. Enabudoso ₂ , H.O. Raji ₃ , O.H. Adams ₄ , A. Njoku ₅ , J. Akinmoladun ₆

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当 Tr 返回 LV 的时间占心动周期 T 的一定百分比时。我们的目标是评估人类胎儿的 WCN 和反射时间 Tr/T。方法：基于 WCN 关系：WCN = HR×L/PWV，脉动 LV 动作的能量消耗优化为 WCN ≈ 0.1（HR：心率，L：有效主动脉长度，PWV：主动脉 PW 速度；Pahlevan 2014, 2020 ）。以 Tr = 2L/PWV（图）重新排列产生 Tr/T = 0.2 作为最佳反射时间。为了通过多普勒获得胎儿的 Tr，需要进行血流动力学建模（图）：PW 两次到达脑循环：第一次作为主波，第二次在反射后返回。MCA 多普勒 (MCA-S) 中的收缩肩 (S) 表示第二个脉冲，延迟 t 对应于 Tr (Mills 1970)。结果：通过这种方法获得了带有 MCA-S 的 IUGR 胎儿的 Tr 数据（Gonser 2018）：Tr = 96 ± 15ms (GA 31 ± 3w)。T = 423ms (FHR 140bpm) 产生 Tr/T = 96ms/423ms = 0.23，与 WCN 建议的 20% 的最佳反射时间非常吻合。结论：尽管存在循环压力，IUGR 胎儿仍保持近乎最佳的搏动时间，这可能是由于能量消耗最小的优先级。因此，MCA-S 的出现不是伪影，而是接近最佳定时 PW 反射的标志。

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VP34.07: Competency‐based assessment of obstetric Doppler training outcome in an ISUOG‐accredited program in Nigeria

when time of return Tr to LV takes a certain percentage of the cardiac cycle T. Our objective was to assess WCN and reflection timing Tr/T in the human fetus. Methods: Based on the WCN relation: WCN = HR×L/PWV, energy consumption of pulsatile LV action is optimised for WCN ≈ 0.1 (HR: heart rate, L: effective aortic length, PWV: aortic PW velocity; Pahlevan 2014, 2020). Rearranging with Tr = 2L/PWV (figure) yield Tr/T = 0.2 as optimal reflection timing. To obtain Tr in the fetus by Doppler, hemodynamic modelling is required (figure): PWs arrive twice at cerebral circulation: 1st as a primary wave and 2nd after reflection and return. A systolic shoulder (S) in MCA Doppler (MCA-S) represents this 2nd impulse and delay t corresponds to Tr (Mills 1970). Results: Tr data of IUGR fetuses with MCA-S were obtained by this method (Gonser 2018): Tr = 96 ± 15ms (GA 31 ± 3w). T = 423ms (FHR 140bpm) yield Tr/T = 96ms/423ms = 0.23, showing good agreement with optimal reflection timing of 20%, as suggested by the WCN. Conclusions: In spite of circulatory stress, IUGR fetuses maintain nearly optimal pulsatile timing, probably due to the priority of minimal energy consumption. Thus appearance of MCA-S is not an artifact, but a sign of nearly optimal timed PW reflection.

更新日期：2020-10-01

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