胎儿先天性心脏病的超声筛选方法对比研究  

Comparative study on prenatal ultrasonographic methods in screening for fetal congenital heart disease

作　　者：刘彦英[1] 吕国荣[1] 李伯义[1] 徐晚虹[1] 陈晓康[1] 陈秋月[1] 李丽雅[1] 李拾林[1] 

机构地区：[1]福建医科大学第二附属医院超声科

出　　处：《中华医学超声杂志（电子版）》2005年第6期353-355,共3页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨胎儿心脏6个切面扫查法筛选胎儿先天性心脏病(CHD)的有效性。方法对4300例孕16～40周孕妇分别采用6个切面扫查法及心尖四腔心切面扫查法产前筛选CHD,并对两种筛选方法的诊断准确性及与临床随访结果的Kappa一致性进行比较分析。结果6个切面扫查法确诊胎儿CHD 46例,其敏感性为90.20%,特异性99.90%,阳性预期值92.00%,阴性预期值99.88%；心尖四腔心切面扫查法诊断CHD 33例,且所有病例均包含在上述46例CHD中,其敏感性为64.71%,特异性99.90%,阳性预期值89.19%,阴性预期值99.57%；6个切面扫查法及心尖四腔心切面法与临床随访结果的一致性研究Kappa值分别为0.910、0.747。结论6个切面扫查法比心尖四腔心切面扫查法筛选胎儿CHD的有效性明显提高,是产前筛选胎儿CHD的有效方法。Objective To evaluate the diagnostic efficacy of six-view method in sereening for fetal congenital heart disease （CHD） by echocardiography. Methods The slx-view method and apical four-eharnber view method of eehocardiography were used separately in prenatal screening for CHD in 4300 pregnant women at 16-40 gestational weeks. The diagnostic accuracy and Kappa consistency with the clinical follow-up outcomes were assessed and compared between the 2 screening methods. Results Forty-six cases of fetal CHD were diagnosed by six-view method. Its diagnostic sensitivity, specificity, positive and negative predictive values were 90.20%, 99.90%, 92.00% and 99.88%, respectively. Among the 46 eases of fetal CHD, 33 cases were diagnosed by apical four-chamber view method. Its diagnostic sensitivity, specificity, positive and negative predictive values were 64.71%, 99.90%, 89.19% and 99.57%, respectively. The consistency study of the two methods with clinical follow-up outcomes showed that the Kappa values of sixview method and apical four-chamber view method were 0. 910 and 0.747, respectively. Conclusions The six-view method was more effective than apical four-chamber view method in screening for fetal CHD by prenatal ultrasonographic evaluation.

关 键 词：产前诊断 超声检查 先天性心脏缺陷 胎儿 超声筛选 

分 类 号：R445.1[医药卫生—影像医学与核医学]