超声测量心房与心脏长径及比值在胎儿房室隔缺损的应用  

The Application of Fetal Artrial and Cardiac Length and Its Ratio with Ultrasound in Fetal Atrioventricular Septal Defect

作　　者：李丽雅[1] 吕国荣[1] 苏淇琛[1] 

机构地区：[1]福建医科大学附属第二医院超声科,福建省泉州市362000

出　　处：《中国超声医学杂志》2011年第8期742-745,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声心动图检测胎儿心房长径(AL)和心脏长径(CL)及其比值(AL/CL),以及这些测值在评估胎儿房室隔缺损(AVSD)中的临床意义。方法检测336例孕20～40周正常胎儿AL和CL及其比值,并将上述参数与AVSD病例中的同类参数进行比较。结果 (1)正常胎儿AL和CL均与孕周呈正相关,线性回归方程:AL:AL=-0.124+0.045孕周(GW),r=0.877,P<0.05;CL:CL=-0.079+0.126孕周(GW),r=0.914,P<0.05;正常胎儿AL/CL比值约为0.33±0.04,其与孕周无相关性(r=0.154,P>0.05)。(2)与正常胎儿比较,AVSD胎儿其AL/CL比值明显增大(P<0.05),若选择AL/CL比值的截点值为0.41,AVSD的检出率为76.2%,假阳性率为1.51%,敏感性为64%,特异性为98.5%。结论 AL/CL比值可以准确地区分胎儿AVSD和胎儿正常心脏。AL/CL比值融入产前超声基础筛查可望提高AVSD产前检出率。Objective To detect the normal values of the fetal artrial length （AL） ,cardiac length（CL）and artrialto cardiac length ratio（A.L/CL） using fetal echocardiography and assess their clinical significance of prenatal screening for atrioventricular septal defect（AVSD）. Methods Fetal echocardiography was performed in 336 normal fetuses from the 20th to the 40th week of gestation. The AL, CL, AL/CL were measured and compared with those of 21 AVSD fetuses. Results The AL, CL of normal fetal heart correlated well with the gestational weeks. Linear regression equation is AL：AL=-0. 124＋0. 045 GW,r=0. 877,P〈0.05;CL：CL=-0. 079＋0. 126 GW,r=0. 914 , P〈0.05, the AL/ CL ratio did not vary significantly throughout pregnancy （AL/CL= 0. 33-1-0. 04,r= 0. 154 , P〈0. 05）. In the AVSD group, the AL/CL ratio is higher than that of the normal fetal heart （P〈0.05）. If a out-off value for the AL/CL ratio of 0.41 was chosen , the detection rate of AVSD was 76.2%, and false-positive rate was 1.51%, sensitivity was 64%, specificity was 98.5%. Conclusions The AL/CL ratio can accurately discriminate AVSD hearts from normal cardiac anatomy. Incorporation of the AL/CL ratio measured into routine antenatal ultrasonography may substantially improve the ability of diagnose AVSD prenatally.

关 键 词：房室隔缺损 胎儿超声心动图 产前诊断 心房长径/心脏长径 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]