11～13^(+6)周运用二切面法筛查胎儿严重心脏畸形  

Applying Two Views to Screening Fetal Heart Defects in the 11-to 13^(+6) Weeks

作　　者：王银[1] 李谊[1] 钱隽[1] 吴丽桑[1] 刘彦英[1] Wang Yin;Li Yi;Qian Jun;Wu Lisang;Liu Yanying(Department of Ultrasound,Guangdong General Hospital,Guangdong Academy of Medicaland Sciences,Guangzhou,Guangdong 510080,China)

机构地区：[1]广东省人民医院(广东省医学科学院)超声科,广州市510080

出　　处：《中国超声医学杂志》2019年第3期284-287,共4页Chinese Journal of Ultrasound in Medicine

基　　金：广东省医学科研基金(No.A2016325)

摘　　要：目的探讨11～13^(+6)周运用4CH和3VT切面筛查胎儿严重心脏畸形的价值。方法对来我院行11～13^(+6)周的NT检查的孕妇,运用4CH和3VT切面叠加彩色多普勒观察胎儿心脏结构。对确诊为心脏畸形的病例,回顾性分析其11～13^(+6)周4CH和3VT切面声像图特征。结果 1 026例胎儿共发现心脏畸形18例,其中早孕期诊断心脏畸形14例,检出率为77.78%(14/18),漏诊4例,漏诊率为22.22%(4/18)。14例中11～13^(+6)周4CH和3VT切面至少有1个切面显示异常,4例4CH和3VT切面均显示正常。结论经验丰富的超声医师于11～13^(+6)周运用4CH和3VT切面叠加彩色多普勒血流显像筛查胎儿严重心脏畸形具有可能性,部分严重心脏畸形的诊断尚需中晚孕期胎儿超声心动图检查进一步补充性诊断。Objective To discuss the value of 4-chamber heart(4 CH) and 3-Vessel and Trachea(3 VT)Views in the diagnosis of fetal serious congenital heart defects at the 11-to 13-Week Scan.Methods Pregnant wommen coming to our hospital between for 11-13+6 weeks′nuchal translucency scanning were included in this study.Fetal heart was observed by 4 CH view plus 3 VT view maping color doppler.Retrospective analysis of all fetuses with congenital heart defects was confirmed.Results A total of 1026 cases were performed the examination,and 18 cases were diagnosed with serious heart disease.Forty of 18 cases were diagnosed in the first trimester,and the detection rate was 77.78%(14/18).Four of 18 cases weren′t diagnosed in the first trimester,and the missed diagnosis rate was 22.22%(4/18).Eleven of 14 cases had abnormal view either 4 CH or 3 VT,and 4 cases had both normal views in the 11-13+6 weeks.Conclusions It is possible for an experienced sonographer to screen some major heart diseases using 4 CH view plus3 VT view maping color doppler in 11-13+6 weeks′scanning,and some heart diseases may need supplementary echocardiograpgy in the two or three trimester.

关 键 词：妊娠初期 超声诊断 胎儿心脏 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.53[医药卫生—诊断学]