孕早期超声软指标在胎儿复杂先天性心脏畸形筛查中的应用价值  

Value of ultrasonic soft index in the screening of fetal complex congenital heart disease in early pregnancy

作　　者：李惠兰[1] 厉进 曹睿 LI Huilan;LI Jin;CAO Rui(Department of Ultrasound Imaging,Nanshan Maternal and Child Health Hospital,Shenzhen 518000,China)

机构地区：[1]深圳市南山区妇幼保健院超声影像科,518000

出　　处：《临床超声医学杂志》2021年第6期414-417,共4页Journal of Clinical Ultrasound in Medicine

基　　金：深圳市南山区技术研发和创意设计项目分项资金教育(卫生)科技资助项目(2013007)。

摘　　要：目的探讨孕早期超声软指标颈项透明层(NT)厚度、静脉导管(DV)频谱及三尖瓣反流(TR)在胎儿复杂先天性心脏畸形(CHD)筛查中的临床价值。方法回顾性分析在我院行孕早期(孕11~13+6周)产前超声检查的孕妇9100例,记录NT厚度、DV频谱和TR情况,并与随访结果对照分析。结果孕早期共检出NT增厚342例,DV频谱异常181例,TR 163例,NT增厚+DV频谱异常或TR 168例,DV频谱异常+TR 124例,三项指标均为阳性92例。胎儿复杂CHD发生率随着NT厚度增加显著增长(P<0.01),DV频谱异常胎儿、TR胎儿复杂CHD的发生率均高于DV频谱正常胎儿和无TR胎儿,差异均有统计学意义(均P<0.01)。NT增厚+DV频谱异常或TR、三项指标联合筛查胎儿复杂CHD的敏感性和阳性预测值均高于DV频谱异常+TR及各项指标单独应用,差异均有统计学意义(均P<0.05)。结论NT增厚、DV频谱异常及TR是筛查胎儿复杂CHD的有效超声软指标,具有较好的临床应用价值。Objective To investigate the clinical value of ultrasonic soft indexes nuchal translucency(NT)thickness,ducts venous(DV)spectrum,and tricuspid regurgitation(TR)in the screening of congenital heart disease(CHD)in early pregnancy.Methods A total of 9100 pregnant women who were registered and had prenatal examinations in our hospital were selected.All pregnant women underwent ultrasound examination at 11~13+6 weeks of gestation,NT thickness,DV spectrum and TR were recorded,and compared with the results of follow-up.Results A total of 342 cases of NT thickening,181 cases of DV spectrum anomalies,163 cases of TR,168 cases of NT thickening+DV spectrum anomalies or TR,124 cases of DV spectrum anomalies+TR,and 92 cases of all the three indicators were detected in early pregnancy.The incidence of complex CHD increased with the thickening of NT(P<0.01).The incidence of complex CHD in fetuses with abnormal DV spectrum and TR fetuses was higher than that of fetuses with normal DV spectrum and fetuses without TR,and the difference were statistically significant(both P<0.01).The sensitivity and positive predictive value of NT thickening+DV spectrum abnormality or TR combined with the three indicators to screen complex fetal CHD were higher than those of DV spectrum abnormality or TR,and individual index,and the differences were statistically significant(all P<0.05).Conclusion NT thickening,DV spectrum abnormalities and TR are effective indicators for screening fetal complex CHD,and have good clinical application value.

关 键 词：超声检查 先天性心脏畸形 软指标 颈项透明层厚度 静脉导管频谱 三尖瓣反流 

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]