二维超声联合四维彩超HD-flow彩色血流显像在产前诊断胎儿先天性心脏发育异常效果  

Effect of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound HD-flow color blood flow imaging for prenatal diagnosing congenital cardiac dysplasia

作　　者：王春梅 WANG Chunmei(Mianyang 404 Hospital, Mianyang, Sichuan Province, 621000)

机构地区：[1]四川绵阳四○四医院,621000

出　　处：《中国计划生育学杂志》2021年第9期1894-1897,2014,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨采用二维超声联合四维彩超超高细微分辨血流技术(HD-flow)进行产前胎儿先天性心脏发育异常(FCHD)诊断的临床效果。方法:选取2018年1月—2020年4月于本院行产前超声检查的单胎孕妇1100例为研究对象。均行常规二维超声检查,对疑似胎儿宫内心脏发育异常者再行四维彩超HD-flow检查。以分娩后超声诊断结果和引产后病理诊断结果作为金标准,分析FCHD检出情况,并比较两种方法检出率。结果:经产后新生儿超声检查和引产病理学检查共发现FCHD 30例(2.7%),二维超声检出率(66.7%)低于二维超声联合四维彩超检查(90.0%)(P<0.05),联合检测误诊3例分别为动脉弓畸形1例、室间隔缺损1例和肺动脉瓣闭锁1例。结论:常规二维超声可作为胎儿先天性心脏畸形的重要初筛手段,对超声提示异常者,建议联合四维彩超HD-flow技术检查,以更准确地对畸形部位、类型等进行评估。Objective:To explore the clinical value of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound HD-flow color blood flow imaging for prenatal diagnosing congenital cardiac dysplasia.Methods:1100 singleton pregnant women who underwent prenatal routine two-dimensional ultrasound examination were selected in this study from January 2018 to April 2020.The women who had been suspected of intrauterine fetal cardiac dysplasia would be given examination of four-dimensional color Doppler ultrasound HD-flow.Based on the results by neonatal ultrasound diagnosis or pathological diagnosis after labor induction as the gold standard,the detection situation of fetal congenital heart diseases(FCHD)was analyzed,and the detection ratio of FCHD was compared between two-dimensional ultrasound alone and two-dimensional ultrasound combined with four-dimensional color ultrasound.Results:In the fetus of 1100 pregnant women,there were 30(2.73%)fetuses or newborns with FCHD.The detection rate of FCHD by two-dimensional ultrasound examination was 66.7%,which was significant lower than that(90.0%)of the combined examination of two-dimensional ultrasound and four-dimensional color Doppler ultrasound HD-flow color blood flow imaging(P<0.05).There were 3 cases with misdiagnose by the combined examinations of the two ultrasound methods,which included 1 case with arterial arch malformation,1 case with ventricular septal defect,and 1 case with pulmonary valve atresia.Conclusion:Conventional two-dimensional ultrasound can be used as an important initial screening method for fetal congenital heart malformations.However,for those fetuses with abnormalities results by two-dimensional ultrasound,it is recommended to combination of two-dimensional ultrasound and four-dimensional color Doppler ultrasound HD-flow color blood flow imaging examination to further accurately evaluating the location and type of abnormalities.

关 键 词：胎儿先天性心脏发育异常 产前超声检查 二维超声 四维彩超 超高分辨血流技术 

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]