孕12~15^(+6)周应用四维STIC技术筛查圆锥动脉干畸形的可行性分析  

Feasibility of four-dimensional STIC technique in screening fetal heart conotruncal defects at 12~15^(+6) weeks of gestation

作　　者：刘雪琳 李德鑫 王义成[3] 孙伟 尹佳园 王思思[4] 温德惠[3] 张敏秀 LIU Xuelin;LI Dexin;WANG Yicheng(Hebei North University,Hebei,Zhangjiakou 075000,China;不详)

机构地区：[1]河北北方学院,河北省张家口市075000 [2]河北省深州市医院超声科 [3]河北北方学院附属第一医院超声医学科 [4]河北北方学院附属第一医院妇产科

出　　处：《河北医药》2022年第7期1022-1025,共4页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20210893)。

摘　　要：目的评估四维时间-空间关联成像技术(STIC)于孕12~15^(+6)周进行胎儿圆锥动脉干畸形筛查的可行性。方法分别运用二维超声心动图和四维STIC技术对孕12~15^(+6)周的孕妇进行胎儿圆锥动脉干畸形关键诊断切面图像的采集,采集胎儿心脏超声标准切面(四腔心切面,左心室流出道切面,右心室流出道切面,三血管气管切面,主动脉弓切面,肺动脉分叉切面),共收集完整病例215例,并对所有病例进行随访。结果两种检查方式的四腔心切面显示率比较,差异无统计学意义(P>0.05),而左心室流出道切面、右心室流出道切面、主动脉弓切面、肺动脉分叉切面、三血管气管切面,四维STIC技术采集的切面显示率均高于二维超声心动图,差异均有统计学意义(P均<0.05),四维STIC技术检查所用时间短于二维超声心动图,差异有统计学意义(P<0.05)。入组病例中检出并经随访确诊为圆锥动脉干畸形5例,四维STIC技术正确诊断病例3例,二维超声心动图正确诊断病例2例,四维STIC技术纠正二维超声心动图检查漏诊病例1例。结论四维STIC技术可于孕12~15^(+6)周对胎儿心脏圆锥动脉干系统发育情况有初步评估,并且在检查时间及圆锥动脉干畸形关键诊断切面的显示率方面优于二维超声心动图。Objective To investigate the feasibility of four-dimensional time-space correlation imaging(STIC)in screening fetal heart conotruncal defects at 12~15^(+6) weeks of gestation.Methods Two-dimensional echocardiography and four-dimensional STIC were used to collect the images of the key sections for the diagnosis of fetal heart conotruncal defects in pregnant women at 12~15^(+6) weeks of gestation.The standard sections of fetal heart were collected:the four-chamber section;the left ventricular outflow tract section;the right ventricular outflow tract section;the three-vessel trachea section;the aortic arch section;the pulmonary artery bifurcation section.A total of 215 complete cases were collected and followed up.Results There was no significant difference in the display rate of the four-chamber section(P>0.05),but the display rate of the left ventricular outflow tract section,the right ventricular outflow tract section,the aortic arch section,the pulmonary artery bifurcation section and the three-vessel trachea section were significantly higher than those by two-dimensional echocardiography(P<0.05).The examination time of four-dimensional STIC technique was significantly shorter than that of two-dimensional echocardiography(P<0.05).Five cases of fetal heart conotruncal defects were diagnosed by echocardiography after follow-up,3 cases were correctly diagnosed by four-dimensional STIC,2 cases were correctly diagnosed by two-dimensional echocardiography,and 1 case that was missed diagnosis by two-dimensional echocardiography was corrected by four-dimensional STIC.Conclusion STIC technique can provide a preliminary assessment of the the development of fetal cardiac conus trunk system at 12~15^(+6) weeks of gestation,which is superior to two-dimensional echocardiography.

关 键 词：时间-空间关联成像技术 胎儿心脏 圆锥动脉干畸形 超声心动图 

分 类 号：R714.53[医药卫生—妇产科学]