血流成像STIC技术联合胎儿心脏智能导航对胎儿心脏异常的检测价值  

The value of blood flow imaging STIC technology combined with fetal heart intelligent navigation in the detection of fetal cardiac abnormalities

作　　者：雷俊华[1] 仝蕊[1] 黄仙[1] 张凯丽 卢丽娟[1] LEI Jun-hua;TONG Rui;HUANG Xian(Department of Ultrasound,Kunming City Maternal and Child Health Hospital,Kunming Yunnan 650031,China)

机构地区：[1]昆明市妇幼保健院超声科,云南昆明650031

出　　处：《临床和实验医学杂志》2023年第3期322-325,共4页Journal of Clinical and Experimental Medicine

基　　金：昆明市卫生健康委员会卫生科研项目(编号:2020-09-02-118)。

摘　　要：目的探究血流成像时间-空间相关成像技术(STIC)联合胎儿心脏智能导航对胎儿心脏异常的诊断价值。方法前瞻性选择2019年1月至2022年1月于昆明市妇幼保健院超声科开展胎儿心脏超声检查的69例单胎妊娠胎儿为研究对象,对其分别开展二维超声诊断后实施STIC容积联合心脏智能导航检测,以产后诊断等结果为金标准(39例为异常病例组,30例为正常对照组)。分别计算二维超声与联合检测对胎儿心脏异常的诊断敏感度、特异度、阳性似然比、阴性似然比、受试者工作特征(ROC)曲线下面积(AUC)以及诊断符合率,同时统计两种检测方式对胎儿心脏异常诊断价值的差异。结果(1)血流成像STIC技术联合心脏智能导航对胎儿心脏异常的诊断敏感度为94.87%,特异度为93.33%,阳性似然比为14.23,阴性似然比为0.05,诊断符合率为94.20%,ROC曲线下面积为0.761;二维超声对胎儿心脏异常的诊断敏感度为76.92%,特异度为86.67%,阳性似然比为5.77,阴性似然比为0.27,诊断符合率为81.16%,ROC曲线下面积为0.659。(2)联合检测在正常对照组胎儿检测中能够提高三血管气管切面、大动脉短轴切面、胃泡切面、导管弓切面和主动脉弓切面的显示率(P<0.05)。(3)三血管气管切面中的肺动脉、右室流出道切面中的肺动脉分叉、导管弓切面中的动脉导管弓、主动脉弓切面中的主动脉弓、上下腔静脉切面中的下腔静脉在联合检测后检出率出现显著提升(P<0.05)。(4)联合检测对异常病例组患者心脏异常的显示情况,结果显示下腔静脉离断、单心房、单心室要素显示率最高达100.00%,左心发育不良和脐静脉异常连接显示率最低为80.00%。结论血流成像STIC技术联合胎儿心脏智能导航技术对胎儿心脏异常的诊断敏感度和特异度均高于90%,能够对胎儿心脏异常的类型进行鉴别诊断,具有较高的临床应用价值。Objective To explore the diagnostic value of blood flow imaging time-space correlation imaging(STIC)combined with fetal cardiac intelligent navigation in fetal cardiac abnormalities.Methods A total of 69 singleton gestation fetuses who underwent fetal cardiac ultrasound examination in the Department of Ultrasound of Kunming City Maternal and Child Health Hospital from January 2019 to January 2022 were prospectively selected as the research subjects,and they were respectively diagnosed by two-dimensional ultrasound and then performed STIC volume combined with cardiac intelligent navigation detection,taking postpartum diagnosis and other results as the gold standard(39 cases were abnormal case group,30 cases were normal control group),the diagnostic sensitivity,specificity,positive likelihood ratio,positive likelihood ratio,and positive likelihood ratio of two-dimensional ultrasound and combined detection for fetal cardiac abnormalities were calculated respectively.Negative likelihood ratio,AUC and diagnostic coincidence rate,and the differences in the diagnostic value of the two detection methods for fetal cardiac abnormalities were also calculated.Results(1)The diagnostic sensitivity of blood flow imaging STIC technology combined with intelligent cardiac navigation for fetal cardiac abnormalities was 94.87%,the specificity was 93.33%,the positive likelihood ratio was 14.23,and the negative likelihood ratio was 0.05.The diagnostic coincidence rate was 94.20%,the AUC was 0.761;the diagnostic sensitivity of two-dimensional ultrasound for fetal cardiac abnormalities was 76.92%,the specificity was 86.67%,the positive likelihood ratio was 5.77,the negative likelihood ratio was 0.27,and the diagnostic coincidence rate was 81.16%,the AUC was 0.659.(2)Combined detection could improve the display rate of three-vessel trachea section,aortic short-axis section,gastric bubble section,ductal arch section and aortic arch section in the fetal detection of normal control group(P<0.05).(3)The detection rate of pulmonary artery in

关 键 词：血流成像时间-空间相关成像技术 心脏智能导航 胎儿心脏异常 诊断价值分析 

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]