四腔心切面+左右心室流出道切面+三血管切面在胎儿心脏畸形筛查中的应用价值  

Application Value of Four-chamber View+ Left and Right Ventricular Outflow Tract View +Three-vessel View in the Screening of Fetal Cardiac Malformation

作　　者：朱文锋 李力 胡丽琳 ZHU Wenfeng;LI Li;Hu Lilin(Department of Ultrasound,The Third Affiliated Hospital of Guangdong Medical University/Longjiang Hospital in Shunde District of Foshan City,Foshan 528318 Guangdong,China)

机构地区：[1]广东医科大学附属第三医院/佛山市顺德区龙江医院,广东佛山528318

出　　处：《现代诊断与治疗》2023年第5期657-659,694,共4页Modern Diagnosis and Treatment

摘　　要：目的 探讨四腔心切面+左右心室流出道切面+三血管切面在胎儿心脏畸形筛查中的应用价值。方法 选取2017年1月至2022年1月在我院进行产前超声检查的2200例孕产妇。应用四腔心切面+左右心室流出道切面+三血管切面对超声图进行分析。经超声诊断为先天性心脏病(CHD)或其他疾病类型均要进行产前诊断及尸检进行佐证。结果 经胎儿尸检或产后确诊,2200产妇中,共有42例确诊为CHD。心脏超声四腔心切面+左右心室流出道切面+三血管切面对胎儿CHD诊断的特异度100%(42/42),灵敏度95.00%(2050/2158)。经超声诊断为永存左上腔患儿为7例、右位主动脉弓患儿为8例、主动脉弓离断患儿为5例、左心发育不良患儿为4例、法乐四联症患儿为4例、永存主动脉干患儿为3例、主动脉缩窄患儿为2例、单心室患儿为3例、大动脉转位患儿为1例、三尖瓣闭锁或发育不良患儿为2例、心内膜垫缺损患儿为1例、心脏反位患儿为1例、室间隔大缺损患儿为1例、房间隔大缺损患儿为1例、心脏普大患儿为2例;四腔心切面、四腔心切面+左右流出道切面、四腔心切面+左、右流出道切面+三血管切面对CHD的检出率低到高为:66.67%、73.81%、100.00%(P<0.05)。结论 心脏超声四腔心切面+左右心室流出道切面+三血管切面对胎儿心脏畸形的检出结果较为准确,对CHD预防效果显著,畸形检出率高,可推广。Objectives To explore the application value of four-chamber view+left and right ventricular outflow tract view+three-vessel view in the screening of fetal cardiac malformations.Methods A total of 2200 pregnant women who underwent prenatal ultrasound examination in our hospital from January 2017 to January 2022 were selected.Four-chamber view+left and right ventricular outflow tract view+three-vessel view were used to analyze the sonogram.Congenital heart disease(CHD)or other disease types diagnosed by the ultrasound should be confirmed by prenatal diagnosis and autopsy.Results After fetal autopsy or postpartum diagnosis,42 out of 2200 puerpera were diagnosed with CHD.The specificity of four-chamber cardiac view+left and right ventricular outflow tract view+three-vessel view in the diagnosis of fetal CHD was 100%(42/42),and the sensitivity was 95.00%(2050/2158).There were 7 cases of persistent left superior vena cava,8 cases of right aortic arch,5 cases of interrupted aortic arch,4 cases of hypoplastic left heart syndrome,4 cases of tetralogy of Fallot,3 cases of persistent aortic trunk,2 cases of aortic coarctation,3 cases of single ventricle,1 case of transposition of the great arteries,2 cases of tricuspid atresia or dysplasia,1 case of endocardial cushion defect,1 case of cardiac inversion,1 case of ventricular septal defect,1 case of large atrial septal defect,and 2 cases of general cardiac enlargement.The detection rates of CHD by four-chamber view,four-chamber view+left and right outflow tract view,four-chamber view+left and right outflow tract view+three-vessel view were 66.67%,73.81%,and 100.00%,respectively(P<0.05).Conclusions Four-chamber view+left and right ventricular outflow tract view+three-vessel view of echocardiography is more accurate in the detection of fetal cardiac malformations,which has a significant preventive effect on CHD and has a high malformation detection rate,and is worthy to be promoted.

关 键 词：四腔心切面 左右心室流出道切面 三血管切面 胎儿心脏畸形筛 

分 类 号：R445.1[医药卫生—影像医学与核医学]