产前超声四腔心切面与三血管切面筛查孕早期胎儿心脏畸形的价值  

Comparison of the Value of Prenatal Four-Chamber View and Three-Vessel View in Screening Fetal Cardiac Malformations in Early Pregnancy

作　　者：曹俊萍 姚建锋 靳维维 CAO Junping;YAO Jianfeng;JIN Weiwei(Department of Ultrasound Medicine of the Third People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第三人民医院超声医学科,河南郑州450000

出　　处：《湖北民族大学学报（医学版）》2024年第1期64-67,共4页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的探讨产前超声四腔心切面(FCV)与三血管切面(3V)筛查孕早期胎儿心脏畸形的价值。方法回顾性分析2020年1月-2022年12月在郑州市第三人民医院进行产前检查的82例孕妇临床资料,所有孕妇均接受超声检查,观察FCV与3V对不同孕周显示状况,以临床结局为准,分析FCV、3V及两者联合对胎儿心脏畸形的诊断效能。分析心脏疾病检出状况及超声影像学表现。结果不同孕周胎儿FCV、3V显示成功率差异显著,孕13+6周FCV、3V显示成功率高于孕11周、孕12周(P<0.05),FCV联合3V对胎儿心脏畸形诊断灵敏度、特异度、准确度、阴性预测值、阳性预测值、Kappa值分别为85.71%、100.00%、98.78%、98.68%、100.00%、0.916,均高于单项诊断(P<0.05)。6例胎儿中室间隔缺损2例(FCV正常/室间隔可见回声中断,3V图像正常),三尖瓣下移畸形1例(FCV表现三尖瓣位置低,三尖瓣重度反流,3V表现“V”字形血管不对称/正常),迷走右锁骨下动脉1例(FCV表现正常,3V表现于气管后方可见一动脉血管向右肩部走行),左心发育不良1例(FCV表现单一粗大血流/血流不对称,3V图像表现“V”字形血管消失或不对称/正常),单心室1例(FCV表现单一粗大血流,3V图像表现“V”字形血管消失或不对称/正常)。结论于孕早期进行FCV与3V联合筛查可有效显示心脏畸形,具有较高的临床应用价值。Objective To investigate the value of prenatal four-chamber view(FCV)and three-vessel view(3V)in screening fetal cardiac malformations in early pregnancy.Methods The clinical data of 82 pregnant women who underwent prenatal examinations in the hospital from January 2020 to December 2022 were analyzed retrospectively.All women were examined with ultrasound to observe the display of different gestational weeks through FCV and 3V.Based on clinical outcomes,the diagnostic performance of FCV,3V,and their combination for fetal cardiac malformations were analyzed.The detection and ultrasound findings of cardiac diseases were analyzed.Results There is a statistically significant difference in the success rate of FVC and 3V display among fetuses at different gestational weeks,and the success rate of FVC and 3V display at 13+6 weeks were higher than those at 11 and 12 weeks(P<0.05).The sensitivity,specificity,accuracy,negative predictive value,positive predictive value and Kappa value of FCV combined with 3V for diagnosing fetal cardiac malformations were the highest,which were 91.678%,100.00%,98.81%,98.61%,100.00%and 0.950.Among 6 fetuses,there were 2 cases of ventricular septal defects(FCV findings were normal/showed echo interruption of ventricular septum,and 3V image was normal),1 case of Ebstein anomaly(FCV showed tricuspid valve in low position and severe tricuspid regurgitation,and 3V showed asymmetric/normal V-shaped vessel),1 case of aberrant right subclavian artery(FCV findings are normal,and 3V showed an arterial blood vessel running to the right shoulder behind the trachea),1 case of hypoplastic left heart(FCV showed single thick blood flow/asymmetric blood flow,and 3V image showed that V-shaped blood vessel disappeared or was asymmetric/normal),and 1 case of single ventricle(FCV showed single thick blood flow,and showed that V-shaped blood vessel disappeared or was asymmetric/normal).Conclusion The combined screening of FCV and 3V in early pregnancy can effectively display fetal cardiac malformations.

关 键 词：超声四腔心切面 三血管切面 孕早期 胎儿心脏畸形 

分 类 号：R445.1[医药卫生—影像医学与核医学]