四维超声在胎儿心脏畸形诊断中的应用  

Application of Four-Dimensional Ultrasound in Diagnosis of Fetal Heart Malformation

作　　者：罗妙云 林爱芹 陈静 LUO Miaoyun;LIN Aiqin;CHEN Jing(Puning Maternal and Child Health and Family Planning Service Center,Puning,Guangdong 513500,China)

机构地区：[1]普宁市妇幼保健计划生育服务中心,广东普宁513500

出　　处：《岭南心血管病杂志》2024年第2期181-184,221,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的分析四维超声在胎儿心脏畸形诊断中的应用价值。方法回顾性选取普宁市妇幼保健计划生育服务中心2019年1月至2022年10月行产前检查并经产后追踪诊断为胎儿心脏畸形的100例孕妇作为研究对象。比较常规二维超声和四维超声时间-空间关联成像技术(spatio-temporal image correlation,STIC)技术对胎儿心脏畸形诊断的准确率、误诊率和漏诊率,并记录单个孕妇行二维超声和四维超声检查的时间。结果在100例心脏畸形胎儿中,以室间隔缺损最为常见,占至39%。将产后追踪诊断作为“金标准”,经比较发现,常规二维超声对胎儿心脏畸形诊断准确率为81.00%,低于四维超声STIC的97.00%,而漏诊率和误诊率分别为11.00%和8.00%,高于四维超声STIC的2.00%和1.00%,差异具有统计学意义(P<0.05)。且单个孕妇二维超声检查平均时间明显长于四维超声检查,差异具有统计学意义[(5.23±0.81)min vs.(4.16±0.77)min,t=9.574,P<0.001]。结论四维超声STIC技术可客观、清晰显示胎儿心脏解剖结构,提高胎儿心脏畸形诊断的准确率,降低误诊和漏诊风险,并进一步提高产前筛查效率,可以作为二维超声检查的有效补充。Objectives To analyze the value of 4-dimensional 4D ultrasound in the diagnosis of fetal cardiac malformations.Methods One hundred pregnant women who underwent prenatal examination and frequent postnatal follow-up diagnosis of fetal cardiac malformation from January 2019 to October 2022 in Puning Maternal and Child Health and Family Planning Service Center were retrospectively selected as study subjects.The accuracy,misdiagnosis and leakage rates of fetal cardiac malformations diagnosed by conventional 2-dimensional(2D)ultrasound and 4D ultrasound spatio-temporal image correlation(STIC)techniques were compared,and the durations of 2D and 4D ultrasound examinations of individual pregnant women were recorded.Results Among the 100 fetuses with cardiac anomalies,ventricular septal defect was the most common,accounting for 39% of cases.Using postnatal follow-up as the“gold standard”,we found that the diagnostic accuracy of conventional 2D ultrasound for fetal cardiac anomalies was 81.00%,which was lower than that of 4D ultrasound STIC(97.00%),while the rates of missed diagnosis and misdiagnosis were 11.00% and 8.00%,respectively,which were higher than those of 4D ultrasound STIC(2.00% and 1.00%)with statistically significant differences(P<0.05).And the mean duration of 2D ultrasound was significantly longer than that of 4D ultrasound in individual pregnant women,with a statistically significant difference[(5.23±0.81)min vs.(4.16±0.77)min,t=9.574,P<0.001)].Conclusions The 4D ultrasound STIC technique can objectively and clearly display the fetal heart anatomy,improve the accuracy of fetal heart malformation diagnosis,reduce the risk of misdiagnosis and missed diagnosis,and further improve the efficiency of prenatal screening,which can be an effective supplement to 2D ultrasound examination.

关 键 词：先天性心脏病 四维超声 时间-空间相关成像技术 胎儿心脏畸形 

分 类 号：R541.1[医药卫生—心血管疾病]