超声检查下NT增厚、颈部水囊瘤对早中孕期胎儿心脏畸形的诊断价值研究  

Diagnostic value of ultrasonography of NT thickening and neck hydrocystoma in fetal heart malformation during early and middle pregnancy

作　　者：高廷廷 姚万松 程梅 郭俊丽 Gao Ting-ting;Yao Wan-song;Cheng Mei;Guo Jun-li(Department of Ultrasound,Zhengzhou Bridge Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大桥医院超声科,河南郑州450000

出　　处：《四川生理科学杂志》2024年第9期1971-1973,2056,共4页

摘　　要：目的:探讨NT增厚、颈部水囊瘤联合诊断早中孕期胎儿心脏畸形的价值。方法:回顾性收集2019.01.01-2023.01.01期间于本院进行早中孕期产检筛查疑似胎儿心脏畸形者129例的临床资料。以产后婴儿的心脏超声检查作为诊断胎儿心脏畸形的金标准,统计胎儿心脏畸形类型构成状况。所有研究对象均行超声检查,对比不同颈部水囊瘤、不同NT增厚者的胎儿心脏畸形发生率;分析NT增厚、颈部水囊瘤与胎儿心脏畸形之间关联性以及对胎儿心脏畸形诊断价值。结果:金标准检查结果显示,心脏畸形胎儿31例,以左心发育不良为主,约占25.81%,其次为主动脉单心房单心室、缩窄/离断,占16.13%左右,最后为永存动脉干、心内膜垫缺损,约占12.90%。NT值厚>4.5 mm胎儿发生心脏畸形几率明显高于NT值厚2.5~4.5 mm胎儿(P<0.05)。囊性包块面积>6.0 cm2胎儿发生心脏畸形率明显高于颈部水囊瘤的囊性包块面积3.0~6.0 cm2胎儿(P<0.05)。Spearman相关性分析可知,NT增厚、颈部水囊瘤与胎儿心脏畸形发生存在正相关(r=0.638、0.597,P<0.05)。NT增厚联合颈部水囊瘤诊断敏感性均显著高于NT增厚与颈部水囊瘤单独检查结果(P<0.05),但三组特异性、准确性、阳性预测值、阴性预测值对比,均无明显差异(P>0.05)。结论:胎儿心脏畸形类型较多,是以主动脉缩窄/离断、单心房单心室为主。胎儿心脏畸形与NT增厚、颈部水囊瘤呈正相关。NT增厚、颈部水囊瘤联合应用可为临床早中期诊断提供参考依据。Objective:To investigate the value of NT thickening combined with neck hygroma in the diagnosis of fetal heart malformation in early and middle pregnancy.Methods:A retrospective study was carried out on 129 cases of suspected fetal heart malformations who were screened during early and middle pregnancy from January 1,2019 to January 1,2023.The gold standard for the diagnosis of fetal heart malformations was taken by postpartum cardiac ultrasonography.All subjects underwent ultrasound examination,and compared the incidence of fetal heart malformation in different cervical hydras tumors and different NT thickening.To analyze the relationship between NT thickening,neck hydras tumor and fetal heart malformation and the diagnostic value of fetal heart malformation.Results:The results of gold standard examination showed that there were 31 cases of cardiac malformation,mainly with left heart dysplasia,accounting for 25.81%,followed by single atrium and single ventricle of main artery,constriction/rupture,accounting for 16.13%,and finally with persistent trunk artery and endocardial pad defect,accounting for 12.90%.The incidence of cardiac malformation in fetuses with NT thickness>4.5 mm was significantly higher than that in fetuses with NT thickness 2.5-4.5 mm(P<0.05).The rate of cardiac malformation in fetuses with cystic mass area>6.0 cm2 was significantly higher than that in fetuses with cystic mass area 3.0~6.0 cm2(P<0.05).Spearman correlation analysis showed that there was a positive correlation between NT thickening and neck hydrocystoma and fetal heart malformation(r=0.638,0.597,P<0.05).The diagnostic sensitivity of NT thickening combined with neck hycystoma was significantly higher than that of NT thickening combined with neck hycystoma alone(P<0.05),but there were no significant differences in specificity,accuracy,positive predictive value and negative predictive value among the three groups(P>0.05).Conclusion:There are many types of fetal heart malformations,mainly aortic coarctation/dissection and single atri

关 键 词：早中孕期 胎儿心脏畸形 颈项透明层增厚 颈部水囊瘤 

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]