产前四维超声联合心动图对胎儿先天性心脏病的诊断价值  

Diagnostic value of prenatal four-dimensional ultrasound combined with echocardiography for fetal congenital heart disease

作　　者：李洁 王生兰[2] 朵生兰 哈灵侠[1] Li Jie;Wang Shenglan;Duo Shenglan;Ha Lingxia(Reproductive Medicine Center,General Hospital of Ningxia Medical University,Yinchuan 750000,China;不详)

机构地区：[1]宁夏医科大学总医院生殖中心,银川750000 [2]青海红十字医院胎儿医学科 [3]青海红十字医院超声科

出　　处：《实用医学影像杂志》2024年第5期335-338,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨临床诊断胎儿先天性心脏病过程中产前四维超声与胎儿超声心动图联合应用价值。方法选择2022年1月至2023年1月于青海红十字医院进行胎儿先天性心脏病筛查的140例产检孕妇作为检查对象,孕20~24周行产前四维超声检查、孕24~28周行胎儿超声心动图检查,记录胎儿先天性心脏病检出情况,并以妊娠终止后的病理诊断及分娩后随访结果为金标准,比较产前四维超声与胎儿超声心动图联合诊断效能、常规心动图单一诊断效能、心脏畸形类型检出率,观察胎儿先天性心脏病超声参数[颈后皮肤厚度(NF值)、脐动脉收缩末期与舒张末期流速最大值比值(S/D)值]。结果金标准提示32例胎儿先天性心脏病,联合诊断准确性、灵敏度、特异度、阳性与阴性预测值均高于单一心动图(P<0.05)。联合诊断对法洛四联症、大动脉转位、单心室、室间隔缺损、房室瓣闭锁、主动脉缩窄、心房异构等不同心脏畸形类型检出率高于单一心动图(P<0.05)。先天性心脏病NF值、S/D值高于非先天性心脏病(P<0.05)。结论产前四维超声与心动图联合诊断效能高,对胎儿先天性心脏病筛查具有较高应用价值,可鉴别诊断疾病类型,指导临床早干预、早防治,提高人口出生质量。Objective To observe and explore the combined application value of prenatal four-dimensional ultrasound and fetal echocardiography in the clinical diagnosis of fetal congenital heart disease.Methods A total of 140 pregnant women who underwent prenatal screening for fetal congenital heart disease at Qinghai Red Cross Hospital from January 2022 to January 2023 were selected as the examination subjects.Prenatal four-dimensional ultrasound examination was performed at 20-24 weeks of pregnancy,and fetal echocardiography was performed at 24~28 weeks of pregnancy.The detection of fetal congenital heart disease was recorded,and the pathological diagnosis after termination of pregnancy and follow-up results after delivery were used as the gold standard,Compare the combined diagnostic efficacy of prenatal four-dimensional ultrasound and fetal echocardiography,the single diagnostic efficacy of conventional echocardiography,and the detection rate of cardiac malformation types.The ultrasound parameters[nuchal fold(NF)value,S/D value]of fetal congenital heart disease were observed.Results The gold standard indicated that the accuracy,sensitivity,specificity,positive and negative predictive values of combined diagnosis were higher in 32 cases with fetal congenital heart disease than those with single echocardiography(P<0.05).The detection rate of different types of cardiac abnormalities such as tetralogy of Fallot,transposition of the great arteries,single ventricle,ventricular septal defect,atrioventricular valve atresia,aortic constriction,and atrial heterogeneity in joint diagnosis was higher than those in single echocardiography(P<0.05).The NF and S/D values of congenital heart disease were significantly higher than those of non-congenital heart disease(P<0.05).Conclusion The combined diagnostic efficacy of prenatal four-dimensional ultrasound and echocardiography is high and has high application value for screening congenital heart disease in fetuses.It can distinguish and diagnose disease types,guide clinical early interv

关 键 词：超声检查 产前 先天性心脏病 心动图 诊断效能 

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]