四维彩超筛查孕中晚期胎儿先天性心脏病的临床价值  

Clinical screening value of four-dimensional color ultrasound for the fetal congenital heart disease during the second trimester of pregnancy

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作  者:朵列娜 田海燕[1] DUO Liena;TIAN Haiyan(The Affiliated Hospital of Inner Mongolia Medical University,Hohhot,Inner Mongolia,Oloo00)

机构地区:[1]内蒙古医科大学附属医院,呼和浩特010000

出  处:《中国计划生育学杂志》2024年第10期2440-2443,共4页Chinese Journal of Family Planning

基  金:内蒙古医科大学联合项目(YKD2022LH006);内蒙古医科大学科技创新团队项目(YKD2024TD008);内蒙古自治区教育厅高等学校青年科技人才发展项目(NMGIRT2305);内蒙古自治区卫生健康委医疗卫生科技计划项目(202201302)。

摘  要:目的:探讨四维彩超对孕中晚期胎儿先天性心脏病的临床筛查价值。方法:回顾性选取1500例2020年3月-2023年9月于本院行产前胎儿先天性心脏病筛查的中晚期孕妇临床资料,孕妇均行产前四维彩超检查,根据胎儿娩出后进行超声心动图检查结合随访6个月是否出现先天性心脏病症状为胎儿先天性心脏病确诊依据,分析四维彩超对胎儿先天性心脏病的筛查效能。结果:1500例胎儿中20例(1.3%)胎儿为先天性心脏病,四维彩超检出真阳性17例、真阴性1474例、假阳性6例、假阴性3例,检出敏感度85.0%、特异性99.6%(1494/1500)、准确率99.4%(1491/1500)、阳性预测值73.9%(17/23)、阴性预测值99.8%(1474/1477)。20例先天性心脏病胎儿中,6例室间隔缺损、5例右心室双出口、4例三尖瓣反流、3例大动脉转位、2例主动脉弓缩窄;四维彩超检出5例室间隔缺损、5例右心室双出口、4例三尖瓣反流、1例大动脉转位、2例主动脉弓缩窄。四维彩超检测中,6例误诊,其中5例房室瓣处花色血流、1例心室舒张异常;3例漏诊,其中2例大动脉转位、1例室间隔缺损。结论:孕中晚期采用四维彩超检查筛查胎儿先天性心脏病效能较高;孕中期(13~28周),尤其22~28周为最佳检查时期,可降低误诊漏诊情况。Objective:To explore the clinical screening value of four-dimensional color ultrasound for fetal congenital heart disease(CHD)during the second trimester of pregnancy.Methods:The clinical data of 1500 pregnant women who had undergone prenatal CHD screening by four-dimensional color Doppler ultrasound in the hospital from March 2020 to September 2023 were selected as the research subjects retrospectively.The diagnosis of fetal CHD was based on the examination result of the neonatal echocardiography after delivery and the presence of CHD symptoms of the neonates during 6 months of follow-up,and the screening efficacy of four-dimensional color Doppler ultrasound for the fetal CHD was analyzed.Results:Among 1500 fetuses,20(1.3%)fetuses were diagnosed with CHD.Four-dimensional color Doppler ultrasound detected 17 fetuses with the true positive CHD,1474 fetuses with the true negative CDH,6 fetuses with the false positive CDH and 3 fetuses with the false negative CHD.The sensitivity,the specificity,the accuracy,the positive predictive value and the negative predictive value of the four-dimensional color Doppler ultrasound of the pregnant women for their fetal CHD were 85.0%,99.6%,99.4%,73.9%and 99.8%,respectively.Among 20 fetuses with CHD,there were 6 cases with ventricular septal defect,5 cases with double outlet right ventricle,4 cases with tricuspid regurgitation,3 cases with transposition of the great arteries and 2 cases with coarctation of the aorta.Four-dimensional color Doppler ultrasound detected 5 cases with ventricular septal defect,5 cases with double outlet right ventricle,4 cases with tricuspid regurgitation,1 case with transposition of the great arteries and 2 cases with coarctation of the aortic arch.In the diagnosis of CHD by four-dimensional color Doppler ultrasound,there were 6 cases with misdiagnosed CHD,including 5 cases with atrioventricular valve color flow abnormality and 1 case with ventricular relaxation abnormality,and there were 3 cases with missed CHD,including 2 cases with transposition of

关 键 词:先天性心脏病筛查 四维彩超 漏诊 误诊 

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]

 

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