胎儿心脏超声在先天性心脏病筛查中的应用价值  

Clinical value of fetal cardiac ultrasound in screening congenital heart disease

作　　者：翟莉莉 刘亚君 马文斌 孙桂玲 Zhai Lili;Liu Yajun;Ma Wenbin;Sun Guiling(Department of Ultrasound,Obstetrics and Gynecology Hospital of Kaifeng,Kaifeng 475000,China)

机构地区：[1]开封市妇产医院超声科,开封475000

出　　处：《中国实用医刊》2024年第17期74-77,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨胎儿心脏超声在先天性心脏病(CHD)筛查中的应用价值。方法队列研究。抽取2021年10月至2023年10月于开封市妇产医院就诊的疑似胎儿CHD的38例孕妇,38例均接受常规三维超声检查和胎儿心脏超声检查,收集胎心心脏图像进行分析;以生产结局或引产结局为金标准,采用Kappa一致性检验分析常规三维超声检查和胎儿心脏超声检查对CHD诊断的一致性。结果38例经生产或引产共确诊胎儿CHD 17例,其中室间隔缺损、肺动脉瓣狭窄伴右室发育不良占比较高。在CHD诊断中,胎儿心脏超声检查检出率(39.47%,15/38)高于常规三维超声检查(36.84%,14/38),P<0.05;胎儿心脏超声检查的敏感度、特异度高于常规三维超声检查(P<0.05);二者与生产或引产的诊断结果一致性较好(Kappa=0.735、0.630,P均<0.05)。在不同类型CHD诊断中,胎儿心脏超声检查诊断符合率(70.59%)高于常规三维超声(52.94%),P<0.05;且常规三维超声和胎儿心脏超声诊断结果与生产或引产的诊断结果一致性较好(Kappa=0.682、0.746,P均<0.05)。结论胎儿心脏超声检查可重点筛查CHD及其类型,具有较高的敏感度及特异度。Objective To investigate the clinical value of fetal cardiac ultrasound in screening congenital heart disease(CHD).Methods A total of 38 pregnant with suspected fetus CHD treated in Obstetrics and Gynecology Hospital of Kaifeng from October 2021 and October 2023 were selected as the research objects of the cohort study.They all underwent routine three-dimensional ultrasound and fetal cardiac ultrasound examinations;and fetal heart images were collected for analysis.Taking outcomes of labor or induced labor as the golden standard,consistency of routine three-dimensional ultrasound and fetal cardiac ultrasound examinations in the diagnosis of CHD were determined by Kappa consistency test.Results Among the 38 fetus with suspected CHD,17 fetus were confirmed according to outcomes of labor or induced labor,of which ventricular septal defect and pulmonary stenosis complicated by right ventricular dysplasia had higher proportions.In the diagnosis of CHD,the detection rates of fetal cardiac ultrasound(39.47%,15/38)was higher than that of the routine three-dimensional ultrasound(36.84%,14/38),P<0.05;fetal cardiac ultrasound had higher sensitivity and specificity than routine three-dimensional ultrasound(P<0.05);both of them had good consistencies with outcomes of labor or induced labor(Kappa=0.735,0.630;both P<0.05).In the diagnosis of different types of CHD,the coincidence rate of fetal cardiac ultrasound(70.59%)was higher than that of routine three-dimensional ultrasound(52.94%),P<0.05;moreover,routine three-dimensional ultrasound and fetal cardiac ultrasound had good consistencies with outcomes of labor or induced labor(Kappa=0.682,0.746;both P<0.05).Conclusions Fetal cardiac ultrasound can emphatically screen CHD and types of the disease,with high sensitivity and specificity.

关 键 词：胎儿心脏超声 先天性心脏病 筛查 临床价值 

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]