彩色多普勒超声技术在早孕期先天性心脏病筛查中的应用价值  

Application value of color Doppler ultrasound technology in screening congenital heart disease in early pregnancy

作　　者：郑帅[1,2] 王静怡 周小雪 谷孝艳 韩建成[1] 赵华巍[2] 迟文静 何怡华 ZHENG Shua;WANG Jingyi;ZHOU Xiaoxue;GU Xiaoyan;Han Jiancheng;ZHAO Huawei;CHI Wenjing;HE Yihua(Department of Center for Fetal Heart Maternal-Fetal Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所胎儿心脏母胎医学中心,100029 [2]北京市海淀区妇幼保健院超声科

出　　处：《心肺血管病杂志》2025年第1期71-75,82,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京市自然科学基金资助项目(7244325);胎儿心脏病母胎医学研究北京市重点实验室(BZ0308);心血管疾病精准医学北京实验室(PXM2018_014226_000013)。

摘　　要：目的:探讨彩色多普勒超声技术在早孕期先天性心脏病(congenital heart disease,CHD)筛查中的应用价值。方法:收集2021年12月至2022年6月,于北京市海淀区妇幼保健院产前诊断中心接受胎儿心脏彩色多普勒超声检查的胎儿1138例,采取四腔心切面(four-chamber view,4CV)、三血管切面(three-vessel view,3VV)及大动脉交叉切面(X sign in aorta and pulmonary artery crossing,X sign)三者联合扫查方法,分析4CV、3VV、X sign及三者联合对早孕期CHD的诊断效能。结果:早孕期胎儿心脏的4CV、3VV及X sign三个切面彩色多普勒超声图像显示率100%;早孕期运用彩色多普勒超声技术筛查发现1138例病例中,胎儿CHD共11例,经证实其中8例为CHD,余3例在中孕期筛查为正常,另有2例胎儿早孕期筛查胎儿心脏正常,进行中孕期筛查确诊CHD;早孕期胎儿彩色多普勒超声技术筛查结果显示,4CV、3VV、X sign三者联合的灵敏度和准确度均高于4CV、3VV、X sign单切面。结论:早孕期彩色多普勒超声技术4CV、3VV、X sign三切面联合应用可有效提高胎儿CHD筛查效果,具有较高应用价值。Objective:To explore the application value of color Doppler ultrasound technology in screening for congenital heart disease(CHD)in early pregnancy.Methods:We prospectively collected 1138 fetuses who underwent fetal cardiac color Doppler ultrasonography at the prenatal diagnostic center of Haidian District Maternal and Child Health Hospital in Beijing from December 2021 to June 2022,We analyzed the diagnostic efficacy of four-chamber view(4CV),three-vessel view(3VV)and in aorta and pulmonary artery crossing(X sign)by adopting a combined scanning method for the diagnosis of CHD in early pregnancy.Results:100%of 4CV,3VV and X sign color Doppler ultrasound images of the fetal heart in early pregnancy were displayed;11 cases of fetal CHD were detected in 1138 cases in early pregnancy using color Doppler ultrasound,of which 8 cases were confirmed to be CHD,and the remaining 3 cases were found to be normal in Mid-trimester screening,while 2 cases were found to be normal in early pregnancy,in Mid-trimester screening was performed to confirm the diagnosis of CHD;The results of early pregnancy screening with fetal color Doppler ultrasound technology showed that the sensitivity and accuracy were all higher for the combination of 4CV,3VV,and X sign than for the single section of 4CV,3VV,and X sign.Conclusions:The combined application of 4CV,3VV and X sign three sections of color Doppler ultrasound in early pregnancy can effectively improve the screening effect of fetal CHD and has high application value.

关 键 词：胎儿 早孕期 先天性心脏病 四腔心 三血管 大动脉交叉 

分 类 号：R54[医药卫生—心血管疾病]