四维超声STIC技术筛查胎儿先天性心脏病的临床价值分析被引量：7

The clinical value analysis of prenatal four-dimensional ultrasound STIC technology in screening fetal congenital heart disease

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摘要目的探讨四维超声时空关联成像(STIC)技术筛查胎儿先天性心脏病的临床价值。方法回顾性分析2018年6月至2020年6月在我院行常规孕检的1580例产妇临床资料,均行二维和四维超声检查。以引产后解剖结果或胎儿出生后随访心电结果为金标准,分析二维和四维超声对胎儿先天性心脏病检查情况和诊断效能。结果1580例产妇均完成二维和四维超声检查,失访8例,中途退出2例,最终成功随访1570例,共检出胎儿先天性心脏病61例(3.89%);四维超声对胎儿心脏畸形检出率、敏感度和阴性预测值高于二维超声,漏诊率低于二维超声,差异有统计学意义(P<0.05);四维超声对胎儿心脏畸形诊断误诊率略低于二维超声,特异度、阳性预测值略高于二维超声,差异无统计学意义(P>0.05)。结论四维超声对胎儿心脏畸形检出率、敏感度和阴性预测值高于二维超声,具有二维超声不可比拟的优势,能够降低漏诊风险,为产前筛查提供更可靠的科学依据。 Objective To explore the clinical value of prenatal four-dimensional ultrasound spatiotemporal correlation imaging(STIC)technology in screening fetal congenital heart disease.Methods A retrospective analysis of the clinical data of 1,580 women who underwent routine pregnancy examinations in our hospital from June 2018 to June 2020,all underwent two-dimensional and four-dimensional ultrasound examinations.Taking the post-induction anatomy results or the fetal follow-up ECG results as the gold standard,the two-dimensional and four-dimensional ultrasound examinations and diagnostic efficacy of fetal congenital heart disease are analyzed.Results All 1580 parturients completed 2D and 4D ultrasound examinations,8 cases were lost to follow-up,2 cases withdrew midway,and finally 1570 cases were successfully followed up.A total of 61 cases(3.89%)of fetal congenital heart disease were detected.The detection rate,sensitivity,and negative predictive value are higher than that of two-dimensional ultrasound,and the missed diagnosis rate is lower than that of two-dimensional ultrasound,and the difference is statistically significant(P<0.05);the misdiagnosis rate of four-dimensional ultrasound for fetal heart malformations is slightly lower than that of two-dimensional ultrasound.The specificity and positive predictive value were slightly higher than two-dimensional ultrasound,and the difference was not statistically significant(P>0.05).Conclusion The detection rate,sensitivity and negative predictive value of four-dimensional ultrasound for fetal heart malformations are higher than two-dimensional ultrasound.It has the incomparable advantages of two-dimensional ultrasound.It can reduce the risk of missed diagnosis and provide a more reliable scientific basis for prenatal screening.