摘要
目的分析胎儿心脏超声检查最佳孕周及不同切面组合对胎儿心脏结构异常的诊断价值。方法选择行胎儿心脏超声的单胎妊娠孕妇1589例,根据孕周分为18-22W组、23-27W组、28-32W组三组。孕妇通过胎儿超声检查获取四腔心切面(4CV)、三血管气管切面(3VT)、左室流出道切面(LVOT)、右室流出道切面(RVOT),诊断胎儿发生先天性心脏病的概率及类型,采用ROC曲线分析胎儿心脏超声检查在诊断先天性心脏病中的价值。结果本实验中4CV、3VT、LVOT、RVOT显示率分别为99.12%、98.36%、97.55%、96.73%。18-22W组、23-27W组两组各切面显示率及先天性心脏病检出率均较高。本实验发现16例先天性心脏病患者,其中室间隔缺损(VSD)、法洛四联症(TOF)、心内膜垫缺损(ECD)、大动脉转位(TGA)占比率分别为50.00%、31.30%、12.50%、6.20%。ROC曲线分析得出,4CV、4CV+3VT、4CV+3VT+LVOT+RVOT诊断先心病的AUC分别为0.689、0.915、0.962。结论胎儿心脏超声对胎儿先天性心脏畸形检出率较高,其中孕23~27周是胎儿心脏畸形检查最合适时期,胎心超4CV+3VT+LVOT+RVOT切面组合诊断先天性心脏病价值最高。
Objective To analyze the diagnostic value of fetal echocardiography at the best gestational age and different section combinations of fetal cardiac ultrasound in the structural abnormalities of fetal heart.Methods 1589 singleton pregnant women who underwent fetal echocardiography were divided into 18-22W group,23-27W group and 28-32W group.Pregnant women were checked by fetal ultrasound to obtain four chamber cardiac section(4CV),three vessel trachea section(3VT),left ventricular outflow tract section(LVOT)and right ventricular outflow tract section(RVOT)to diagnose the probability and type of fetal congenital heart disease.ROC curve was used to analyze the value of fetal cardiac ultrasound in the diagnosis of congenital heart disease.Results The display rates of 4CV,3VT,LVOT and RVOT were 99.12%,98.36%,97.55%and 96.73%,respectively.The display rate of each section and the detection rate of congenital heart disease were high in 18-22W group and 23-27W group.In this study,16 patients with congenital heart disease were found.The proportions of ventricular septal defect(VSD),tetralogy of Fallot(TOF),endocardial cushion defect(ECD)and transposition of great arteries(TGA)were 50.00%,31.30%,12.50%and 6.20%,respectively.ROC curve analysis showed that the AUCs of 4CV,4CV+3VT,4CV+3VT+LVOT+RVOT in the diagnosis of congenital heart disease were 0.689,0.915 and 0.962,respectively.Conclusion Fetal echocardiography has a high detection rate for fetal congenital heart malformations.The most appropriate period for fetal heart malformation examination is 23–27 weeks of pregnancy.The combination of fetal heart ultra 4CV+3VT+LVOT+RVOT has the highest diagnosis value in the congenital heart disease.
作者
李亚丽
黄晓新
袁博
LI Yali;HUANG Xiaoxin;YUAN Bo(Ultrasonography Lab,Xi’an Gaoxin Hospital,Xi’an,Shaanxi 710000,China)
出处
《中国优生与遗传杂志》
2021年第10期1500-1503,共4页
Chinese Journal of Birth Health & Heredity
关键词
心脏超声检查
最佳孕周
胎儿
心脏结构
诊断
cardiac ultrasound
optimal gestational age
fetus
cardiac structure
diagnosis
