Objective To investigate the clinical value of two-dimensional echocardiography combined with STIC technique in the localization and quantification of simple ventricular septal defect prenatally. Methods One thousand nine hundred and eighty-six pregnant women registered in Anzhen hospital were included in our study,33 cases were confirmed with simple ventricular septal defect,ultrasound typing of fetal ventricular septal defect based on the current typing system widely used in surgery,the cases were divided 7 types: perimembranous type, simple membranous type, parietal septum type, under the crest type, crest type, subpulmonary type and muscular type. Fetal echocardiography combined with STIC technique was performed in 33 fetus for localization and quantification of simple ventricular septal defect typing, the fetal echocardiography result were analyzed in comparison with the postpartum echocardiography. Results The result of two dimensional echocardiography combined with STIC technique of all the 33 cases included 30 cases of confirmed simple ventricular septal defect, 10 casesof perimembranous type, 3 cases of simple membranous type, 3 cases of parietal septum type, 14 cases of muscular type. The accuracy of echocardiographic typing was 90. 9% ( 30/33 ); one case of small perimembranous ventricular septal defect was missed,the misdiagnostic rate was 3. 0% ( 1/33 );the other two cases dignosed as simple ventricular septal defect turned to be normal after postpartum echocardiographic follow-up, the misdiagnosis rate was 6. 1%( 2/33 ). The 33 cases included 1 case of restrictive ventricular septal defect and 32 cases of non-restractive ventricular septal defect. Conclusions Two-dimensional echocardiography with STIC technology ultrasound section can detect the fetal ventricular septal defect location accurately and directly. This study provided a reliable method for typing location and quantitative of fetal ventricular septal defect,it is very important for the selection and timing of ventricular septal defect surgery after birth.%目的 探讨二维超声心动图结合空间-时间关联成像(STIC)技术对胎儿单纯性室间隔缺损超声定位分型及定量诊断的临床应用价值.方法 应用二维超声心动图结合STIC技术,采用目前外科常用的分型方法(膜周型、单纯膜部型、隔瓣下型、嵴下型、嵴内型、干下型、肌部型)对在北京安贞医院经胎儿超声心动图检查诊断的33例单纯性室间隔缺损胎儿进行超声定位分型和定量诊断,并与胎儿产前二维超声心动图及新生儿超声心动图随诊结果进行比较.结果 与33例新生儿超声心动图随诊结果比较,产前二维超声心动图与STIC技术联合检出的30例(膜周型10例,单纯膜部型3例,隔瓣下型3例,肌部型14例)单纯性室间隔缺损胎儿与产后超声心动图随诊结果相符合,定位分型诊断符合率为90.9%(30/33);漏诊1例膜周部小室间隔缺损,漏诊率为3.0%(1/33);误诊2例(6.1%,2/33),产前胎儿超声心动图诊断单纯性室间隔缺损而新生儿复查超声心动图未见异常.产前超声心动图定量诊断胎儿限制性室间隔缺损 1例(1/33),非限制性室间隔缺损 32例(32/33),与产后随诊结果完全符合.结论 应用二维超声心动图联合STIC技术和合理的超声切面可准确、直观、清晰显示胎儿室间隔缺损部位,产前行胎儿室间隔缺损超声定位分型和定量诊断可为胎儿出生后选择手术时机和手术方式提供重要参考依据.
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