多切面联合超声筛查中晚孕胎儿心脏病的探讨

摘要

目的 探讨多切面联合超声在中晚孕胎儿心脏病筛查中的应用价值.方法 应用彩超筛查孕18～36周胎儿共16 500例.并通过尸体解剖证实和产后超声随访对照.对四腔心观(FCV)、四腔心+三血管-气管观(FCV+3VT)及多切面联合3种方法的诊断价值进行分析.结果 共检出先天性心脏病胎儿共96例.多切面联合法的Youden指数(0.904 5)优于FCV法(0.511 7)和FCV+3VT法(0.797 2),P<0.05.3种方法中以多切面联合法的Youden指数及灵敏度最高,漏诊率最低.结论 多切面联合扫查的灵敏度最高,漏诊率最低,可作为产前超声筛查中晚期妊娠胎儿心脏的适宜方法.%Objective To investigate multi-views conjoined screening (MVCS) for fetal heart disease in the second and third trimester pregnancy by prenatal ultrasound. Methods The four-chamber view (FCV) alone, FCV with three vessels and trachea view FCV+3VT, MVCS of 16500 consecutive fetuses aged from 18 to 36 week were examined to screen for fetal cardiac malformations with color Doppler. Suspected fetal cardiac disease was confirmed by postmortem or postnatal echocardiography and/or surgery. Then, the sensitivities of screening tests were compared among the three methods. Results 96 fetuses was identified fetal heart disease. The Youden indexes of MVCS (0. 9045)were more than FCV(0. 5117) and FCV+3VT(0. 7972)(P＜0. 05), Compared with FCV and FCV+3VT,MVCS was with the most sensitive and lowest missed diagnosis. Conclusions MVCS is a good method to diagnose fetal heart disease in the second and third trimester pregnancy with the most sensitive and lowest missed diagnosis.