Factors controlling fetal echocardiography determine the diagnostic accuracy of isolated ventricular septal defect

摘要

Background:Fetal echocardiography (FECG) is a key screening tool for prenatal cardiac abnormalities.Herein,we examined the ultrasonic factors determining prenatal ultrasonic diagnosis of isolated ventricular septal defect (IVSD).Methods:The diagnostic role of ultrasonic factors was investigated in patients in middle or late pregnancy,diagnosed with IVSD by FECG and confirmed using postnatal echocardiography.Results:One hundred and six patients with IVSD were enrolled;the majority had perimembranous VSD.The combined imaging mode of 2 dimentionalechocardiography (2DE) and color doppler flow imaging (CDFI) showed the highest rate (56.6%) of IVSD detection,while CDFI was more efficient than 2DE (32.1% vs.11.3%).The single-view mode was more efficient than multiple-view mode (75.5% vs.24.5%).The highest efficient mode to detect IVSD was achieved using combined imaging mode on the single view of the left ventricular outflow tract view (LVOTV) (28.3%).FECG correctly classified 71.7% of fetal IVSD.There was a significant difference of accuracy rate in classifying IVSD among the three different imaging modes (x2=7.141,P<0.05).The single imaging mode of CDFI and the mode of CDFI combined with 2DE correctly classified 75.9% and 75.0% of fetal IVSD,respectively.LVOTV was the most accurate view of fetal IVSD classification (85.2%;x2=15.782,P<0.05).There was no difference in accuracies of IVSD classification among multiple-view modes (x2=2.343,P>0.05) or between single-view mode and multiple-view mode (x2=0.32,P>0.05).Conclusion:Single LVOTV in CDFI or CDFI combined with 2DE of FECG were the most effective diagnostic modes for fetal IVSD diagnosis.