| 员小春,刘梅梅,张 欢,赵华云,刘保民.孕早期超声心动图对超声软指标阳性胎儿复杂先天性心脏病的诊断价值[J].,2017,17(28):5536-5539 |
| 孕早期超声心动图对超声软指标阳性胎儿复杂先天性心脏病的诊断价值 |
| Diagnostic Value of Echocardiography for the Early Pregnancy Complicated Congenital Heart Disease with Ultrasound Soft Index Positive Fetus |
| 投稿时间：2017-06-05 修订日期：2017-06-26 |
| DOI：10.13241/j.cnki.pmb.2017.28.032 |
| 中文关键词: 超声心动图 孕早期 超声软指标 先天性心脏病 |
| 英文关键词: Echocardiography Early Pregnancy Ultrasonography Soft Index Congenital Heart Disease |
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| 中文摘要: |
| 摘要 目的：明确各孕周胎儿超声心动图四腔观、腹部横断面观等切面显示率，探讨孕早期超声心动图对超声软指标阳性胎儿复杂先天性心脏病(CHD)的诊断价值。方法：用GE Voluson E8彩色超声诊断仪(探头频率4~8 MHz)对120例超声软指标阳性胎儿进行孕早期(11~13＋6周)超声心动图检查，探查胎儿方位、腹部大血管位置、心脏位置、心尖指向及超声心动图各切面，判断胎儿心脏结构是否正常，将检查结果与引产病理尸检、孕中期(孕18~24周)复查或分娩后新生儿期超声心动图检查结果作对照，并以ROC曲线分析孕早期超声心动图的灵敏度和特异度。结果：孕早期胎儿超声心动图对胎儿心脏四腔观、腹部横断面观、动脉导管弓观、左心室流出道观、主动脉弓观、三血管气管观、上下腔静脉长轴观的显示率均随孕周的增加而提高，分别为72.7%、89.2%、80.0%、65.8%、70.0%、72.5%、74.2%。胎儿孕早期超声心动图对复杂性CHD的灵敏度为86.4%(19/22)，特异度为96.7%(87/90)，准确度为72.7%(16/22)，ROC曲线下面积(AUC)为0.81。结论：孕早期胎儿超声心动图对各切面的显示率随孕周的增加而提高，且超声图像特征基本同于孕中期超声检查。孕早期超声心动图筛查复杂性CHD胎儿特异性好，灵敏度及准确度均较高，对于部分复杂性CHD胎儿可作出提示性诊断，对减少先天性畸形胎儿出生率有重要意义。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the section display rates of fetal echocardiographic in gestational weeks, such as the four - chamber view, abdominal cross-sectional view, etc, and investigated the diagnostic value of echocardiography for early pregnancy complicated congenital heart disease(CHD) with ultrasound soft index positive fetus. Methods: 120 cases of positive fetal whose ultrasonic soft indexes were positively detected by echocardiography in the early pregnancy (11~13＋6weeks) with the GE Voluson E8 color ultrasonic diagnosis(transducer frequency 4~8 MHz), and a number of indicators such as fetal orientation, abdominal large vessel position, cardiac position, apical point and echocardiographic sections to determine whether the fetal heart structure was normal was explored, the results of examination was compared with the pathological examination of induced labor, the period of gestation (18~24weeks) or the ultrasonic cardiogram of the newborns after delivery, and the sensitivity and specificity of echocardiography in early pregnancy was analyzed with the ROC curve. Results: The fetal echocardiographic findings of four chamber view, abdominal cross-sectional view, ductus bow view, left ventricular outflow tract view, aortic arch view, three vessel and trachea view, long axis of the vena cava view increased with the increase of gestational age, The indicators were 72.7%, 89.2%, 80.0%, 65.8%, 70.0%, 72.5%, 74.2%. The sensitivity of echocardiography in fetal early pregnancy to complex CHD was 86.4%(19/22), and specificity was 96.7%(87/90), and accuracy was 72.7%(16/22), and the area under the ROC curve (AUC) was 0.81. Conclusion: The section display rates of the fetal echocardiographic in gestational weeksincreased with the increase of gestational age. And the ultrasonographic features are basically equivalent to mid-pregnancy ultrasound. Early pregnancy echocardiography screening complex CHD fetus has good specificity, sensitivity and accuracy, which can make a prompt diagnosis for some complex CHD fetuses, and has important significance to reduce the birth rate of congenital malformation. |
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