四腔心头侧偏转法快速筛查胎儿先天性心脏畸形的体会

Experience on four-chamber view with the ultrasonic plane tilting cephalicly in rapid screening fetal congenital cardiac malformations

目的探讨四腔心头侧偏转法在基层医院产前快速筛查胎儿先天性心脏畸形的价值。方法采用四腔心头侧偏转法对6474例孕妇快速筛查胎儿心脏畸形,即在四腔心切面的基础上依次获得左右心室流出道切面、三血管切面及三血管气管切面,以引产或产后诊断为金标准,评价此方法快速筛查胎儿心脏畸形的价值。结果正常胎儿心脏检查时间(150±30)s,心脏畸形胎儿检查时间(25±10)min。产后确诊心脏畸形胎儿17例(0.26%),超声产前共检出14例,漏诊3例,无假阳性病例。结论四腔心切面头侧偏转法是一种简单、快速、易学、可靠的胎儿心脏畸形筛查方法,在胎儿产前心脏畸形筛查中有重要的应用价值。

Objective To explore the value of four-chamber view with the ultrasonic plane tilting cephalicly in rapid screening of fetal congenital cardiac malformations in primary hospital. Methods With the ultrasonic plane tilting cephalicly, the four chamber view of the heart is obtained. We can rapidly obtain the left and right ventricular outflow tract views, tree vessels view, tree vessels and trachea view in sequence. Rapid screening of the fetal cardiac malformations was performed in 6474 pregnant women by this method. Using the final diagnosis after birth as a golden standard, the value of this rapid screening method was evaluated in detecting fetal cardiac malformations. Results The examination time of fetal echoeardio- graphy was about 150±30 s and the time of diagnosis of cardiac malformations of each case was 25±10 minutes. Fourteen cases were detected prenatally in 17 cases with cardiac malformations,3 cases were missed and there were no false positive cases. The incidence of heart malformations was 0.26% in this group. Conclusions The four-chamber view with the ultrasonic plane tilting cephaliely is a simple, rapid, easy and reliable way with important application value in fetal cardiac malformations screening.