针对性胎儿心脏超声检查的诊断价值分析

The diagnostic value of targeted analysis(4 degree) of fetal echocardiography

目的探讨针对性胎儿心脏超声检查的诊断价值。方法选取我院2015年1~6月间孕妇360例,均为胎儿产前初筛时怀疑心脏异常或有胎儿先天性心脏畸形（CHD）高危因素者,行针对性胎儿心脏超声检查,并与产后或引产后随访结果进行比较。结果超声产前检查出CHD83例,正常产后或引产后随访为86例,超声产前诊断检出率为23.1%（83/360）,符合率为96.5%（83/86）,敏感度93.3%,特异度100%。漏诊3例,分别为肺动脉狭窄2例、室间隔小缺损1例,漏诊率为0.83%（3/360）。针对性胎儿心脏超声产前检查对于单心房或单心室、心内膜垫缺损、二、三尖瓣闭锁、左心或右心发育不良、法洛四联征、室间隔缺损、永存动脉干、大动脉转位、主动脉弓离断、完全性肺静脉异位引流、永存左上腔、右室双出口、右位主动脉弓进行筛查时,其检出率、符合率和随访结果差异无统计学意义。结论针对性胎儿心脏超声检查对CHD的诊断具有较高价值。

Objective To investigate the diagnostic value of targeted fetal echocardiography analysis.Methods Three hundred and sixty pregnant women who were suspected to be heart abnormalities or with high risk of congenital heart disease（ CHD） from January,2015 to June,2015 in our hospital were selected.They were examined with targeted fetal echocardiography and followed up till to postpartum or post-abortion.Results Eighty-three cases were diagnosed as CHD by using the ultrasonic antenatal examination.Eighty-six cases were followed up after delivery or abortion.The detection rate of ultrasound prenatal diagnosis was 23. 1%（ 83 / 360）.The agreement rate was 96. 5 %（ 83 / 86）.The sensitivity and specificity were 93. 3% and 100%,respectively.Three cases were missed diagnosis,in which 2 cases were pulmonary stenosis,and one case was ventricular septal defect.The missed diagnostic rate was 0. 83%（ 3 /360）.The detection rate,agreement rate and follow-up results in targeted prenatal ultrasound screen for fetal heart such as single atrium or single ventricle,endocardial cushion defect,mitral or tricuspid atresia,left heart or right heart hypoplasia,tetralogy of Fallot,ventricular septal defect,truncus arteriosus,transposition of great arteries,aortic arch,total anomalous pulmonary venous drainage,persistent left superior vena,double outlet right ventricle and right aortic arch had no significant difference. Conclusion The targeted fetal echocardiography has high diagnostic value for CHD.