超声节段分析联合连续扫描法诊断胎儿心脏圆锥动脉干畸形的应用价值

Application value of ultrasound segmental analysis combined with continuous scanning in diagnosis of fetal heart conotruncal defects

目的探讨超声节段分析联合连续扫描法在诊断胎儿心脏圆锥动脉干畸形(CTD)的临床价值。方法对24 050例单胎妊娠孕妇采用超声节段分析法进行胎儿心脏筛查,对可疑的胎儿再联合连续扫描法进一步重点检查。分析产前与产后超声心动图或尸检结果的差异。结果 24 050例孕妇中,37例产后超声心动图及尸检证实为CTD。超声节段分析法诊断CTD 31例,漏诊3例,误诊3例;运用节段分析联合连续扫描法诊断CTD 36例,漏诊1例,误诊1例。超声节段分析联合连续扫描法检出CTD的灵敏度高于单独超声节段分析法(94.6%vs.83.8%)(P<0.05)。结论超声节段分析联合连续扫描法能有效提高胎儿CTD的诊断灵敏度。

Objective To investigate the value of ultrasound segmental analysis combined with continuous scanning in the diagnosis of fetal heart conotruncal defects （CTD）. Methods Fetal heart screening was performed in 24,050 pregnant women with single pregnancy. Ultrasound continuous scanning was carried out further in the fetus with suspicious abnormal heart. The postpartum echocardiography or autopsy was performed. The difference between the prenatal and postpartum diagnosises was analyzed. Results Of 24,050 pregnant women, 37 cases with CTD were confirmed by postpartum echocardiography and autopsy. The CTD was diagnosed by ultrasound segmental analysis in 31 fetuses, 3 CTD cases were missedly diagnosed and 3 CTD cases were misdiagnosed. With ultrasound segmental analysis combined with continuous scanning, the CTD was diagnosed in 36 cases, one CTD case was missed diagnosis and one CTD case was misdiagnosed. The sensitivity in the diagnosis of fetal CTD was higher with combined use of ultrasound segmental analysis and continuous scanning than using ultrasound segmental analysis alone （ 94.6 % vs. 83. 8 %） （P〈0. 05）. Conclusion Combined use of ultrasound segmental analysis and continuous scanning can effectively improve the sensitivity in the diagnosis of fetus CTD.