三维超声时间空间联合成像技术对早孕期胎儿心脏畸形的筛查价值（英文）

Cardiac Screening in the First Trimester Using Three-dimensional Ultrasound with Spatiotemporal Image Correlation

【目的】三维超声时间空间联合成像技术对早孕期胎儿心脏畸形筛查的临床应用价值。【方法】回顾性分析2013年1月4日至2016年6月30日在我院行早孕期心脏筛查且产前可疑心脏畸形共87例,与追踪结果比较,分析三维超声时间空间联合成像技术对心脏畸形诊断的价值,同时分析不同切面包括四腔心切面、左心室流出道切面、右心室流出道切面及三血管-气管切面的诊断价值。【结果】纳入本研究的87例病例中,包括严重心脏畸形62例(71.3%,62/87)和非严重心脏异常25例(28.7%,25/87)。与出生后超声心动图或引产后尸检结果比较,应用三维超声STIC技术共分析诊断正确心脏畸形78例(89.7%)。单纯四腔心切面对心脏畸形的检出率为48.3%(42/87),四腔心切面联合左心室流出道切面的检出率为64.4%(56/87),四腔心切面联合右心室流出道切面的检出率为66.7%(58/87),四腔心切面联合三血管气管切面的检出率为79.3%(69/87),四腔心切面联合左心室、右心室流出道切面及三血管气管切面的检出率为89.7%(78/87)。【结论】三维超声时间空间联合成像技术可在早孕期进行胎儿心脏筛查,联合四腔心切面、左右心室流出道及三血管气管切面筛查可提高心脏畸形的检出率。

[Objective] To evaluate the value of cardiac screening in the first trimester by using three-dimensional ultrasound with spatiotemporal image correlation （STIC） and to analyze the value of different views for cardiac assessment. [ Methods ] This study retrospectively reviewed the eighty-seven fetuses with congenital heart diseases which were diagnosed in our institution between Janu- ary 4th 2013 and June 30th 2016. We compared the detection rate of prenatal ultrasound screening with STIC in the first trimester and the results of postnatal echocardiography or autopsy. In addition, the detection rates of the different planes, including four-chamber view （4CV）, outlet of the left ventricle （OLV）, outlet of the right ventricle （ORV） and three vessels-trachea view （3VT） were ana- lyzed, [Results ] Severe cardiac anomalies were identified in 62 fetuses （71.3%） and non-severe cardiac anomalies were identified in 25 fetuses （28.7%）. Seventy-eight cases （89.7%, 78/87） with congenital heart diseases could be detected by using three-dimension- al ultrasound with STIC.The detection ratesfor 4CV, 4CV＋OLV, 4CV＋ORV, 4CV＋3VT, 4CV＋OLV＋ORV and 4CV＋OLV＋ORV＋ 3VT were 48.3%, 64.4%, 66.7%, 79.3%, 69.0% and 89.7% respectively. [Conclusions] Three-dimensional ultrasound with STIC could detect congenital heart disease in the first trimester. The four-chamber view plus outlet of the left ventricle, outlet of the right ventricle and three vessels-trachea view could increase the detection rates of congenital heart diseases.