四维超声成像技术诊断孕中期胎儿心脏畸形的价值探讨

The value of four-dimensional ultrasound imaging in the diagnosis of fetal heart malformation in the second trimester

目的探讨四维超声成像技术在筛查孕中期胎儿心脏畸形中价值,并观察其对心脏畸形的显示情况。方法回顾性分析40例孕中期(24~26周)接受心脏四维超声成像技术及二维超声检查孕妇的病例资料,胎儿均经病理学检查确诊为先天性心脏畸形。观察心脏四维超声成像技术及二维超声对胎儿心脏畸形的检出率及对心脏畸形部位显示情况。结果四维超声成像扫描时间为7.0~15.1 min,平均(9.9±1.1)min,所有胎儿均可获得四腔心容积,并清楚显示二尖瓣、三尖瓣及四腔心等结构。40例先天性心脏畸形胎儿中,二维超声共检出36例(90%),四维超声成像共检出37例(92%),二维超声和四维超声检出率差异无统计学意义(P>0.05)。四维超声成像对冠状动脉畸形显示率高于二维超声,对主动脉畸形显示率低于二维超声,差异有统计学意义(P<0.05)。结论四维超声成像对胎儿心脏畸形检出率高,尤其对冠状动脉畸形显示率高,但其对主动脉畸形显示率稍低。

Objective To investigate the value of four-dimensional ultrasound imaging in screening fetal heart malformations in the second trimester and the manifestations of cardiac malformations.Methods Clinical information of 40 cases pregnant women who received four-dimensional ultrasound imaging and two-dimensional ultrasound examination at mid-pregnancy(24-26 weeks)was analyzed,and the fetus was confirmed by pathology as congenital heart malformation.The detection rate and display rate of cardiac malformation in four-dimensional ultrasound imaging and two-dimensional ultrasound examination was analyzed.Results The average scan time of the four-dimensional ultrasound imaging was(9.9±1.1)min(7.0-15.1 min).All fetuses could obtain a four-chamber heart volume and clearly showed structures such as mitral,tricuspid,and four-chamber.Among the 40 cases of congenital heart malformation,36 cases(90%)were detected by two-dimensional ultrasound,and 37 cases(92%)were detected by four-dimensional ultrasound imaging.There was no significant difference in the detection rate between two-dimensional ultrasound and four-dimensional ultrasound(P>0.05).Four-dimensional ultrasound imaging showed a higher rate of coronary artery malformation than two-dimensional ultrasound,and the rate of aortic malformation was lower than that of two-dimensional ultrasound,and the difference was statistically significant(P<0.05).Conclusion Four-dimensional ultrasound imaging has a high detection rate of fetal heart malformation and a high display rate of coronary artery malformation,but its display rate of aortic malformation is slightly poor.