超声心动图结合四维超声在胎儿心脏畸形诊断中的价值分析

Analysis of the Value of Echocardiography Combined with Four Dimensional Ultrasound in the Diagnosis of Fetal Cardiac Malformations

目的探讨超声心动图结合四维超声诊断胎儿心脏畸形的临床价值。方法选取2019年1月~12月于我科产检的孕妇1000例,所有孕妇行四维超声检查,若四维超声存在问题则加做超声心动图,并以胎儿出生后1月检查为金标准,比较四维超声以及超声心动图结合四维超声诊断胎儿心脏畸形的阳性率。结果经胎儿出生后1个月检查结果显示,1000例孕妇中942例胎儿正常,而58例存在心脏畸形,58例胎儿心脏畸形中,包括左室发育异常12例,右室发育异常12例,室间隔缺损15例,三尖瓣下移10例,双主动脉弓9例。单独四维超声检查结果显示36例存在心脏畸形,检出率为3.60%(36/1000),包括左室发育异常7例,右室发育异常6例,室间隔缺损13例,三尖瓣下移6例,双主动脉弓4例,其检测的准确率为62.07%(36/58);超声心动图结合四维超声检查结果显示55例胎儿心脏畸形,检出率为5.50%(55/1000),包括左室发育异常12例,右室发育异11例,室间隔缺损15例,三尖瓣下移9例,双主动脉弓8例,其检测的准确率为94.83%(55/58);超声心动图结合四维超声筛查胎儿心脏畸形的检出率、准确率均高于单独四维超声检查(P<0.05)。结论超声心动图结合四维超声对胎儿心脏畸形的检出率更高、筛查更准确。

Objective To investigate the clinical value of echocardiography combined with four-dimensional ultrasound in the diagnosis of fet al heart malformations.Methods A total of 1000 pregnant women who delivered in our department from January 2019 to December 2019 were selected,and all pregnant women underwent four-dimensional ultrasound,plus echocardiography if there was a problem in four-dimensional ultrasound,and after the first month of life examination was used as the gold standard,the four-dimensional ultrasound,as well as the positive rate of four-dimensional ultrasound combined with four-dimensional ultrasound in the diagnosis of fet al cardiac malformations were compared.Results The results of examination at 1 month after transplacental birth showed that 942 fetuses of 1000 pregnant women were normal,while 58 had heart malformations,including left ventricular dysplasia in 12,right ventricular dysplasia in 12,ventricular septal defect in 15,subvalvular tricuspid valve in 10,and double aortic arch in 9.Four dimensional ultrasound results alone showed the presence of cardiac malformations in 36 cases,with a detection rate of 3.60%(36/1000),including left ventricular dysplasia in 7 cases,right ventricular dysplasia in 6 cases,ventricular septal defect in 13 cases,subtricuspid valve in 6 cases,and double aortic arch in 4 cases,whose detection accuracy was 62.07%(36/58);echocardiography combined with four-dimensional ultrasound results showed 55 fet al cardiac malformations,with a detection rate 5.50%(55/1000),including 12 cases of left ventricular dysplasia,11 cases of right ventricular dysplasia,15 cases of ventricular septal defect,9 cases of tricuspid valve inferior displacement,8 cases of double aortic arch,and its detection accuracy was 94.83%(55/58).The detection rate and accuracy of fet al heart malformations by combining echocardiography with four-dimensional ultrasound screening were higher than those by four-dimensional ultrasound alone(P<0.05).Conclusion Echocardiography combined with four-dimensional ultrasound has a higher detection rate and more accurate screening for fet al cardiac malformations.