四维彩超、二维超声在产前胎儿先天性心脏病筛查中的应用比较

Comparison of Four-dimensional Color Doppler Ultrasonography and Two-dimensional Ultrasonography in Prenatal Screening of Congenital Heart Disease

目的:比较四维彩超、二维超声两种检测方法在产前胎儿先天性心脏病筛查中的应用价值。方法:选取2016年7月-2018年9月期间在本院接受胎儿先天性心脏病筛查的高危孕妇413例,分别进行四维彩超、二维超声检查,经孕妇及家属同意引产者经外院引产后证实,继续妊娠者待胎儿出生后随访,对两种方法诊断先天性心脏病的临床价值进行观察并比较两种方法的诊断效果。结果:共确诊41例先天性心脏病胎儿。经二维超声检测37例,其中3例误诊,7例漏诊,特异性82.9%、敏感度84.2%、准确性83.3%;四维彩超检测41例,其中2例误诊,2例漏诊,特异性95.1%、敏感度89.5%、准确性93.3%;与二维超声相比,四维彩超在心脏患病类型的判断准确率显著提高(P<0.05);与二维超声法相比,四维彩超单例样本检测时间、每幅图像所用时间均缩短(P<0.05)。结论:四维超声对产前胎儿先天性心脏病筛查准确率高、检测时间短。

Objective:To compare the values of four-dimensional color Doppler ultrasound and two-dimensional ultrasound in prenatal screening of fetal congenital heart disease.Methods:413 high-risk pregnant women who received fetal congenital heart disease screening in our hospital from Jul 2016 to Sep 2018 were selected,four-dimensional color Doppler ultrasound and two-dimensional ultrasound were performed respectively,pregnant women and their families agreed that the induced labor was confirmed by the other hospital after induction.The pregnant women were followed up after the birth of the fetus.The clinical value of the two methods in the diagnosis of congenital heart disease was observed and the diagnostic effect of the two methods was compared.Results:A total of 41 fetuses with congenital heart disease were diagnosed in this study.By two-dimensional ultrasonography,37 cases of congenital heart disease were diagnosed,3 cases were misdiagnosed,and 7 cases were missed,with the specificity,sensitivity,and accuracy were 82.9%,84.2%,and 83.3%respectively;four-dimensional color Doppler ultrasonography showed 41 cases suffered from congenital heart disease,of which 2 cases were misdiagnosed,and 2 cases were missed,with the specificity,sensitivity,and accuracy were 95.1%,89.5%,and 93.3%respectively;compared with two-dimensional echocardiography,the accuracy of four-dimensional color Doppler echocardiography in judging the type of heart disease was significantly improved(P<0.05);compared with the two-dimensional ultrasound method,the detection time of single sample and the time of each image in four-dimensional color Doppler ultrasound were shorter(P<0.05).Conclusion:Four-dimensional ultrasound in prenatal fetal congenital heart disease screening has a high accuracy and a short detection time.