超声心动图联合彩色多普勒血流显像在胎儿先天性心脏病筛查中的应用

Application of echocardiography combined with color doppler flow imaging in screening fetal congenital heart disease

目的探讨超声心动图联合彩色多普勒血流显像(CDFI)在胎儿先天性心脏病(CHD)筛查中的应用。方法回顾性分析2019年6月至2020年6月于本院接受产前检查的500例妊娠>18周产妇的临床资料,所有产妇均接受超声心动图及CDFI检查。以产后综合检查为金标准,比较超声心动图、CDFI及两者联合检测对CHD的筛查价值。结果检查后,超声心动图诊断CHD的灵敏度、特异度、准确度分别为52.63%、98.96%、97.20%,Kappa值为0.574;CDFI诊断CHD的灵敏度、特异度、准确度分别为57.89%、98.96%、97.40%,Kappa值为0.615;联合检测诊断CHD的灵敏度、特异度、准确度分别为94.74%、98.75%、98.60%,Kappa值为0.830;检查后,联合检测灵敏度高于超声心动图、CDFI单一检测,差异有统计学意义(P<0.05)。结论超声心动图、CDFI均能较好诊断CHD,但两者联合诊断灵敏度高于两者单独诊断,临床可根据产妇情况采取联合诊断,以提升对CHD的诊断效能。

Objective To investigate the application of echocardiography combined with color Doppler flow imaging(CDFI)in screening fetal congenital heart disease(CHD).Methods The clinical data of 500 pregnant women with pregnancy>18 weeks who received prenatal examination in our hospital from June 2019 to June 2020 were retrospectively analyzed.All the pregnant women received echocardiography and CDFI.Taking postpartum comprehensive examination as the gold standard,the screening value of echocardiography,CDFI and their combined detection for CHD was compared.Results After examination,the sensitivity,specificity and accuracy of echocardiography in diagnosing CHD were 52.63%,98.96%and 97.20%,respectively,and the Kappa value was 0.574;the sensitivity,specificity and accuracy of CDFI in diagnosing CHD were 57.89%,98.96%and 97.40%respectively,and the Kappa value was 0.615;the sensitivity,specificity and accuracy of combined detection for CHD were 94.74%,98.75%and 98.60%respectively,and the Kappa value was 0.830;after examination,the sensitivity of combined detection was higher than that of echocardiography and CDFI single detection,and the difference was statistically significant(P<0.05).Conclusion Echocardiography and CDFI can both diagnose CHD better,but the sensitivity of combined diagnosis is higher than that of single diagnosis.In order to improve the diagnostic efficiency of CHD,combined diagnosis can be adopted according to the situation of the parturient.