彩色多普勒超声四腔心平面头侧偏斜法在孕期胎儿心脏畸形筛查诊断中的应用研究

Application of color Doppler ultrasound four-chamber heart plane head-to-side deflection method in screening and diagnosis of fetal heart malformations during pregnancy

目的探讨彩色多普勒超声(简称“彩超”)四腔心平面头侧偏斜法在孕期胎儿心脏畸形筛查诊断中的应用价值。方法选取2019年1月至2021年8月于聊城市妇幼保健院行产前超声检查的4914例疑似存在胎儿心脏畸形指标和危险因素孕妇作为研究对象,均行彩超常规四腔心平面和彩超四腔心平面头侧偏斜法检查,以活产胎儿超声心动图诊断或引产尸检结果为金标准,统计胎儿心脏畸形检出率,并比较彩超常规四腔心切面和彩超四腔心平面头侧偏斜法图像显示情况及其诊断胎儿心脏畸形的准确率。结果4914例孕妇中,金标准共检出胎儿心脏畸形53例(1.08%);彩超四腔心平面头侧偏斜法中获取满意心脏切面比例为98.25%,高于彩超常规四腔心切面中获取的96.58%,差异有统计学意义(P<0.05)。彩超四腔心平面头侧偏斜法对胎儿心脏畸形诊断准确率为98.11%,高于彩超常规四腔心切面的84.91%,差异有统计学意义(P<0.05)。结论彩超四腔心平面头侧偏斜法可更准确检出胎儿心脏畸形,为产前筛查提供更可靠的科学依据,有助于提高出生人口质量。

Objective To explore the application value of color Doppler ultrasound four-chamber cardiac plane head-to-side deflection method in the screening and diagnosis of fetal heart malformations during pregnancy.Methods 4914 pregnant women with suspected fetal heart malforma-tion indicators and risk factors who underwent prenatal ultrasound in Liaocheng Women and Children Health from January 2019 to August 2021 were selected as the study subjects,all of them underwent conventional four-chamber view and four-chamber cardiac plane head-to-side deflection method by color ultrasound,using the results of live birth echocardiography or induced labor autopsy as the gold standard,the detection rate of fetal heart malformations was counted,and the image display and the accuracy of diagnosing fetal heart malformation were compared between the conven-tional four-chamber view and four-chamber cardiac plane head-to-side deflection method.Results Among the 4914 pregnant women,53 cases(1.08%)of fetal heart malformations were detected by gold standard;the proportion of satisfactory heart sections were obtained by color ultrasound four-chamber cardiac plane head-to-side deflection method was 98.25%,which was higher than 96.58%obtained by color ultrasound conventional four-chamber view,and the difference was statistically significant(P<0.05).The accuracy rate of fetal heart malformation diagnosis by color ultra-sound four-chamber cardiac plane head-to-side deflection method was 98.11%,which was higher than 84.91%by color ultrasound conventional four-chamber view,and the difference was statistically significant(P<0.05).Conclusion Color Doppler ultrasound four-chamber cardiac plane head-to-side deflection method can more accurately detect fetal heart malformations,provide a more reliable scientific basis for prenatal screening,and help to improve the quality of birth population.