超声心动图不同切面筛查胎儿先天性心脏病的敏感性研究

目的探讨超声心动图各常用切面观在筛查胎儿先天性心脏病中的敏感性，寻找一种操作更简便，诊断准确性更高的最佳切面。方法应用四腔心切面观（4cv）、四腔心切面加主动脉根部短轴切面观（4CV＋AR～SAV）、四腔心切面加左右室流出道切面观（4CV＋VOTV）、四腔心切面加三血管平面观（4CV＋3VV）、四腔心切面加三血管-气管平面观（4CV＋3VVT）筛查2600例孕22～38周的胎儿，比较各切面诊断先天性心脏病的敏感性。结果超声检查胎儿先天性心脏病40例，经引产和产后证实39例。4CV、4CV＋（AR—SAV）、4CV＋VOTV、4CV＋3VV和4CV＋3VVT筛查胎儿先天性心脏病的敏感性分别为49％、62％、75％、90％和90％。结论4CV＋VOTV、4CV＋3VVT筛查胎儿先天性心脏疾病的敏感性高，4CV＋VOTV＋3VVT可作为产前筛查胎儿先天性心脏病的常规检查切面。

Sensitivity of prenatal echocardiography for fetal congenital heart disease

Objective To explore the sensitivity of different view screening for fetal congenital heart diseases, and to search for an examination method which has high diagnostic accuracy and convenience. Methods Two thousand six hundred fetus aged from 22 to 38 weeks were screened by four chamber view （4CV） , four chamber view with aortic root short axis view （4CV ＋ AR - SAV）, four chamber view with left and right ventricular outflow tract view （4CV ＋ VOTV） ,four chamber view with three vessels view （4CV ＋ 3VV） and four chamber view with three vessels and trachea view （4CV ＋ 3VVT）. The sensitivity for congenital heart disease diagnosis in each view was compared. Results Thirty - nine of 40 cases with fetal congenital heart disease were confirmed by prenatal echocardiography, the sensitivity of 4CV, 4CV ＋ AR - SAV, 4CV ＋ VOTV, 4CV ＋ 3VV, 4CV ＋3VVT screening for fetal congenital heart disease was 49%, 62%, 75%, 90% ,90%, respectively. Conclusion 4CV ＋ VOTV and 4CV ＋ 3VVT have high sensitivity in screening fetal congenital heart disease, while 4CV ＋ VOTV ＋ 3VVT can be used as routine examination view for screening fetal congenital heart disease.