首页 | 本学科首页   官方微博 | 高级检索  
检索        

二维超声四切面法在胎儿先天性心脏病产前筛查中的价值
引用本文:叶宝英,李丽蟾,陈瑞玉,牛建梅,陈炯,施立晔.二维超声四切面法在胎儿先天性心脏病产前筛查中的价值[J].中华围产医学杂志,2011,14(12).
作者姓名:叶宝英  李丽蟾  陈瑞玉  牛建梅  陈炯  施立晔
作者单位:200032,上海交通大学医学院附属国际和平妇幼保健院超声科
基金项目:上海交通大学医学院科技基金项目
摘    要:目的 评价二维超声四切面法,即四腔心切面、左室流出道切面、右室流出道切面和三血管平面在胎儿先天性心脏病(congenital heart disease,CHD)筛查中的价值. 方法 应用二维超声四切面法对孕21~25周的2419例胎儿进行CHD筛查,并对所有2382例活产新生儿行超声心动图检查.统计学分析采用x2检验,并计算敏感性、特异性、阳性预测值和阴性预测值. 结果 2419例胎儿中产前筛查出CHD共281例(11.62%),其中简单型CHD 245例(87.18%)、复杂型CHD 36例(12.82%).高危因素组和非高危因素组阳性率分别为13.60%(34/250)和11.39%(247/2169),差异无统计学意义(x2=1.069,P=0.301).产前四切面法筛查阳性且新生儿期超声心动图检查诊断CHD 36例,总体敏感性、特异性、阳性预测值、阴性预测值分别为12.8%、99.8%、90.0%和89.7%;诊断简单型CHD 7例,敏感性2.9%;复杂型CHD 29例,敏感性80.6%.产后新生儿诊断CHD252例,占活产新生儿总数的10.58%(252/2382),其中简单型241例,复杂型11例. 结论 二维超声产前四切面法对简单型CHD诊断敏感性较低,对复杂型CHD诊断的敏感性较高.在常规产前超声检查中加入心脏四切面法可筛查出大部分的胎儿复杂型CHD,而简单型CHD漏诊率仍较高,新生儿超声心动图普查可弥补产前CHD筛查的不足.

关 键 词:心脏缺损  先天性  超声检查  产前  超声心动描记术

Value of four combined views of two-dimensional echocardiography in prenatal screening for fetal congenital heart disease
YE Bao-ying,LI Li-chan,CHEN Rui-yu,NIU Jian-mei,CHEN Jiong,SHI Li-ye.Value of four combined views of two-dimensional echocardiography in prenatal screening for fetal congenital heart disease[J].Chinese Journal of Perinatal Medicine,2011,14(12).
Authors:YE Bao-ying  LI Li-chan  CHEN Rui-yu  NIU Jian-mei  CHEN Jiong  SHI Li-ye
Abstract:Objective To investigate the value of combined four-chamber view,left and right ventricular outflow tract view and three-vessel view of two-dimensional echocardiography (2DE) in prenatal screening for fetal congenital heart disease (CHD). Methods Four combined views of 2DE were used to detect fetal hearts in 2419 fetuses at 21~ 25 gestational weeks.The echocardiograms were performed on all 2382 live-birth infants.Chi-square test was applied for statistical analysis.Sensitivity,specificity,positive predict value and negative predict value were calculated. Results The prevalence of fetal CHD was 11.62% (281/2419).Among the 281 CHD fetuses,87.18% were simple CHD (n=245) and 12.82% were complex CHD (n=36).No difference was found in the positive rate of fetal CHD between the high-risk group and non-high-risk group 13.60%(34/250) vs 11.39%(247/2169),x2=1.069,P<0.05].Thirty-six cases of CHD could be detected by the four combined views in prenatal screening with the sensitivity,specificity,positive and negative predictive value of 12.8%,99.8%,90.0% and 89.7%,respectively.However,the diagnostic sensitivity of four combined views for simple CHD was 2.9%(7/245) and 80.6%(29/36) for complex CHD.The prevalence of neonatal CHD was 10.58% (252/2382),including 241 with simple CHD and 11 complex ones. Conclusions Four combined views of 2DE for prenatal screening is less sensitive in detecting simple CHD than complex CHD.Most of the complex CHD could be diagnosed by four combined views of 2DE before birth,but the misdiagnosis rate is high in simple CHD.The echocardiograms performed on newborns might make up for the lack.
Keywords:Echocardiography  Ultrasonography  Prenatal  Congenital heart defects
本文献已被 万方数据 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号