胎儿心脏超声智能导航技术在获取胎儿超声心动图快速筛查切面主要诊断要素中的应用价值

目的评价胎儿心脏超声智能导航技术（5D Heart）在胎儿超声心动图五个快速筛查切面诊断要素中的应用价值。 方法选取2016年10月至12月在浙江大学医学院附属邵逸夫医院超声科接受胎儿超声心动图检查的中晚孕期单胎胎儿220例，使用容积探头对220例中晚孕期单胎胎儿采集以四腔心切面为初始切面的三维容积数据共384个，采用5D Heart后处理成像，获取5个快速筛查切面，对5个切面21个要素化内容进行评分，采用χ²检验比较5D Heart与传统技术在5个诊断切面的要素显示是否存在差异，采用Pearson相关分析对5D Heart技术与传统二维超声心动图在正常胎心及异常胎心组中要素显示率作相关性分析。应用秩和检验分别对同一观察者不同时间评分结果，2个经验相对不足的医师评分结果及其分别与经验丰富的医师的评分结果进行比较。 结果220例胎儿共获取384个容积数据，其中200例胎儿的317个心脏容积数据能够用于分析，获取成功率为82.6%。5D Heart技术与传统技术在胎儿心动图快速筛查5个切面要素的显示量，差异无统计学意义（χ²=5.17，P=0.27）；正常胎心组与异常胎心组比较，切面要素显示率分别为89.6%、85.2%（r=0.94，P=0.02）。同一观察者不同时间评分结果比较、两个经验相对不足的医师比较以及分别与经验丰富的医师比较，评分结果差异无统计学意义（均P>0.05）。 结论胎儿心脏超声智能导航技术在获取胎儿快速筛查切面及显示胎儿超声心动图要素化诊断信息方面具有较高的可靠性及重复性，减少操作者技术经验的依赖性，在CHD胎儿图像规范化采集与分析、科研教学、远程会诊及基层医院筛查中具有重要的应用前景。

Application value of fetal heart ultrasound intelligent navigation technique in display of key diagnostic elements in rapid screening views of fetal echocardiography

ObjectiveTo evaluate the application value of fetal heart echocardiography intelligent navigation (5D Heart) in the display of key diagnostic elements in five rapid screening fetal echocardiographic views. MethodsThree hundred and eighty-four 3D volume datasets of 220 normal singleton fetuses in the second and third trimesters were acquired. After processing the datasets using 5D Heart, five rapid screening views were acquired, and 21 key diagnostic elements of the five cardiac diagnostic sections were graded. The 2 test was used to compare the difference in the key diagnostics elements of the five rapid screening views between 5D heart and the traditional technique. Pearson correlation was used to compare the detection rate of key diagnostic elements between 5D Heart technique and traditional two-dimensional echocardiography in normal fetuses and fetuses with congenital heart disease. The rank sum test was used to detect the consistency and reliability of the results. ResultsA total of 384 fetal volume datasets were obtained from 220 fetuses, of whom 317 heart volume datasets were available for analysis, with a success rate of 82.6%. There was no difference in the key diagnostic elements of the five rapid screening views between 5D heart and the traditional technique (χ²=5.17, P=0.27). Compared with the abnormal fetal heart group (89.6%), the detection rate of diagnostic elements in the normal fetal heart group was 85.2% (r=0.94, P=0.02). No significant differences were found when comparing the grading results of one observer in different periods of time, the grading results between two experienced doctors, or the grading results among the experienced doctor and one relatively inexperienced doctor (P>0.05). ConclusionsFetal cardiac ultrasound intelligent navigation technique has high reliability and repeatability in obtaining fetal rapid screening views and displaying fetal elemental diagnostic information. It has tremendous potential in standardized data collection and analysis of cardiac diagnostic sections in fetuses with congenial heart disease, as well as in training and teaching, remote medical consultation, and screening in primary hospitals.