产前超声筛选胎儿中晚期心脏病的临床研究

目的探讨四腔心观（FCV）加三血管-气管观（3VT）在胎儿中晚期心脏病产前超声筛选中的临床意义。方法应用Sequoia512彩色多普勒超声诊断仪，检查孕18～40周胎儿共3211例，与尸体解剖证实和产后超声追踪对照，比较单纯FCV、FCV加左、右室流出道观（FCV＋VOTV）、FCV加大动脉短轴观（FCV＋SAV）、FCV＋3VT筛选胎儿中晚期心脏畸形的敏感性。结果FCV筛选胎儿心脏病的敏感性为54％（91／169），FCV＋VOTV的敏感性为70％（118／169），FCV＋SAV的敏感性为66％（112／169）；FCV＋3VT的敏感性为85％（143／169），明显高于前三者（P〈0、05）。结论FCV＋3VT可以明显提高筛选技术的敏感性，缩短检查时间，可以作为筛选妊娠中晚期胎儿心脏病的首选方法。

Clinical study of screening for fetal heart disease in the second and third trimester pregnancy by prenatal echocardiography

Objective To investigate the clinical significance of the four-chamber view with three vessels and trachea view(FCV+3VT) screening for fetal cardiac malformation in the second and third trimester pregnancy. Methods The four-chamber view (FCV) alone, FCV with left and right ventricular outflow tract view(FCV+VOTV), FCV with short-axis view of great artery(FCV+SAV), and FCV+3VT of 3211 consecutive fetuses aged from 18 to 40 week were examined to screen for fetal cardiac malformations with Sequoia 512 ultrasound diagnostic system.Suspected fetal cardiac disease was confirmed by postmortem or postnatal echocardiography and/or surgery. Then, the sensitivities of screening tests were compared among the four methods. Results The sensitivity of FCV alone, FCV+VOTV, FCV+SAV, FCV+3VT was 54%( 91/169 ),70%( 118/169 ),66%( 112/169 ),85%( 143/169 ), respectively. FCV+ 3VT was significantly superior to the other screening methods (P< 0.05 ). Conclusions The screening method of FCV+3VT has the satisfactory sensitivity and specificity with the features of simple, convenient, reliable and suitable for screening for fetal cardiac malformation in the second and third trimester pregnancy.