超声心动图顺序分段法诊断胎儿先天性心脏病的应用

目的:探讨超声心动图顺序分段法诊断胎儿先天性心脏病方法的临床价值。方法:2006年1月1日至2007年7月31日对2851例胎儿进行超声心动图检查,高危胎儿857例,分别用顺序分段法及四腔心切面法加两心室流出道切面法检查,以引产后尸解或生后超声心动图作为对照标准。结果:终止妊娠胎儿尸解和生后超声心动图检查证实胎儿先天性心脏病28例,节段畸形51例;顺序分段法发现胎儿先天性心脏病27例,敏感性96.4%,节段性畸形50例,敏感性98.0%;四腔心切面加两心室流出道法发现胎儿先天性心脏病22例,敏感性78.6%,节段性畸形37例,敏感性72.5%。两种方法诊断胎儿先天性心脏病敏感性差异有显著的统计学意义(P<0.01)。结论:超声心动图顺序分段法是诊断胎儿先天性心脏病较可靠的方法,已成为产前筛选胎儿先天性心脏病的重要方法。

Application of the Fetal Echocardiography for the Prenatal Diagnosis of Congenital Heart Disease with the Sequential Segmental Approach

Objective To evaluate the clinical value of fetal echocardiography with the sequential segmental approach as a routine examination in prenatal diagnosis of congenital heart disease.Methods 2 851 pregnant women accepted fetal heart check with echocardiography and including 857 high-risk pregnancies.All fetuses were examined using color Doppler echocar- diography with sequential segmental approach and four chamber plns two ventricular outflow tract views.Echocardiographic re- sults were compared with necropsy specimens of the fetal heart after termination of pregnancy or postnatal echocardiography. Results Necropsy specimens or postnatal echocardiography verified congenital heart defects in 28 cases with 51 segment anom- alies.The sequential segmental approach by color Doppler echocardiography demonstrated CHD in 27 cases with 50 segmental anomalies.The sensitivity of sequential segmental approach for detecting CHD were 96.4 %,and for detecting segmental a- nomaly were 98.0 %,respectively.The four chamber plus two ventricular outflow tract views demonstrated CHD were.78.6 %,and for detecting segmental anomaly were 72.5 %,respectively.The sensitivity differences of the two methods detecting CHD and segmental anomaly were significant(P<0.01).Conclusion Fetal echocardiography with sequential segmental ap- proach is a reliable method for diagnosing fetal CHD.It has become an important method for prenatal screening CHD.