产前四维超声对胎儿先天性心脏病的诊断方法及临床价值

目的：探讨四维超声技术对胎儿先天性心脏病的诊断方法及价值。方法整群选取该院超声科2010—2015年初步筛选的879例高危孕妇产前进行二维超声和四维超声进行产前筛查，以引产后解剖结构或产后随访结果作为金标准，评价四维超声产前诊断胎儿先心病的临床价值。结果四维超声共正确检出38例先心病胎儿、漏诊1例、误诊3例，诊断的灵敏度为97.44%、特异度为99.64%、漏诊率为2.56%、误诊率为0.36%、诊断一致性kappa值为0.948；二维超声正确检出35例先心病胎儿，漏诊4例、误诊8例，诊断的灵敏度为89.74%、特异度为99.05%、漏诊率为10.26%、误诊率为0.95%、诊断一致性kappa值为0.847。结论四维超声技术对胎儿先天性心脏病的诊断具有较高的临床价值，与临床确诊结果的一致性较高。

The Diagnostic Methods and Clinical Value of Prenatal Four Dimensional Ultrasound in the Diagnosis of Fetal Congenital Heart Disease

Objective To explore the diagnostic methods and value of four dimensional ultrasound for fetal congenital heart disease. Methods Group selected Court Ultrasound 2010 to 2015 of 879 cases of initial screening of high-risk pregnant women, two-dimensional ultrasound and 4D prenatal ultrasound prenatal screening to post-abortion anatomical structure or postpartum follow-up results as the gold standard, four-dimensional ultrasound evaluation of antenatal the clinical value of diagnosis of fetal congenital heart disease. Results A total of four-dimensional ultrasound correctly detected 38 cases of congenital heart disease in the fetus, missed 1 case misdiagnosed three cases, the diagnostic sensitivity of 97.44% and a specificity of 99.64%, 2.56% rate of missed diagnosis, misdiagnosis rate was 0.36%, kappa value diagnostic consistency 0.948; ultrasonography correctly detected 35 cases of congenital heart disease in the fetus, missed four cases, 8 cases of misdiagnosis, diagnostic sensitivity of 89.74% and a specificity of 99.05%, 10.26% rate of missed diagnosis, misdiagnosis rate was 0.95%, consistent with the diagnosis kappa value of 0.847. Conclusion Four-dimensional ultrasound technology with high clinical value in the diagnosis of congenital heart disease, and high consistency of the results of clinical diagnosis.