| 江秋霞,沈龙源,陈林君,李秋雯,蔡准顿,吕国荣.经阴道超声五切面检查法诊断孕早期高危妊娠胎儿先天性心脏病[J].中国医学影像技术,2025,41(9):1544~1547 |
| 经阴道超声五切面检查法诊断孕早期高危妊娠胎儿先天性心脏病 |
| Transvaginal ultrasound five-view method for diagnosing fetal congenital heart disease in early pregnancy of high-risk pregnancy |
| 投稿时间：2025-02-07 修订日期：2025-07-19 |
| DOI：10.13929/j.issn.1003-3289.2025.09.019 |
| 中文关键词: 心脏缺损,先天性|胎儿|超声检查,产前 |
| 英文关键词:heart defects, congenital|fetus|ultrasonography, prenatal |
| 基金项目:福建省卫健委科技计划项目(2022GGB008)。 |
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| 中文摘要: |
| 目的 探讨经阴道超声五切面检查法诊断孕早期高危妊娠胎儿先天性心脏病(CHD)的价值。方法 前瞻性纳入428胎11~13+6周高危妊娠胎儿,联合二维灰阶和CDFI以经腹部和经阴道五切面[上腹部横切面、四腔心切面、三血管气管(3VT)切面、心室流出道切面及双侧锁骨下动脉切面]及二切面法(四腔心切面和3VT切面)行胎儿心脏检查;以孕中期或孕晚期胎儿超声心动图、引产后病理检查或出生后新生儿超声心动图检查结果为标准,比较3种检查法对孕早期胎儿CHD的诊断效能。结果 共确诊120胎CHD (120/428,28.04%)。经阴道超声五切面检查法误诊11胎、漏诊19胎,其诊断高危妊娠胎儿CHD的敏感度、特异度、阳性预测值及阴性预测值分别为84.17%、96.43%、90.18%及93.99%,均高于经阴道二切面检查法(70.83%、91.88%、77.27%及88.99%)及经腹检查法(72.50%、91.23%、76.32%及89.49%,P均＜0.05)。结论 利用经阴道超声五切面检查法可有效诊断孕早期高危妊娠胎儿CHD。 |
| 英文摘要: |
| Objective To explore the value of transvaginal ultrasound five-view method for diagnosing fetal congenital heart disease (CHD) in early pregnancy of high-risk pregnancy. Methods Totally 428 singleton fetuses at 11—13+6 weeks of gestation in high-risk pregnancies were prospectively enrolled. Fetal cardiac examinations were performed using two-dimensional grey scale imaging combined with CDFI via transabdominal ultrasound method, transvaginal ultrasound five-view method (upper abdominal transverse view, four-chamber view, three-vessel and trachea[3VT] view, ventricular outflow tract view and bilateral subclavian artery view) and transvaginal ultrasound two-view method (four-chamber view and 3VT view). Taken results of pregnant metaphase or late pregnancy fetal echocardiography, post-abortion pathology or postnatal neonatal echocardiography as gold standards, the diagnostic performances of the above 3 methods for diagnosing fetal CHD in early pregnancy were compared. Results CHD was diagnosed in 120 (120/428, 28.04%) fetuses. Transvaginal ultrasound five-view method made 11 false positives and 19 false negatives, with sensitivity, specificity, positive predictive value and negative predictive values for diagnosing fetal CHD in the first trimester of high-risk pregnancy of 84.17%, 96.43%, 90.18% and 93.99%, respectively, which were all significantly higher than of transvaginal ultrasound two-view method (70.83%, 91.88%, 77.27% and 88.99%) and transabdominal ultrasound method (72.50%, 91.23%, 76.32% and 89.49%; all P＜0.05). Conclusion Transvaginal ultrasound five-view method could be used to effectively diagnose fetal CHD in the first trimester of high-risk pregnancy. |
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