胎儿先天性心脏畸形的产前超声筛查.pdf

《胎儿先天性心脏畸形的产前超声筛查.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、堕塑重匿堂苤查!生旦箜鲞箜3期』linUl~asoundinMed，March2015，Vo1．17，No．3·199··经验交流·I1~JL先天性心脏畸形的产前超声筛查查长松黄月红戚丽丁丽莉石岩梁振茹王秀娜摘要目的探讨胎儿先天性心脏畸形产前超声筛查的价值。方法对12469例胎儿进行了系统性超声心动图检查，观察胎儿上腹部横切面、四腔心切面、左(右)室流出道切面、三血管切面、主动脉弓和肺动脉弓切面等二维及彩色血流图。按Rustico等分类将心脏畸形分为严重畸形和非严重畸形。结果79例先天性心脏畸形中，产前超声检

2、出52例(65．8％)。严重心脏畸形39例，超声检出36例，假阴性3例；非严重心脏畸形40例，超声检出l6例，假阴性24例，假阳性3例。产前超声检出严重、非严重心脏畸形敏感性分别为92．3％、40．O％，特异性100％、99．9％，阳性预测值100％、84．2％，阴性预测值99．9％、99．6％。产前超声检出52例心脏畸形中，28例(53．8％)四腔心切面异常；20例流出道切面和三血管切面异常。17例(32．6％)伴1处或多处心外畸形。结论产前超声心动图可准确检出胎儿严重心脏畸形，而非严重畸形容易漏诊。关键词

3、超声心动描记术；胎儿畸形；心脏畸形，先天性[中图法分类号]R714．53；R540．45[文献标识码]APrenatalultrasonicscreeningoffetalcongenitalcardiacmalformationZhaChangsong，HuangYuehong，QiLi，DingLili，ShiYan，LiangZhenru，WangXiunaDepartmentofSpecialDiagnosis，the404thhospitalofPLA，Weihai264200，ChinaABSTR

4、ACTObjeetiveTostudytheclinicalvalueofprenamluttrasonicscreeningoffetalcongenitalcardiacmalformation．Methods12469caseswereexaminedbycomprehensiveechocardiography，includingfetalupperabdominalview，four—chamberview，leftandrightventricleoutflowtractview，three—ve

5、sselview，aorticarchviewandductalarchview．CardiacdefectswereclassifiedattheendofstudyasmajororminoraccordingtoRustico’sreport．ResultsTherewere79caseswithcongenitalheartmalformation，52cases(65．8％)wereprenatallydetected．39caseswithmajorcardiacdefects，36caseswe

6、reprenatallydetected，3caseswerefalsenegatives．40caseswithminorcardiacdefects，16caseswereprenatallydetected，24caseswerefalsenegativesand3caseswerefalsepositives．Thesensitivityoftheechocardiographicscreeningformajorandminordefectswere92_3％and40．O％，thespecific

7、itywere100％and99．9％。thepositivepredictivevaluewere100％and84．2％，thenegativepredictivevaluewere99．9％and99．6％，respectively．52casesdetectedbyprenatalultrasound，28cases(53．8％)showedabnormalfour-chamberview．20casesshowedabnormalleftorrightventricleoutflowtractand

8、three—vesselview．Therewereoneormoreextracardiacdefectsin17cases(32．6％)．ConclusionItisanaccuratemethodforprenatalultrasonicscreeningoffetalmajorcardiacmalformation，butitisusualformissingthedetectionoffe