超声多切面法在胎儿先天性心脏病早期筛查中的效能评价

Multi-plane approach for early screening of fetal congenital heart disease using echocardiography

  • 摘要: 目的 评价超声多切面法在胎儿先天性心脏病(congenital heart disease,CHD)早期筛查中的应用价值。 方法 选取2012年1月- 2017年12月在儋州市人民医院分娩孕妇共12 658例,采用超声多切面法进行CHD筛查,并与随访的产后超声、新生儿心脏手术或尸检结果作对比,计算超声多切面法诊断胎儿CHD的敏感性、特异性、阳性预测值和阴性预测值。 结果 12 658例分娩孕妇中产前超声检出胎儿先天性心脏病166例,检出率为1.31%(166/12 658)。12 492例胎儿产前检查正常,产后检出15例CHD,漏诊率为1.2‰。166例产前检出CHD胎儿有16例误诊。超声多切面法诊断胎儿CHD的敏感性为90.91%,特异性为99.87%,阳性预测值为90.36%,阴性预测值为99.88%。超声多切面法诊断胎儿CHD的准确率为99.76%。 结论 超声多切面法在胎儿CHD早期筛查中具有较高的应用价值。

     

    Abstract: Objective To evaluate the diagnosis accuracy of multi-plane echocardiography for fetal congenital heart disease (CHD). Methods Twelve thousand six hundred and fifty-eight pregnant women in Danzhou People's Hospital from January 2012 to December 2017 were selected. The fetal CHD was screened by multi-plane echocardiography, and then compared with the follow-up postnatal ultrasound, neonatal cardiac surgery or autopsy results. The sensitivity, specificity, positive predictive value and negative predictive value of echocardiography were calculated. Results One hundred and sixty-six cases of congenital heart disease were detected by prenatal echocardiography in 12 658 pregnant women, with the detection rate of 1.31% (166/12 658). CHD was identified in 15 neonates out of 12 492 normal cases after delivery, and the rate of missed diagnosis was 1.2‰. Of the 166 cases of fetal CHD, 16 cases were misdiagnosed. The sensitivity, specificity, positive predictive value, negative predictive value of ultrasound multi section method in diagnosing fetal CHD were 90.91%, 99.87%, 90.36%, 99.88%, respectively. The accuracy of ultrasound multi section method in diagnosing fetal CHD was 99.76%. Conclusion Multi-plane echocardiography has high applicative value in prenatal CHD diagnosis.

     

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