摘要
目的:探究经腹部联合经阴道超声获得四腔心切面(4CV)和三血管气管切面(3VT)在诊断早孕期胎儿心脏结构畸形中的应用。方法:选择2020年1月至2024年1月在我院进行早孕期超声检查的9184例胎儿为研究对象,其中疑似心脏结构畸形胎儿104例。采用受试者工作特征(ROC)曲线评估经腹部联合经阴道超声对早孕期胎儿心脏结构畸形的检出情况及诊断效能。结果:经分娩后及产前诊断中心确认,104例疑似病例中实际心脏结构畸形39例,包括左心发育不良11例、右心发育不良6例、单心室8例、房室间隔缺损5例、法洛四联症9例。经阴道超声在图像清晰程度、显示完整情况及整体质量上均显著高于经腹部超声(P<0.001)。同时,BMI≤24 kg/m^(2)的孕妇超声图像质量也优于BMI>24 kg/m^(2)的孕妇。经4CV联合3VT超声诊断早孕期胎儿心脏结构畸形的ROC曲线下面积达0.979,鉴别不同类型心脏结构畸形的准确性为84.62%。结论:经腹部联合经阴道4CV、3VT超声对早孕期胎儿心脏结构畸形的诊断效能良好,鉴别准确性高,为临床提供了可靠的诊断依据。
Objective:To explore the application of transabdominal combined with transvaginal ultrasound in obtaining the four-chamber view(4CV)and three-vessel and trachea view(3VT)for the diagnosis of fetal cardiac structural anomalies in early pregnancy.Methods:A total of 9184 fetuses who underwent ultrasound examination in early pregnancy at our hospital from January 2020 to January 2024 were selected as the study subjects,among which 104 fetuses were suspected of having cardiac structural anomalies.The receiver operating characteristic(ROC)curve was used to evaluate the detection and diagnostic efficacy of transabdominal combined with transvaginal ultrasound for fetal cardiac structural anomalies in early pregnancy.Results:After delivery and confirmation by the prenatal diagnostic center,39 out of the 104 suspected cases were actually diagnosed with cardiac structural anomalies,including 11 cases of left ventricular hypoplasia,6 cases of right ventricular hypoplasia,8 cases of single ventricle,5 cases of atrioventricular septal defect,and 9 cases of tetralogy of Fallot.Transvaginal ultrasound was significantly superior to transabdominal ultrasound in terms of image clarity,completeness of display,and overall quality(P<0.001).Additionally,the ultrasound image quality of pregnant women with BMI≤24 kg/m^(2)was better than that of those with BMI>24 kg/m^(2).The area under the ROC curve for the diagnosis of fetal cardiac structural anomalies in early pregnancy using the combination of 4CV and 3VT ultrasound was 0.979,with an accuracy of 84.62%for differentiating different types of cardiac structural anomalies.Conclusion:Transabdominal combined with transvaginal 4CV and 3VT ultrasound demonstrates good diagnostic efficacy and high accuracy in the diagnosis of fetal cardiac structural anomalies in early pregnancy,providing a reliable diagnostic basis for clinical practice.
作者
李萍
李利琼
胡谢
刘敏
LI Ping;LI Liqiong;HU Xie;LIU Min(Ultrasound Medicine Department,The People’s Hospital of Leshan,Sichuan 614000,China)
出处
《影像科学与光化学》
2026年第1期117-125,共9页
Imaging Science and Photochemistry
关键词
经腹部联合经阴道超声
四腔心切面
三血管气管切面
早孕期
胎儿心脏结构畸形
transabdominal combined with transvaginal ultrasound
four-chamber view
three-vessel and trachea view
early pregnancy
fetal cardiac structural anomalies
