四维超声STIC技术在胎儿心脏畸形辅助诊断中的应用价值

发布时间：2017-12-27 14:19

  本文关键词：四维超声STIC技术在胎儿心脏畸形辅助诊断中的应用价值　出处：《中华全科医学》2016年03期 　论文类型：期刊论文

  更多相关文章： 先天性心脏病 时间-空间关联成像技术(STIC) 孕期筛查 超声诊断

【摘要】：目的探讨实时动态四维时间-空间关联成像技术(STIC)在胎儿心脏畸形辅助诊断中的应用及其诊断准确率。方法选取超声心动图筛查出胎儿先天性心脏病可疑的孕妇,再应用STIC技术进行数据采集、脱机分析。对终止妊娠或娩出后死亡胎儿,以尸检病理诊断为确诊结果;对活产胎儿以新生儿超声诊断为确诊结果。比较实时四维超声STIC和二维超声对胎儿心脏畸形诊断的准确率。结果产前筛查人群12 782例,纳入受试对象217例,有效对象203例,其中112例经引产后尸解病理证实或上级三甲医院超声确诊,其余娩出的活产胎儿经超声或CT、MRI明确诊断。超声心动图诊断心脏畸形的准确率为94.09%,漏诊率为4.43%,误诊率为1.48%;四维超声STIC诊断心脏畸形的准确率为98.52%,漏诊率为0.99%,误诊率为0.49%;四维超声STIC诊断心脏畸形的准确率高于超声心动图(χ~2=5.61,P0.05),漏诊率低于超声心动图(χ~2=4.58,P0.05),而漏诊率比较差异无统计学意义(χ~2=0.25,P0.05)。结论实时四维超声STIC技术在胎儿心脏畸形辅助诊断中具有较好的临床应用价值,有助于弥补二维超声诊断不完善、不精确的缺憾,提高了产前胎儿心脏畸形诊断的准确性,从而为产前筛查提供了更加可靠的科学依据。
[Abstract]:Objective to investigate the application of real-time dynamic four-dimensional spatio temporal correlation imaging (STIC) in the diagnosis of fetal cardiac malformation and its diagnostic accuracy. Methods the pregnant women with suspected fetal congenital heart disease were screened by echocardiography, and STIC technique was used to collect and analyze the data. On the termination of pregnancy or death of the fetus after delivery, diagnosis results in autopsy pathology diagnosis; to live births to the diagnosis of neonatal ultrasound diagnosis. The accuracy of real time four dimensional ultrasound STIC and two-dimensional ultrasound in the diagnosis of fetal heart malformation was compared. The results of prenatal screening population in 12782 cases, the subjects included 217 cases, effective 203 cases, 112 cases were confirmed by autopsy were diagnosed with pathology or superior hospital, the rest of the delivery of live births by ultrasound or CT, MRI diagnosis. The accurate rate of diagnosis of heart malformation echocardiography was 94.09%, the misdiagnosis rate was 4.43%, the misdiagnosis rate was 1.48%; the accuracy rate of STIC diagnosis of four-dimensional ultrasound cardiac malformation was 98.52%, the misdiagnosis rate was 0.99%, the misdiagnosis rate was 0.49%; the accuracy rate of four-dimensional ultrasound diagnosis of cardiac malformations was higher than that of STIC echocardiography (x ~2=5.61, P0.05), the rate of misdiagnosis is lower than echocardiography (~2=4.58, P0.05), and the misdiagnosis rate was no significant difference (~2=0.25, P0.05). Conclusion the real-time four-dimensional STIC technology has good clinical application value in diagnosis of fetal cardiac malformations, help compensate for the two-dimensional ultrasound diagnosis of incomplete and uncertain defects, improve the accuracy of prenatal diagnosis of fetal cardiac malformations, thus providing a more reliable basis for prenatal screening.
【作者单位】： 嘉兴市妇幼保健院超声科;
【基金】：2014年度浙江省科技计划项目(2014KYB361)
【分类号】：R445.1;R714.53
【正文快照】： 先天性心脏病(congenital heart disease,CHD)是临床上一种常见胎儿畸形,流行病学调查研究显示胎儿期发生率约0.4%~1.3%[1],且大多预后不佳,故而CHD产前诊断对改善妊娠的结局意义重大。目前,胎儿超声心动图检查已成为产前筛查CHD的首选方法,但是由于检查受宫内条件限制,以及胎，

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