二维超声联合四维超声筛查胎儿心脏畸形的临床价值
阮晓丹① 陈仙明
莆田市妇幼保健院
摘要：目的：探讨二维超声联合四维超声筛查胎儿心脏畸形的临床价值。方法：选取82例高度疑似胎儿心脏畸形的孕产妇，均进行二维超声、二维超声联合四维超声筛查，以新生儿心脏彩超检查或尸检（终止妊娠的胎儿、死亡新生儿）结果作为“金标准”,评估二维超声联合四维超声筛查胎儿心脏畸形的临床价值。结果：82例高度疑似胎儿心脏畸形的孕产妇，确诊的有52例；二维超声联合四维超声筛查灵敏度、特异度、准确度均高于二维超声检查，两组比较差异有统计学意义（P＜0.05）;二维超声联合四维超声检查与“金标准”检查胎儿心脏畸形有较好的一致性（Kappa=0.947）。结论：二维超声联合四维超声筛查胎儿心脏畸形有较高的诊断价值。
关键词：胎儿心脏畸形;二维超声;四维超声;
Clinical value of two-dimensional ultrasonography combined with four-dimensional ultrasonography in screening fetal cardiac malformations
RUAN Xiaodan①,CHEN Xianming.(Putian Maternal and Child Health Hospital,Putian 351100,China)
Abstract Objective: To investigate the clinical value of two-dimensional ultrasonography combined with four-dimensional ultrasonography in screening fetal cardiac malformations. Methods: A total of 82 pregnant and lying-in women who were highly suspected of fetal cardiac malformation were selected and screened by two-dimensional ultrasonography, and two-dimensional combined with four-dimensional ultrasonography, respectively. The results of neonatal cardiac color ultrasound examination or autopsy (fetuses whose pregnancies have been terminated, or dead newborns) were used as the gold standard to evaluate the clinical value of two-dimensional ultrasound combined with four-dimensional ultrasound in screening fetal cardiac malformations. Results: Among the 82 pregnant and lying-in women who were highly suspected of fetal heart malformations, 52 cases were confirmed; the sensitivity, specificity and accuracy of two-dimensional ultrasonography combined with four-dimensional ultrasonography were all higher than those of two-dimensional ultrasonography, and the differences were statistically significant(P<0.05); two-dimensional ultrasonography combined with four-dimensional ultrasonography showed excellent consistency with the gold standard for fetal cardiac malformations (Kappa=0.947). Conclusion: Two-dimensional ultrasonography combined with four-dimensional ultrasonography has high diagnostic value in screening fetal cardiac malformations.
Keywords:fetal cardiac malformations; two-dimensional ultrasound; four-dimensional ultrasound
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