摘要
目的探讨胎儿超声心动图对肺血少之右心系统阻塞性心脏畸形的诊断价值。方法回顾2017年3月~2020年3月本院孕20~28周有高危倾向或自愿要求行胎儿超声心动图检查的1036例孕妇,获取并分析胎儿心脏位置、各节段图像及合并畸形情况,相关统计学资料分析超声心动图检查准确度。结果1036例孕妇中检出右位心胎儿86例,86例右位心中镜像心39例(45.35%)、右旋心37例(43.02%)、右房异构4例(4.65%)、左房异构6例(6.98%)。超声心动图对心脏各节段、心室与大动脉连接有诊断意义(P<0.05),与心血管造影诊断一致性强(Kappa>0.5)。右旋心和右镜心存在肺动脉狭窄或闭锁者相比,差异有统计学意义(P<0.05);超声心动图对心脏合并畸形诊断的敏感度95.00%(76/80)、特异性83.33%(5/6)、准确性94.19%(81/86),超声心动图与心血管造影一致性强(Kappa=0.503)。结论右心系统阻塞性心脏畸形各节段均可出现异常,多合并复杂的肺血少异常情况,超声心动图更直观、全面观察心脏解剖学及血流动力学变化,对判断合并肺血少的复杂畸形具有较高诊断价值。
Objective To investigate the diagnostic value of fetal echocardiography for obstructive heart malformations of the right ventricular system with low lung blood.Methods From March 2017 to March 2020,1036 pregnant women who had a high-risk tendency or voluntarily requested fetal echocardiography during their pregnancy period of 20 to 28 weeks in our hospital were reviewed.The position of the fetal heart,the images of each segment and the combined malformations were obtained and analyzed,and the accuracy of echocardiography with relevant statistical data were analyzed.Results There were 86 cases of dextrocardia fetus,39 cases of dextrocardia mirror images(45.35%),37 cases of dextrorotation heart(43.02%),4 cases of right atrial heterogeneity(4.65%),and 6 cases of left atrial heterogeneity(6.98%)detected in 1036 pregnant women.Echocardiography had diagnostic significance for the connection of various segments of the heart,ventricle and aorta(P<0.05),and it was consistent with the diagnosis of cardiovascular angiography(Kappa>0.5).Compared with those with pulmonary artery stenosis or atresia in dextrorotation heart and right-sided heart,the difference was significant(P<0.05).The sensitivity of echocardiography to the diagnosis of cardiac malformations was 95.00%(76/80),specificity was 83.33%(5/6),accuracy was 94.19%(81/86),and the consistency between echocardiography and cardiovascular angiography was strong(Kappa=0.503).Conclusion Each segment of right heart system obstructive cardiac malformation can be abnormal,and most of them are complicated with abnormal pulmonary blood deficiency.Echocardiography is more intuitive and comprehensive to observe the changes of cardiac anatomy and hemodynamics,which has high diagnostic value in judging the complicated malformation with pulmonary blood deficiency.
作者
郑倩颖
顾晔
孔亚荣
马征戈
曹硕
吴向玲
ZHENG Qianying;GU Ye;KONG Yarong;MA Zhengge;CAO Shuo;WU Xiangling(Department of Ultrasound,Baoding First Central Hospital,Baoding 071000,China)
出处
《分子影像学杂志》
2021年第4期701-705,共5页
Journal of Molecular Imaging
关键词
胎儿超声心动图
肺血少
右心系统阻塞
心脏畸形
fetal echocardiography
low lung blood
right ventricular system obstruction
heart malformation
