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目的:探讨超声多切面多种手法在胎儿先天性心脏病(CHD)筛查中的诊断价值。方法:在增城区荔城街社区卫生服务中心选取3282例孕妇,在孕16~38周时运用超声多切面联合显示法,不同胎位不同手法在上腹部短轴切面、四腔心切面、左心室流出道切面、右心室流出道切面、三血管-气管切面、动脉导管弓切面、主动脉弓切面、上下腔静脉入右房切面,对胎儿的先天性心脏病(CHD)进行筛查,并将产前超声检查结果与尸检结果或新生儿超声检查结果作比较。结果:产前超声检查发现心脏异常16例,经尸检结果与新生儿超声检查结果对比,确诊18例,漏诊2例,误诊1例;产前超声诊断的敏感度为88.89%(16/18),准确度为93.75%(15/16),特异度为99.93%(32647/3266)。结论:超声多切面多种手法在产前胎儿先天性心脏病筛查应用中的敏感度、准确度、特异度高,具有较高的临床应用价值。
Objective: To investigate the diagnostic value of multi-slice sonography in the screening of fetal congenital heart disease (CHD). Methods: A total of 3282 pregnant women were enrolled in the community health service center of Li Cheng Street in Zengcheng District. At the age of 16-38 weeks, ultrasound combined multi-slice display method and different fetal position method were used in the short-axis section of upper abdomen, Outflow tract section, right ventricular outflow tract section, tri-vascular-tracheal section, arterial catheter arch section, aortic arch section, superior and inferior vena cava into the right atrium section, fetal congenital heart disease (CHD) screening, and prenatal Ultrasound results compared with autopsy results or neonatal ultrasound findings. Results: There were 16 cases of cardiac abnormalities detected by prenatal ultrasonography, 18 cases were diagnosed by autopsy and 2 cases were misdiagnosed. The sensitivity of prenatal ultrasound was 88.89% (16/18) , The accuracy was 93.75% (15/16) and the specificity was 99.93% (32647/3266). Conclusion: The sensitivity, accuracy and specificity of multi-slice multi-facets approach in prenatal fetal congenital heart disease screening are high and have high clinical value.