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目的评价二维超声心动图(2DE)与2DE联合时空关联成像(STIC)技术在胎儿先天性心脏大动脉畸形的诊断价值。方法选择我院可疑有胎儿心脏大动脉畸形175例孕妇,先行2DE后,在2DE基础上联合STIC成像技术,以胎儿心尖四腔心切面及主动脉弓长轴切面作为初始采集图像,结合多平面成像模式(MPR)、超声断层成像模式(TUI)、表面成像等进行脱机离线分析进行诊断。最终诊断以病理尸检、出生后行新生儿2DE或心外手术结果为准。对比2DE与2DE联合STIC技术在胎儿先天性心脏大动脉畸形检查的准确度。结果 175例可疑心脏大血管畸形胎儿,其中9例(5.1%)失访,在166例产前诊断病例中,患有心脏大动脉畸形41例(24.7%),其中22例胎儿终止妊娠并尸检,10例产后手术证实,9例行心脏超声检查并长期随访证实。2DE正确诊断大动脉畸形33例,8例未正确诊断,2DE联合STIC成像正确诊断大动脉畸形40例,1例未正确诊断,2DE与2DE联合STIC技术在诊断胎儿心脏大动脉畸形符合率分别为95.2%和99.4%,差异有统计学意义(χ2=4.111,P=0.043)。结论 STIC技术对胎儿心脏大动脉畸形诊断具有独特优势,2DE联合STIC技术可以获得更加准确的诊断信息。
Objective To evaluate the diagnostic value of two-dimensional echocardiography (2DE) and 2DE combined with spatio-temporal correlation imaging (STIC) in the diagnosis of fetal congenital heart arteries malformations. Methods A total of 175 pregnant women suspected to have fetal cardiac aorta malformations were enrolled in this study. After 2DE, 2DE and STIC imaging were combined to acquire the primary apical four-chamber view and aortic arch long axis as the initial acquisition images. Combined with multi-plane imaging modalities MPR), ultrasonographic tomography (TUI), surface imaging and other off-line offline diagnosis. The final diagnosis of pathological autopsy, birth neonatal 2DE or cardiac surgery outcome shall prevail. Comparing the accuracy of 2DE and 2DE combined with STIC in the detection of fetal congenital heart malformations. Results A total of 175 fetuses with suspicious cardiac malformations were investigated. Among them, 9 (5.1%) were lost to follow-up. Of the 166 prenatal diagnoses, 41 (24.7%) had cardiac aorta malformations, of which 22 fetuses terminated their pregnancy and were necropsied. 10 cases confirmed postpartum surgery, 9 cases underwent echocardiography and confirmed by long-term follow-up. 2DE correct diagnosis of aortic abnormalities in 33 cases, 8 cases were not correctly diagnosed, 2DE combined with STIC imaging correct diagnosis of 40 cases of aortic anomalies, 1 case was not correctly diagnosed, 2DE and 2DE combined with STIC in diagnosis of fetal cardiac malformation coincidence rates were 95.2% and 99.4%, the difference was statistically significant (χ2 = 4.111, P = 0.043). Conclusion The STIC technique has unique advantages in the diagnosis of fetal cardiac malformations. 2DE combined with STIC technique can obtain more accurate diagnostic information.