【摘要】：目的 心臟大血管結(jié)構(gòu)發(fā)育畸形是一類(lèi)較常見(jiàn)的胎兒先天性發(fā)育畸形，由于受多種因素影響，產(chǎn)前常規(guī)二維超聲心動(dòng)圖檢查對(duì)胎兒先天性心臟病的診斷有一定局限性，本課題旨在探討二維超聲心動(dòng)圖聯(lián)合時(shí)間-空間關(guān)聯(lián)成像(STIC)技術(shù)在胎兒先天性心臟病篩查中的應(yīng)用價(jià)值。 方法 收集2011年9月~2013年5月在我院進(jìn)行胎兒產(chǎn)前畸形篩查的孕婦11036例。用GE-Voluson E8儀器進(jìn)行二維超聲掃查及三維STIC成像，部分胎兒進(jìn)行STIC容積數(shù)據(jù)庫(kù)采集及脫機(jī)分析，并記錄二維超聲及STIC心臟掃描時(shí)間。先天性心臟病胎兒引產(chǎn)后進(jìn)行尸體解剖或出生后隨訪(fǎng)結(jié)果對(duì)照。 結(jié)果 1.單純二維超聲心動(dòng)圖與二維超聲聯(lián)合STIC技術(shù)兩種檢查方法對(duì)95例胎兒先心病的診斷符合率(分別為95.79%、98.95%)比較，差異無(wú)統(tǒng)計(jì)學(xué)意義。 2.檢出的先心病胎兒中，87例記錄二維篩查時(shí)間，平均每個(gè)胎兒心臟用時(shí)(9.68±2.13)min，，每幅圖像所用時(shí)間(1.03±0.80)min，79例記錄STIC技術(shù)掃描時(shí)間，平均每次STIC掃描用時(shí)(7.76±2.42)min，每幅圖像所用時(shí)間(0.78±0.56)min，對(duì)兩種方法所得每例樣本和每幅圖像的時(shí)間進(jìn)行比較，差異均有統(tǒng)計(jì)學(xué)意義(P0.05，P0.01)。 3.不同孕周二維超聲心動(dòng)圖與STIC技術(shù)各重要切面顯示合格率差異無(wú)統(tǒng)計(jì)學(xué)意義，隨著孕齡增大，STIC技術(shù)對(duì)各重要切面顯示合格率較二維超聲的優(yōu)勢(shì)逐漸變小。 4.確診為完全型大動(dòng)脈轉(zhuǎn)位的胎兒心臟根據(jù)是否合并室間隔缺損（VSD）及肺動(dòng)脈狹窄（PAS），可將完全型大動(dòng)脈轉(zhuǎn)位分為三型，即單純型大動(dòng)脈轉(zhuǎn)位、完全型大動(dòng)脈轉(zhuǎn)位伴室間隔缺損、完全型大動(dòng)脈轉(zhuǎn)位伴室間隔缺損及肺動(dòng)脈狹窄。 結(jié)論 1.STIC技術(shù)較二維超聲縮短了心臟檢查時(shí)間，特別是有心臟發(fā)育畸形胎兒的胎心照射時(shí)間得到大大縮短。 2.二維超聲聯(lián)合STIC技術(shù)對(duì)胎兒先心病的檢出率及診斷符合率均有所提高。
[Abstract]:Objective the macrovascular structural malformation of the heart is a kind of common fetal congenital developmental malformations. Due to the influence of many factors, antenatal routine two-dimensional echocardiography has some limitations in the diagnosis of fetal congenital heart disease. The purpose of this study was to evaluate the value of two-dimensional echocardiography combined with time-space correlation imaging (STIC) in the screening of fetal congenital heart disease. Methods from September 2011 to May 2013, 11036 pregnant women with fetal malformation were screened in our hospital. Two-dimensional ultrasound scanning and three-dimensional STIC imaging were performed with GE-Voluson E8 instrument. STIC volume database collection and offline analysis were carried out in some fetuses, and the scanning time of two-dimensional ultrasound and STIC heart was recorded. The results of postmortem or post-birth follow-up of fetuses with congenital heart disease were compared. Result 1. There was no significant difference between two-dimensional echocardiography and two-dimensional echocardiography combined with STIC in the diagnosis of 95 cases of fetal congenital heart disease (95.79% and 98.95%, respectively). two銆

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