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目的:探讨彩色多普勒超声检查在胎儿先天性心脏畸形中的应用价值。方法:回顾性分析经引产或产后证实先天性心脏畸形的胎儿51例。所有孕妇产前经1～2次常规超声检查,均随访至正常分娩或引产前1周;使用Philips IU22彩色多普勒超声诊断仪,从4CV、AR-SAV、VOTV、3VV及3VVT等切面观察胎儿心脏情况。结果:①51例中,房间隔缺损13例,室间隔缺损10例,法洛氏四联症7例,心内膜垫缺损5例,单心房、单心室4例,右心室发育不良4例,左心室发育不良3例,大动脉转位2例,三尖瓣下移2例,心脏肿瘤1例。超声共检出46例,诊断符合率为90.19%。②4CV+VOTV、4CV+3VV及4CV+3VVT切面对胎儿先天性心脏畸形的诊断符合率均明显高于单纯4CV切面(P<0.05)。4CV+3VV及4CV+3VVT切面对胎儿先天性心脏畸形的诊断符合率均明显高于其他三种切面(P<0.05)。结论:产前彩超检查对胎儿先天性心脏畸形检出率高,具有很高的临床应用价值,选择合理的切面可以提高检出率。
Objective: To investigate the value of color Doppler ultrasonography in detecting fetal congenital heart defects. Methods: A retrospective analysis of 51 cases of fetuses confirmed by induced or postnatal congenital heart defects. All pregnant women were routinely subjected to 1 ~ 2 routine ultrasound examinations and were followed up until normal delivery or 1 week before induction. Philips IVU22 color Doppler ultrasound was used to observe the changes from 4CV, AR-SAV, VOTV, 3VV and 3VVT Fetal heart condition. Results ① In 51 cases, there were 13 cases of atrial septal defect, 10 cases of ventricular septal defect, 7 cases of tetralogy of Fallot, 5 cases of endocardial cushion defect, 4 cases of single atrium, 4 cases of single ventricle and 4 cases of dysplasia of right ventricle. 3 cases of left ventricular dysplasia, 2 cases of aortic transposition, tricuspid regurgitation in 2 cases, 1 case of cardiac tumors. 46 cases were detected by ultrasound, the diagnostic coincidence rate was 90.19%. The coincidence rate of 4CV + VOTV, 4CV + 3VV and 4CV + 3VVT in diagnosis of congenital heart malformation were significantly higher than that of simple 4CV (P <0.05). The coincidence rates of 4CV + 3VV and 4CV + 3VVT on fetal congenital heart malformation were significantly higher than those of the other three sections (P <0.05). Conclusion: Prenatal color Doppler ultrasound examination of fetal congenital heart rate detection rate is high, with high clinical value, choose a reasonable section can increase the detection rate.