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[1]凌 文 翁宗杰 邱秀青 馬 宏吳秋梅 賴遠(yuǎn)芳 陳錦文 劉 敏.九切面節(jié)段分析法在胎兒復(fù)雜先天性心臟病診斷中的應(yīng)用價(jià)值[J].福建醫(yī)藥雜志,2020,42(06):9-13.
　LING Wen,WENG Zongjie,QIU Xiuqing,et al.Clinical value of nine-section segmental analysis in the diagnosis of complex fetal congenital heart disease[J].FUJIAN MEDICAL JOURNAL,2020,42(06):9-13.
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九切面節(jié)段分析法在胎兒復(fù)雜先天性心臟病診斷中的應(yīng)用價(jià)值()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
42
期數(shù):
2020年06期
頁(yè)碼:
9-13
欄目:
臨床研究
出版日期:
2020-12-15

文章信息/Info

Title:
Clinical value of nine-section segmental analysis in the diagnosis of complex fetal congenital heart disease
文章編號(hào):
1002-2600(2020)06-0009-05
作者:
凌 文 翁宗杰1 邱秀青2 馬 宏3吳秋梅 賴遠(yuǎn)芳 陳錦文 劉 敏
福建省婦幼保健院 福建醫(yī)科大學(xué)附屬醫(yī)院超聲科(福州 350001)
Author(s):
LING Wen; WENG Zongjie; QIU Xiuqing; MA Hong; WU Qiumei; LAI Yuanfang; CHEN Jinwen; LIU Min.
Department of Ultrasound, Fujian Maternity and Child Health Hospital,Affiliated Hospital of Fujian Medical University, Fuzhou,Fujian 350001,China
關(guān)鍵詞:
胎兒先天性心臟病;  超聲;  病理解剖;  血管鑄型
Keywords:
fetal congenital heart disease;  ultrasound;  pathological anatomy;  vascular cast
分類號(hào):
R714.53 R445.1
文獻(xiàn)標(biāo)志碼:
B
摘要:
目的 評(píng)價(jià)產(chǎn)前超聲九切面節(jié)段分析法在診斷胎兒復(fù)雜先天性心臟病中的臨床應(yīng)用價(jià)值。方法 回顧性分析119例復(fù)雜先天性心臟病產(chǎn)前超聲圖像,以解剖及鑄型為金標(biāo)準(zhǔn),分析四切面節(jié)段分析法和九切面節(jié)段分析法的診斷效能差異。結(jié)果 四切面法與九切面法的診斷準(zhǔn)確率分別為84.5%和93.1%。四切面法和九切面法在靜脈與心房連接處異常、心房與心室連接處異常、心室與大動(dòng)脈連接處異常以及心臟其他畸形方面一致性良好(Kappa≥0.4),診斷準(zhǔn)確率差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05); 在胎兒內(nèi)臟心房位置異常、主動(dòng)脈與肺動(dòng)脈及其分支異常方面,四切面法與九切面法的一致性差(Kappa<0.4),兩者診斷準(zhǔn)確率的差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。四切面法漏診29處畸形,誤診7處畸形; 九切面法漏診9處畸形,誤診7處畸形與四切面法完全相同。九切面法診斷復(fù)雜先天性心臟畸形的漏診率明顯低于四切面法(P<0.05)。結(jié)論 產(chǎn)前超聲四切面法可用于低危胎兒的心臟篩查; 九切面法可獲得更多切面信息,對(duì)復(fù)雜心臟畸形的診斷具有重要價(jià)值。
Abstract:
Objective To evaluate the clinical value of nine-section segmental analysis in prenatal ultrasound diagnosis of complex fetal congenital heart disease.Methods Through taking anatomy and vascular casting as the gold standard, the prenatal ultrasound images of 119 patients with complex fetal congenital heart disease were analyzed retrospectively.Thus the diagnostic efficiency differences between four-section segmental analysis and nine-section segmental analysis were analyzed.Results The diagnostic accuracy of four-section segmental analysis and nine-section segmental analysis were 84.5% and 93.1% respectively.The four-section segmental analysis and nine-section segmental analysis showed good consistency in abnormal connection between veins and atria, abnormal connection between atria and ventricles, abnormal connection between ventricles and great arteries, and other cardiac malformations(Kappa≥0.4), and the difference in diagnostic accuracy was not statistically significant(P>0.05).In terms of abnormal location of fetal viscera and atrium, as well as abnormalities of the aorta/pulmonary artery and their branches, the four-section segmental analysis and the nine-section segmental analysis showed poor consistency(Kappa<0.4), and the difference in diagnostic accuracy was statistically significant(P<0.05).The four-section segmental analysis missed 29 malformations and misdiagnosed 7 malformations.The nine-section segmental analysis missed 9 malformations and misdiagnosed 7 malformations the same as the four-section segmental analysis.The rate of missed diagnosis of complex fetal congenital heart malformations by nine-section segmental analysis was significantly lower than that by four-section segmental analysis(P<0.05).Conclusion The four-section segmental analysis can be used for heart screening of low-risk fetuses,and the nine-section segmental analysis can obtain more section information,which is of great value in the diagnosis of complex fetal congenital heart disease.

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備注/Memo

備注/Memo:
基金項(xiàng)目:福建省自然科學(xué)基金資助項(xiàng)目(2017J01235)1 通信作者,Email:[email protected]; 2 婦產(chǎn)科; 3 病理科
更新日期/Last Update: 1900-01-01