2017 年第 12 期 第 12 卷

心脏超声“3+1”切面在复杂先天性心脏病产前筛查中的应用

Application of "3+1" combined echocardiographic views in prenatal screening of complex congenital heart disease

作者：张雅慧金梅丁文虹杨静莫莹叶文倩吕震宇王志远霍玉峰石诗

英文作者：Zhang Yahui Jin Mei Ding Wenhong Yang Jing Mo Ying Ye Wenqian Lyu Zhenyu Wang Zhiyuan Huo Yufeng Shi Shi

单位：100029首都医科大学附属北京安贞医院小儿心脏中心北京市心肺血管疾病研究所

英文单位：Pediatric Cardiac Center Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China

关键词：先天性心脏病；胎儿超声心动图；四腔心切面；左右心室流出道切面；三血管切面

英文关键词：Congenitalheartdisease；Fetalechocardiography；Four-chamberview;Leftandrightventricularoutflowtractsview;Three-vesselview

• 摘要：

• 目的    探讨心脏超声“3+1”切面（四腔心切面，左、右心室流出道切面+三血管切面）在胎儿复杂先天性心脏病产前筛查中的作用。方法    选取2007年1月至2015年10月于北京市先天性心脏病筛查、治疗和监测网络覆盖单位进行心脏超声“3+1”切面产前筛查的胎儿43 127例，以新生儿期超声结果或引产尸检结果验证产前胎儿心脏病筛查结果，评价心脏超声“3+1”切面对胎儿心脏病筛查的临床价值。结果    在43 127例胎儿中，应用心脏超声“3+1”切面共筛查出胎儿先天性心脏病413例，其中复杂先天性心脏病252例。出生后复查或尸检共确诊复杂先天性心脏病266例，其中产前误诊6例，漏诊14例。心脏超声“3+1”切面对胎儿复杂先天性心脏病筛查的敏感度为94.7%，特异度为100.0%。结论    心脏超声“3+1”切面在筛查胎儿复杂先天性心脏病中具有较高的临床价值，在胎儿心血管畸形的二级预防中起到了关键作用。

• Objective    To evaluate the value of "3+1" combined echocardiographic views (four-chamber view, left and right ventricular outflow tracts view, three-vessel view) in prenatal screening of complex congenital heart disease. Methods    Totally 43 127 fetuses who had congenital heart disease screening before birth by "3+1" combined echocardiographic view from January 2007 to October 2015 were enrolled through the congenital heart disease screening, treatment and monitoring network in Beijing. Echocardiographic results and autopsy results of induced abortion were analyzed. Results    In 43 127 fetuses, 413 cases of congenital heart disease were screened by "3+1" combined echocardiographic view including 252 cases of complex congenital heart disease; 266 cases of congenital heart disease were confirmed by echocardiography after birth or autopsy; there were 6 cases of prenatal misdiagnosis and 14 cases of missed diagnosis. The sensitivity and specificity of "3+1" combined echocardiographic view in diagnosis of fetal complex congenital heart disease were 94.7% and 100.0% respectively. Conclusion    The "3+1" combined echocardiographic views has a high value in diagnosis of fetal complex congenital heart disease.