CAJ | 학술논문

目的探讨时间-空间关联成像联合超声断层显像模式(TUI-STIC)在产前诊断圆锥动脉干畸形中的应用价值.方法分别对1508例先天性心脏病高危胎儿进行二维超声心动图(2DE)检查并采集TUI-STIC心脏容积数据分析,产前检查结果与产后新生儿超声心动图、多排螺旋CT及引产后尸检结果进行对比.结果 1508例胎儿中,2DE诊断圆锥动脉干畸形35例,TUI-STIC诊断圆锥动脉干畸形39例.TUI-STIC补充及纠正2DE诊断9例(共占22％),纠正2DE诊断右室双出口亚型3例,其诊断灵敏度为97.5％,特异度100％,阳性预测值100％,阴性预测值99.9％,准确率99％.2DE与TUI-STIC一致性检验Kappa=0.244,P=0.018 (P＜0.01),McNemar检验显示差异有统计学意义,P =0.004(P＜0.01).结论 TUI-STIC可以提高心室大动脉连接及位置关系的显示率及异常的发现率,有利于大动脉空间定位,对于完善圆锥动脉干畸形的诊断及鉴别诊断具有较大的应用价值.
목적 탐토시간-공간관련성상연합초성단층현상모식(TUI-STIC)재산전진단원추동맥간기형중적응용개치.방법 분별대1508례선천성심장병고위태인진행이유초성심동도(2DE)검사병채집TUI-STIC심장용적수거분석,산전검사결과여산후신생인초성심동도、다배라선CT급인산후시검결과진행대비.결과 1508례태인중,2DE진단원추동맥간기형35례,TUI-STIC진단원추동맥간기형39례.TUI-STIC보충급규정2DE진단9례(공점22％),규정2DE진단우실쌍출구아형3례,기진단령민도위97.5％,특이도100％,양성예측치100％,음성예측치99.9％,준학솔99％.2DE여TUI-STIC일치성검험Kappa=0.244,P=0.018 (P＜0.01),McNemar검험현시차이유통계학의의,P =0.004(P＜0.01).결론 TUI-STIC가이제고심실대동맥련접급위치관계적현시솔급이상적발현솔,유리우대동맥공간정위,대우완선원추동맥간기형적진단급감별진단구유교대적응용개치.
Objective To investigate the application value of spatio-temporal image correlation (STIC) combined with tomographic ultrasound imaging(TUI) in the prenatal diagnosis of conotruncal defects(CTD).Methods Two-dimensional(2D) fetal echocardiography to screen and TUI-STIC volumes from 1508 cases of fetuses of high risk with congenital heart disease.Postnatal work-up and pathological results were available for all fetuses with CTD.Results Thirty nine cases with CTD were found by TUI-STIC while thirty five cases were found by 2D echocardiography,but TUI-STIC had new findings and corrected the diagnosis in 9 cases as compared with 2D echocardiography.The sensitivity,specificity,positivity predictive value,negative predictive value and accuracy of TUI-STIC in evaluating CTD were 97.5 ％,100％,100 ％,99.9 ％ and 99 ％.The Kappa value of consistency test between 2DE and TUI-SIC was 0.244(P ＜ 0.01),McNemar test showed that the difference was statistically significant (P ＜ 0.01).Conclusions TUI-STIC allows a complete sequential analysis of fetal conotruncal defects and supplying additional information over 2D fetal echocardiography,it could improve the prenatal diagnosis rate.TUI-STIC is helpful in diagnosis of prenatal conotruncal defects.