【摘要】 目的分析超声心动图诊断胎儿法洛四联症(TOF)的价值。方法选取2017年1月至2019年6月在云南省第二人民医院超声科接受胎儿超声心动图检查的558例孕妇作为研究对象,以引产后病理解剖及产后超声心动图随访结果为金标准,计算产前超声心动图诊断灵敏度、特异度、准确率,并对TOF的声像特征进行分析。结果共有558例孕妇接受超声心动图检查,经过引产后病理解剖及产后超声心动图随访结果证实共25例TOF胎儿。产前超声心动图检出TOF胎儿共26例,伴肺动脉狭窄的典型TOF20例,伴室间隔缺损的肺动脉闭锁3例,伴肺动脉瓣缺如的TOF2例,误诊2例,漏诊1例。产前超声心动图诊断灵敏度、特异度、准确率、误诊率、漏诊率分别约96%(24/25)、99.62%(531/533)、99.46%(555/558)、0.38%(2/533)、4%(1/25)。以室间隔缺损,主动脉骑跨,肺动脉狭窄、闭锁、肺动脉瓣缺如声像特征为主。结论胎儿产前超声心动图是诊断TOF最有重要价值的影像学方法,对评估胎儿预后有重要的临床指导意义。更多还原

【Abstract】 Objective To analyze the value of echocardiography in the diagnosis of fetal tetralogy of Fallot( TOF). Methods 558 pregnant women who underwent fetal echocardiography in the department of ultrasound of the Second People’s Hospital of Yunnan Province from January 2017 to June 2019 were selected as the research objects. The pathological anatomy after the induction of labor and the results of postpartum echocardiography follow-up were as used the gold standard to calculate the prenatal echocardiography. The diagnosis sensitivity, specificity, accuracy rate were shown, and the sound image characteristics of TOF were analyzed.Results A total of 558 pregnant women underwent the echocardiographic examination. After the induction of labor,pathological anatomy and postpartum echocardiographic follow-up results confirmed a total of 25 cases of TOF fetus.Prenatal echocardiography detected 26 cases of TOF fetus,20 cases of typical TOF with pulmonary artery stenosis,3 cases of pulmonary atresia with ventricular septal defect,2 cases of TOF with absent pulmonary valve,2 cases of misdiagnosis,and 1 case of missed diagnosis. The diagnostic sensitivity,specificity,accuracy,misdiagnosis rate and missed diagnosis rate of prenatal echocardiography were approximately 96%( 24/25), 99.62%( 531/533),99.46%(555/558),0.38%(2/533)and 4%(1/25),respectively. It is mainly characterized by ventricular septal defect,aortic straddling,pulmonary artery stenosis,atresia,and absence of pulmonary valve. Conclusion Pre-natal fetal echocardiography is the most important imaging method for the diagnosis of TOF,and it has important clinical guiding significance for evaluating the prognosis of the fetus.更多还原