【摘要】 目的 探讨产前孕23～27周心脏超声不同切面组合对胎儿室间隔缺损的预测作用。方法 本研究为前瞻性研究，选取2021年1月—2024年4月在泉州市光前医院进行产前检查的873例孕23～27周产妇作为研究对象，发生室间隔缺损患者7例（含1例漏诊），非室间隔缺损患者866例，分别对采用四腔心切面（four chamber view,4CA）、三血管气管切面（three vessels and trachea view,3VT）、左室流出道切面（left ventricular outflow tract,LVOT）、右室流出道切面（right ventricular outflow tract,RVOT）、拓展切面主动脉弓/动脉导管弓切面（A）以及上下腔静脉切面（V）进行超声诊断，比较单独检测以及联合诊断之间的差异。结果 通过对不同切面的影像获取率比较，影像获取率从高到低依次为4CV(99.66%)、3VT(99.08%)、LVOT(98.63%)、RVOT(98.51%)、A(98.28%)以及V(97.48%)切面；通过检出一致性分析，4CV、3VT、LVOT、RVOT、A、V切面及联合检测的一致性均较高（P <0.05），且联合检测高于各切面单独检测的一致性。通过联合检测以及单独检测分析，4CV、3VT、LVOT、RVOT、A及V切面单独检测与联合检测的准确率、敏感度、特异度比较差异均无统计学意义（P> 0.05）。结论 通过超声不同切面的诊断，可以全面了解胎儿室间隔缺损的结构、形态以及与其他结构的关系，帮助医生做出准确的诊断和制定适当的治疗方案。更多还原

【Abstract】 Objective To explore predictive effect of different section combinations of cardiac ultrasound on fetal ventricular septal defect during 23-27 weeks of pregnancy. Methods This was a prospective study, which including 873 pregnant women at 23 to 27 weeks gestation who underwent prenatal examination in Quanzhou Guangqian Hospital from January 2021 to April 2024were selected as subjects. There were 7 patients with ventricular septal defect(including 1 missed diagnosis) and 866 patients without ventricular septal defect. Four chamber view(4CA), three vessels and trachea view(3VT), left ventricular outflow tract(LVOT), right ventricular outflow tract(RVOT), extended section of aortic arch/ductus arteriosus arch(A) and section of superior and inferior vena cava(V) were ultrasonically diagnosed to compare the differences between separate detection and combined diagnosis. Results By comparing image acquisition rates of different sections, image acquisition rates from high to low were 4CV(99.66%), 3VT(99.08%), LVOT(98.63%), RVOT(98.51%),A(98.28%) and V(97.48%) sections. Through the detection consistency analysis, the consistency of 4CV, 3VT, LVOT, RVOT,A and V sections and the combined detection were all higher(P < 0.05), and the consistency of the combined detection was higher than that of the separate detection of each section. Through joint detection and individual detection analysis, the accuracy,sensitivity, and specificity of individual and joint detection of 4CV, 3VT, LVOT, RVOT, A, and V sections, the difference were not statistically significant(P > 0.05). Conclusion Through the diagnosis of different sections of ultrasound, the structure, shape and relationship between fetal ventricular septal defect and other structures could be fully understood, which could help doctors make accurate diagnosis and make appropriate treatment plan.更多还原