Applying Four-Chamber View and Three-Vessel Trachea View Combined With HD-Flow to Screening Fetal Cardiovascular Malformations in First-Trimester Pregnancy
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2022.0118
- VernacularTitle:四腔心与三血管气管切面联合HD-flow筛查早孕期胎儿心血管畸形的应用价值
- Author:
Yu-jun HUANG
1
;
Yun-xiao ZHU
1
;
Dong-mei LIN
1
;
Ying TAN
1
;
Kun YUAN
1
;
Wen-fen LIU
1
Author Information
1. Department of Medical Ultrasonics， The Seventh Affiliated Hospital of Sun Yat-sen University ， Shenzhen 518107， China
- Publication Type:Journal Article
- Keywords:
cardiovascular malformation;
the first trimester ultrasound;
prenatal diagnosis;
four chamber view;
three-vessel trachea view
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2022;43(1):146-151
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo evaluate the value of four-chamber view （4CV） and three-vessel trachea view （3VTV） combined with HD-flow in screening for fetal cardiovascular mailformations （CVMs） in unselected population during early pregnancy （11~13+6 weeks）. MethodsFrom May 2018 to December 2019， 1145 fetuses were ultrasonic scanned routinely at 11~13+6 weeks at our hospital. The 4CV and 3VTV of fetal hearts were assessed by Power Doppler with flow direction （high definition flow， HD-flow），and the sonographic findings and follow-up outcomes were documented. Suspected CVMs were confirmed by the postpartum echocardiography or autopsy results. The sensitivities， specificities， PPVs and NPVs of diagnostic tests were compared among the two views and combined views. ResultsThere were 948 fetuses included in this study， with 19 cases of CVMs. The sonographic findings of 12 cases （12/19） with 22 CVMs were consistent entirely with the follow-up outcomes， including 7 cases of complex CVMs. In 1 case （1/19） with complex CVM， the diagnosis was not entirely consistent to the autopsy result. The 6 cases （6/19） of abnormal atrioventricular septum were not detected in early pregnancy. In the 19 cases of CVMs， abnormalities were found by displaying 4CV in 8 cases， by displaying 3VTV in 11 cases， and by displaying 4CV combined with 3VTV in 13 cases. The sensitivity of 4CV， 3VTV， 4CV+3VTV was 31.5%， 57.9%， 68.4%， with significant difference between 4CV and 4CV+3VTV（P=0.016） .The specificity and PPVs were all 100% （P>0.05）. The NPVs of them were 98.6%， 99.1% and 99.4%， with no statistical difference （P>0.05）. ConclusionsDisplaying the 4CV combined with 3VTV of fetal heart in the first-trimester ultrasound examination resulted in higher detect ratio of fetal cardiovascular malformations rather than scanning only with the 4CV， especially for those serious CVMs with poor prognosis， which is important for clinical management appropriately.
