Li Huidong, Peng Fanghua, Wu Chao, Kong Dexuan, Zhang Qi, Zhang Zhikun
Department of Ultrasound, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin 300100, P.R. China.
Exp Ther Med. 2020 Feb;19(2):1161-1166. doi: 10.3892/etm.2019.8325. Epub 2019 Dec 13.
Diagnostic value of four-dimensional ultrasonography with spatio-temporal image correlation (STIC) technique combined with two-dimensional ultrasonography for fetal cardiac malformation and chromosomal abnormalities in early pregnancy was investigated. Medical data of 178 pregnant women enrolled in Tianjin Central Hospital of Gynecology and Obstetrics for screening of fetal cardiac malformations and chromosomal abnormalities from January 2014 to March 2016 were collected. According to the results of the pregnant women's biopsy and the results of labor induction and delivery, 95 fetuses were diagnosed with chromosomal abnormalities and cardiac malformations, 40 fetuses with cardiac malformations and no chromosomal abnormalities, and 43 fetuses with neither cardiac malformations nor chromosomal abnormalities. Fetal cardiac malformations and chromosomal abnormalities were diagnosed by three methods: single two-dimensional ultrasonography, single four-dimensional ultrasonography with STIC, and a combination of two-dimensional ultrasonography and four-dimensional ultrasonography with STIC. The two-dimensional ultrasonography diagnosed 97 cases of fetal cardiac malformation and 61 cases of chromosomal abnormalities, four-dimensional ultrasonography with STIC diagnosed 122 cases of fetal cardiac malformation and 81 cases of chromosomal abnormalities. The combination of two-dimensional ultrasonography and four-dimensional ultrasonography diagnosed 130 cases of fetal cardiac malformation and 90 cases of chromosomal abnormalities. The sensitivities of four-dimensional ultrasonography with STIC and the combination of two-dimensional ultrasonography and four-dimensional ultrasonography were significantly higher than that of single examination by two-dimensional ultrasonography (P<0.05), while the diagnostic sensitivities by four-dimensional ultrasonography with STIC and the combined diagnosis were not statistically significant (P>0.05). The diagnostic accordance rates of the single four-dimensional ultrasonography and the combined diagnosis for fetal cardiac malformations and chromosomal abnormalities were not much different (P>0.05), but both were greatly higher than that of single two-dimensional ultrasonography diagnosis (P<0.05). Thus, a combination of four-dimensional ultrasonography with STIC and two-dimensional ultrasonography is recommended for screening fetal defects.
研究了时空图像相关（STIC）技术的四维超声联合二维超声对早孕期胎儿心脏畸形和染色体异常的诊断价值。收集了2014年1月至2016年3月在天津市中心妇产科医院进行胎儿心脏畸形和染色体异常筛查的178例孕妇的医学资料。根据孕妇活检结果及引产和分娩结果，95例胎儿被诊断为染色体异常和心脏畸形，40例胎儿有心脏畸形但无染色体异常，43例胎儿既无心脏畸形也无染色体异常。采用三种方法诊断胎儿心脏畸形和染色体异常：单纯二维超声、单纯STIC四维超声以及二维超声与STIC四维超声联合。二维超声诊断出97例胎儿心脏畸形和61例染色体异常，STIC四维超声诊断出122例胎儿心脏畸形和81例染色体异常。二维超声与四维超声联合诊断出130例胎儿心脏畸形和90例染色体异常。STIC四维超声及二维超声与四维超声联合诊断的敏感度显著高于单纯二维超声检查（P<0.05），而STIC四维超声与联合诊断的诊断敏感度差异无统计学意义（P>0.05）。单纯四维超声及联合诊断对胎儿心脏畸形和染色体异常的诊断符合率差异不大（P>0.05），但均显著高于单纯二维超声诊断（P<0.05）。因此，推荐采用STIC四维超声与二维超声联合进行胎儿缺陷筛查。
