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四维超声时空关联成像纳入常规,q台JL,b脏筛查的可行性
赵艳春
摘要
目的方法
吕国荣陈秋月刘金蓉候敏凌乐文陈晓康李丽雅
探讨四维超声时空关联成像技术纳入常规胎儿心脏筛查的可行性。
应用STIC技术获取的数据库中随机选择30例心脏结构畸形和30例心脏结构正常的胎儿作为研究对象。60例胎儿心
脏经产后随访或尸解有54例获得明确诊断结果。后由4组(A、B、C、D组)不同水平的医师在不知道诊断结果的情况下对先前存盘的心脏容积数据做快速离线分析。从事产科超声检查5年及以上者定为具有产前二维超声筛查经验的高水平医师,和5年以下者定为中低水平医师;应用STIC技术1年及以上即定为STIC技术应用经验丰富。A组具有中低水平的产前二维超声筛查经验无STIC技术应用经验,B组具有中低水平产前二维超声筛查经验但有STIC技术应用经验,C组具有高水平产前二维超声筛查经验而无STlC技术应用经验,D组既有高水平产前二维超声筛查经验又有丰富的STIC技术应用经验。
结果
A、B、C、D
4组正确诊断率分别为:75.OO%、77.78%、84.26%、87.04%,A组与B组、C组与D组、A组与C
组、B组与D组比较正确诊断率均无明显差别(x2值分别为0.23、0.34、2.85、3.19,P均>0.05),A组与D组比较有差别(Xz=5.09,P<O.05)。总正确诊断率为81.02%(350/432)。
结论STIC技术易于掌握且对医师的专业经验依赖性小,可以纳入常规胎儿先天性心脏病的筛查中.
关键词
超声
产前筛查
胎儿
先天性心脏畸形时空关联成像
TheFeasibilityofFour-dimensionalUltrasoundImagingUsingSpatiotemporal
ImageCorrelationinRoutineFetalHeartScreeningZhaoYanchun,LilGuorong,ChenQiuyue,etal
DepartmentofUltrasound,theSecondAffliatedHospitalofFujianMedicalUniversity,
Quanzhou,Fujian
362000China
Abstract:objectiveToinvestigatethefeasibilityoffour-dimensionalultrasoundimagingusingspatiotemporal
FromthevolumesgainedpreviouslybySTICtech—
imagecorrelation(STIC)inroutinefetalheartscreening.Methods
nologyweselected30fetuseswithheartmalformationsand30fetuseswith
normal
heartrandomly
or
asour
researchob—
ject.Theresultsofprenataldiagnosiswerefollowedup,eitherbypostnatalechocardiography
groupsists
bynecropsy.Four
con—
sonographers(A,B,C,D)participatingintheofflineanalysisdidn'tknowanydiagnosisresult.Everygroup
over
oftWOsonographers.Thesonographerengagedinobstetricssonographic
or
to
fiveyearsisthought
Andthe
one
to
havehigh
leveltwo-dimensionai(2D)echocardiographicexperiencenologyfor
one
below-to-mediumlevel.usedSTICtech-
year
is
thought
to
beskillful.PhysiciansinGroupAandBhavelow-to-mediumlevel2Dechocardio-
graphicexperience.PhysiciansinAgrouphaveexperienceusingSTICtechnologybutphysiciansinBgrouphaven’t.PhysiciansinCandDgrouphavehighlevel2Dechocardiographicexpefience.PhysiciansinCgrouphaveofSTICtechnologybut
physiciansinDgrouphave.Results
no
experience
are
Theaccuracyratingofdiagnosisoffourgroups
no
75.OO%,77.78%,84.26%and87.04%respectively.TherewasobviousdifferencebetweenGroupAandGroup
B,GroupCandGroupD,GroupAandGroupC.GroupBandGroupD(X2is0.23。0.34。2.85。3.19respectively。P>0.05),buttherewasdifferencebetweenGroupAandGroupdiagnosisis81.02%(350/432).Conclusions
D(f—s.09,P<O.05).The
overallaccuracyratingof
to
ThisstudyhasshownthatSTICtechnologyiseasy
grasp
rarelyde-
pendent
on
sonographerKworkexperience;therefore,incorporationofSTICvolumeacquisitionintotheroutinefetal
heartscreeningprogramisfeasible.
Keywords:
Ultrasonography,Prenatalscreening,Fetal,Heartdefectscongenital,
Spatio-temporalimage
correlation
基金项目:泉州市优秀人才培养专项经费(N“10A12)
作者单位:362000福建省泉州市。福建医科大学附晨第二医院超声辩通讯作者:吕国荣E-mail:Igr—feus@sina.COrn