静脉导管频谱在11~14周筛查胎儿异常中的价值

doi:10.3969/j.issn.1006-7795.2014.02.008

首都医科大学学报 ›› 2014, Vol. 35 ›› Issue (2): 179-183.doi: 10.3969/j.issn.1006-7795.2014.02.008

静脉导管频谱在11~14周筛查胎儿异常中的价值

刘冬梅, 杨敏, 刘勇

首都医科大学附属北京世纪坛医院超声科, 北京 100038

收稿日期:2013-12-18 出版日期:2014-04-21 发布日期:2014-04-16

Value of abnormal ductus venosus flow frequency spectrum in early detection of abnormalities at 11-14 weeks gestation

Liu Dongmei, Yang Min, Liu Yong

Department of Ultrasound, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China

Received:2013-12-18 Online:2014-04-21 Published:2014-04-16
Contact: 杨敏 E-mail:yangminivf60@163.com

摘要/Abstract

摘要：

目的探讨胎儿静脉导管频谱在11~14周早期筛查胎儿异常中的诊断价值。方法超声观察1 091例孕妇11~14周胎儿静脉导管频谱心室收缩峰值血流速度（peak velocity during ventricular systole，S）、心室舒张期峰值流速（peak velocity during ventricular diastole，D ）、心房收缩期流速（velocity during atria systole，A），同时测量颈项透明层厚度（nuchal translucency，NT），对高危孕妇行羊膜腔穿刺检测染色体和超声胎儿心脏形态学筛查，异常胎儿引产后行病理尸检，所有胎儿随访至出生后42 d。结果 1 091例孕妇中成功测得静脉导管频谱1 017例（显示率为93.21%），胎儿静脉导管S（45.64±7.35）m/s，D（37.66±7.57）m/s，A（12.42±4.87）m/s。静脉导管A波倒置（全心房收缩期）19例，静脉导管A波生理性消失或反向36例（随访36例胎儿均正常出生），NT增厚（NT≥2.5 mm）26例。羊膜腔穿刺染色体异常5例。1 091例胎儿中胎儿异常17例。静脉导管A波倒置及NT增厚预测胎儿异常的敏感度、特异度、阳性预测值、阴性预测值分别为70.5%、99.3%、63.1%、99.5%和64.7%、98.7%、44%、99.4%。联合应用静脉导管A波倒置及NT增厚作为预测胎儿异常的指标，敏感度为82.3%。结论静脉导管频谱A波倒置能够早期提示胎儿异常，可以与NT增厚同时作为早期筛查胎儿异常的指标，提高胎儿异常的检出率及诊断准确率。

关键词: 静脉导管, 颈项透明层, 彩色多普勒超声

Abstract:

Objective To explore the value of abnormal ductus venosus flow frequency spectrum in early detection of abnormalities at 11-14weeks gestation. Methods Totally 1 091 pregnant women at 11-14 weeks gestation were screened by the color Doppler ultrasound. The nuchal translucency were measured and the ductus venosus flow were evaluated. The following variables were measured: S-peak, D-peak, A-wave. Results The abnormal DV and NT were detected in 19/1 091(1.7%) and 26/1 091(2.3%), respectively. The occurrence rate of reversed flow during atrial contraction(RA) is 3.29%(36/1 091). The sensitivity, specificity, and positive and negative predictive values of abnormal DV flow and NT for determining increased test risk were 70.5%, 99.3%, 63.1%, 99.5% and 64.7%, 98.7%, 44%, 99.4%. The sensitivity of abnormal DV flow or NT for determining increased test risk was 82.3%. Conclusion Abnormal DV flow can provide an important information in the first trimester. When abnormal DV and NT were both positive, the risk of fetus abnormality increased.

Key words: ductus venosus, nuchal translucency, color Doppler ultrasound

中图分类号:

R447.1

刘冬梅, 杨敏, 刘勇. 静脉导管频谱在11~14周筛查胎儿异常中的价值[J]. 首都医科大学学报, 2014, 35(2): 179-183.

Liu Dongmei, Yang Min, Liu Yong. Value of abnormal ductus venosus flow frequency spectrum in early detection of abnormalities at 11-14 weeks gestation[J]. Journal of Capital Medical University, 2014, 35(2): 179-183.

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静脉导管频谱在11~14周筛查胎儿异常中的价值

Value of abnormal ductus venosus flow frequency spectrum in early detection of abnormalities at 11-14 weeks gestation

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