The Research Of Two-dimensional And Four-dimensional Ultrasound Screening For Fetal Congenital Heart Disease

Objective To evaluate the diagnostic efficacy of the'basic scan','extended basic scan'and'extended basic scan combined with fetal echocardiography'in screening fetal congenital heart disease (FCHD).Methods These three different grades of cardiac scans were used separately in prenatal screening for FCHD in 17504 pregnant women at 15~40 gestational weeks. The diagnostic accuracy and Kappa consistency with the clinical follow-up outcomes were assessed and compared between the 3 screening methods.Results The diagnostic sensitivity, specificity, positive and negative predictive value were 80.4%, 99.9%, 92.7%, 99.8%;88.6%, 99.9%, 96.6%, 99.9%;89.9%, 99.9%, 96.6%, 99.9%, respectively. The consistency study of the three methods with clinical follow-up outcomes showed that the Kappa values of these different methods were 86.0%, 92.3%, 93.0%, respectively.Conclusions The'extended basic scan'and the'extended basic scan combined with fetal echocardiography'were more effective than that of the'basic scan'method in screening FCHD using prenatal ultrasonographic evaluation. Objective To explore the 'spin' technique for Spatio-temporal Image Correlation (STIC) , assess that whether the image quality of Multiplanar Reconstruction(MPR) virtual planes are better than common 2D planes, and whether STIC volume datasets can be transmitted via Internet and analyzed offline at a remote setting.Methods 30 cases of normal fetuses at the second and third trimester were scanned by 3 sonographers using the STIC with MPR modality and common 2D modality to obtain 9 standard planes of fetal echocardiogram for each case. Compare scan time and image quality between STIC with MPR modality and common 2D modality.Result Comparing with inexperienced sonographers, experienced sonographer obtained the planes with better quality and less scan time(P both <0.01) using 2D modality. But using STIC with MPR modality, neither the images quality nor scan time shows significant difference(P >0.05)between inexperienced sonographers and experienced sonographer. And inexperienced sonographers obtained the better image quality using STIC with MPR modality than 2D modality in some planes.Conclusion STIC with MPR modality ultrasonography shows less rely on the experience of sonographers, less scan time, and higher antepartum detection rate of fetal congenital heart.