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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >Sonographic grading of fetal intracardiac echogenic foci in a population at low risk of aneuploidy.
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Sonographic grading of fetal intracardiac echogenic foci in a population at low risk of aneuploidy.

机译：在非整倍性风险较低的人群中，胎儿心内回声灶的超声分级。

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PURPOSE: We screened pregnant women at low risk of a fetal chromosomal abnormality for the presence of fetal intracardiac echogenic foci (ICEF) and graded those foci by using sonographic gain reduction. Our objectives were to determine the interobserver reliability of the technique and the association of ICEF, by grade, with fetal aneuploidy. METHODS: Pregnant women who were 18-35 years old, at low risk for fetal chromosomal abnormalities, and referred for targeted sonography at 16-24 weeks' menstrual age were eligible to participate. All patients whose fetuses had ICEF were offered fetal chromosomal analysis. The presence of ICEF was ascertained by an apical 4-chamber view of the fetal heart and graded independently by 2 examiners blinded to each other's assessment. Grading was based on the difference in echogenicity of the ICEF and the thoracic spine as the ultrasound gain was reduced; in grade 1, the ICEF image was lost before that of the thoracic spine; in grade 2, the ICEF and thoracic spine images disappeared at the same gain setting; and in grade 3, the thoracic spine image was lost before that of the ICEF. RESULTS: During the 6-month study period, 383 eligible women were examined, and ICEF were seen in 35 fetuses (9.1%): 25 (71.4%) in the left ventricle, 1 (2.9%) in the right ventricle, and 9 (25.7%) in both ventricles. ICEF grading was successfully performed in all 33 of the women with fetal ICEF who elected to participate. Twenty-one (63.6%) had grade 1, 9 (27.3%) had grade 2, and 3 (9.1%) had grade 3 ICEF. Interobserver agreement was noted in 27 (90.0%) of 30 available paired second-trimester observations (kappa = 0.8), indicating excellent agreement. Two fetuses (6.1%) with grade 1 ICEF but no other risk factors for aneuploidy had chromosomal abnormalities, as compared with 1 fetus (0.3%) in the control group, which had no ICEF (p = 0.02). CONCLUSIONS: Sonographic grading of ICEF is feasible and reliable. The presence of fetal ICEF in a population otherwise at low risk for aneuploidy seemsto warrant the performance of fetal chromosomal analysis.
机译：目的：我们筛查了胎儿染色体异常异常风险低的孕妇是否存在胎儿心内回声灶（ICEF），并通过超声检查降低了这些病灶的等级。我们的目标是确定该技术的观察者之间的可靠性以及ICEF与胎儿非整倍性的关系（按年级）。方法：年龄在18-35岁，胎儿染色体异常风险低且在月经期16-24周接受定向超声检查的孕妇有资格参加。所有胎儿均具有ICEF的患者均接受了胎儿染色体分析。 ICEF的存在是通过对胎儿心脏的心尖四腔视图确定的，并由对彼此评估不知情的两名检查员独立分级。分级的依据是随着超声增益的降低，ICEF和胸椎的回声性不同。 1年级时，ICEF图像早于胸椎丢失;在2级时，ICEF和胸椎图像在相同增益设置下消失;在3年级时，胸椎图像丢失得比ICEF丢失。结果：在为期6个月的研究期内，检查了383名合格女性，在35例胎儿（9.1％）中发现了ICEF：左心室25例（71.4％），右心室1例（2.9％）和9例（25.7％）在两个心室中。对所有33名选择参加胎儿ICEF的女性均成功进行了ICEF评分。 21名（63.6％）为1级，9名（27.3％）为2级，3（9.1％）为3级ICEF。在30个配对的孕中期观察中，有27个（90.0％）观察者之间达成一致（kappa = 0.8），这表明存在极好的一致性。患有1级ICEF但无其他非整倍性危险因素的两名胎儿（6.1％）具有染色体异常，而没有ICEF的对照组中的1名胎儿（0.3％）没有染色体异常（p = 0.02）。结论：ICEF的超声分级是可行和可靠的。在非整倍性风险较低的人群中，胎儿ICEF的存在似乎可以保证进行胎儿染色体分析。

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