Diagnostic performance of conventional ultrasound views combined with short-axis view of the cardiac base and pulmonary artery bifurcation plane for common fetal congenital heart disease

doi:10.3877/cma.j.issn.1672-6448.2026.05.011

Abstract

Abstract:

Objective

To evaluate the diagnostic efficacy of routine ultrasound views combined with the short-axis view of the cardiac base (SAVCB) and the pulmonary artery bifurcation plane (PABP) for common fetal congenital heart disease (CHD).

Methods

This retrospective study included 176 pregnant women with fetuses suspected of having CHD who underwent prenatal examination at Shenzhen Nanshan People's Hospital from April 2018 to December 2025. Based on postnatal gold-standard diagnoses, they were divided into a CHD group (n=132) and a normal control group (n=44). All participants underwent routine ultrasound views plus additional SAVCB and PABP examinations. Key ultrasound parameters were quantified, including pulmonary artery (PA) diameter, aortic (AO) diameter, PA/AO ratio, superior vena cava (SVC) diameter, pulmonary valve peak velocity (PV_max), aortic valve peak velocity (AV_max), PV_max/AV_max ratio, left pulmonary artery (LPA) diameter, and right pulmonary artery (RPA) diameter. The t-test was used to compare the above-mentioned ultrasound parameters between the two groups. Receiver operating characteristic (ROC) curves were used to assess the diagnostic performance of different view combinations, with calculation of the area under the curve (AUC), sensitivity, specificity, and Youden index.

Results

The CHD group demonstrated significantly higher SVC and PV_max/AV_max compared with the control group [(5.89±0.73) mm vs (4.21±0.65) mm and (0.97±0.22) vs (0.75±0.13); t=-13.572 and -6.271, respectively; both P＜0.001], and significantly lower PA/AO, LPA, and RPA than the control group ([(1.07±0.11) vs (1.34±0.26), (2.52±0.35) mm vs (3.75±0.42) mm, and (2.68±0.32) mm vs (3.91±0.38) mm; t=9.653, 19.173, and 21.040, respectively; all P＜0.001]. The combined screening protocol integrating conventional views with SAVCB and PABP achieved the best diagnostic performance, with a detection rate of 84.44% for fetal CHD, an AUC of 0.902, a sensitivity of 95.45%, and a specificity of 84.85%.

Conclusion

The screening strategy integrating conventional ultrasound views with SAVCB and PABP significantly enhances the diagnostic efficacy for fetal CHD and optimizes the prenatal screening framework for this condition.

Key words: Congenital heart disease, fetal, Ultrasonic examination, Basal short-axis view, Pulmonary artery bifurcation view

Qiuluan Zhuo, Huixian Pang, Hongyan Wei, Xinkui Jiang, Wei Jiang. Diagnostic performance of conventional ultrasound views combined with short-axis view of the cardiac base and pulmonary artery bifurcation plane for common fetal congenital heart disease[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2026, 23(05): 408-415.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2026.05.011

https://chaosheng.cma-cmc.com.cn/EN/Y2026/V23/I05/408

Figures/Tables 7

项目	正常对照组（44例）	CHD组（132例）	统计值	P值
年龄（岁， $x ¯$ ±s）	30.63±6.72	29.47±5.82	t=1.101	0.273
孕周（周， $x ¯$ ±s）	27.48±1.37	27.81±1.30	t=1.439	0.152
初产妇[例（%）]	28（63.64）	90（68.18）	χ²=0.309	0.579
体质量（kg， $x ¯$ ±s）	55.72±4.38	56.32±4.87	t=0.725	0.469
孕期贫血[例（%）]	32（72.73）	107（81.06）	χ²=1.380	0.240
妊娠高血压[例（%）]	3（6.82）	14（10.61）	χ²=0.195	0.659
妊娠糖尿病[例（%）]	15（34.09）	59（44.70）	χ²=1.523	0.217
妊娠结局[例（%）]			χ²=30.247	＜0.001
引产	2（4.55）	68（51.52）
足月分娩	42（95.45）	64（48.48）

项目	正常对照组（44例）	CHD组（132例）	统计值	P值
年龄（岁， $x ¯$ ±s）	30.63±6.72	29.47±5.82	t=1.101	0.273
孕周（周， $x ¯$ ±s）	27.48±1.37	27.81±1.30	t=1.439	0.152
初产妇[例（%）]	28（63.64）	90（68.18）	χ²=0.309	0.579
体质量（kg， $x ¯$ ±s）	55.72±4.38	56.32±4.87	t=0.725	0.469
孕期贫血[例（%）]	32（72.73）	107（81.06）	χ²=1.380	0.240
妊娠高血压[例（%）]	3（6.82）	14（10.61）	χ²=0.195	0.659
妊娠糖尿病[例（%）]	15（34.09）	59（44.70）	χ²=1.523	0.217
妊娠结局[例（%）]			χ²=30.247	＜0.001
引产	2（4.55）	68（51.52）
足月分娩	42（95.45）	64（48.48）

组别	例数	PA/AO	SVC内径（mm）	PV_max/AV_max	LPA内径（mm）	RPA内径（mm）
正常对照组	44	1.34±0.26	4.21±0.65	0.75±0.13	3.75±0.42	3.91±0.38
CHD组	132	1.07±0.11	5.89±0.73	0.97±0.22	2.52±0.35	2.68±0.32
t值		9.653	-13.572	-6.271	19.173	21.040
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

检查方案	肺动脉瓣闭锁（32例）	法洛四联症（31例）	肺动脉狭窄（27例）	合计
常规切面	24（75.00）	21（67.74）	21（77.78）	66（73.33）
常规切面+SAVCB	26（81.25）	22（70.97）	22（81.48）	70（77.78）
常规切面+PABP	27（84.38）	21（67.74）	22（81.48）	70（77.78）
常规切面+SAVCB+PABP	30（93.75）	23（74.19）	23（85.19）	76（84.44）
χ²值	12.897	8.365	9.124	15.683
P值	＜0.001	＜0.001	＜0.001	＜0.001

检查方案	AUC	95%CI	敏感度（%）	特异度（%）	准确性（%）	约登指数
常规切面	0.795^a	0.729~0.862	84.09	75.00	77.27	0.591
常规切面+SAVCB	0.841^a	0.782~0.900	88.64	79.54	81.82	0.682
常规切面+PABP	0.856^a	0.801~0.911	90.91	80.30	82.95	0.712
常规切面+SAVCB+PABP	0.902	0.858~0.945	95.45	84.85	87.50	0.803

类型	AUC	95%CI	敏感度（%）	特异度（%）	准确性（%）	约登指数
简单型CHD	0.667	0.595~0.738	81.82	51.52	59.1	0.333
复杂型CHD	0.784	0.725~0.843	90.91	65.91	72.2	0.568

References 20

1	Stiller B, Grundmann S, Höhn R, et al. Adults with congenital heart disease—a new, expanding group of patients [J]. Dtsch Arztebl Int, 2023, 120(12): 195-202.
2	滕云, 黄冰鑫, 陈寄梅. 胎儿先天性心脏病的治疗现状和研究进展 [J]. 中华胸心血管外科杂志, 2021, 37(7): 443-446.
3	Ding L, Zhu X, Qian X, et al. Diagnostic effect of prenatal ultrasonography on fetal congenital heart disease [J]. Minerva Pediatr, 2022, 74(3): 387-389.
4	Carvalho JS, Axt-Fliedner R, Chaoui R, et al. ISUOG Practice Guidelines (updated): fetal cardiac screening [J]. Ultrasound Obstet Gynecol, 2023, 61(6): 788-803.
5	黄羽君, 朱云晓, 林冬梅, 等. 四腔心与三血管气管切面联合HD-flow筛查早孕期胎儿心血管畸形的应用价值 [J]. 中山大学学报(医学科学版), 2022, 43(1): 146-151.
6	贺新建, 魏九茹, 崔云, 等. 超声心动图对婴幼儿右位动脉导管未闭的筛查诊断方法及价值 [J]. 中华超声影像学杂志, 2023, 32(8): 679-684.
7	Vasquez Choy AL, Zonana Amkie R, Adebo DA. Role of cardiac CTA to evaluate branch pulmonary artery stenosis and ductal insertion pattern in right-sided congenital heart defects [J]. Pediatr Cardiol, 2024, 45(7): 1581-1587.
8	李辉, 李英来, 王希艳, 等. 孕中期三血管气管切面联合肺动脉主干增宽指导胎儿心脏畸形诊断的价值 [J]. 中国临床医学影像杂志, 2024, 35(10): 729-733.
9	潘美, 尤利益, 彭晓慧, 等. 国际妇产超声学会2023年胎儿心脏超声筛查指南解读 [J]. 中华超声影像学杂志, 2023, 32(11): 946-951.
10	冯丽, 吴青青. ISUOG实践指南(更新):早孕期胎儿超声检查解读 [J/OL]. 中华医学超声杂志(电子版), 2024, 21(6): 547-551.
11	Zhang J, Xiao S, Zhu Y, et al. Advances in the application of artificial intelligence in fetal echocardiography [J]. J Am Soc Echocardiogr, 2024, 37(5): 550-561.
12	贺新建, 魏九茹, 陈娇阳, 等. “十二切面超声筛查诊断法”应用于基层单位新生儿复杂型先天性心脏病筛查的可行性研究 [J]. 中华围产医学杂志, 2022, 25(8): 582-591.
13	Barris DM, Mikhno M, Kornblit M, et al. Clinical utility of repeat fetal echocardiography in congenital heart disease [J]. Ultrasound Obstet Gynecol, 2023, 62(5): 695-700.
14	Turgut ÜK, Erdemoğlu E, Sezik M. Evaluation of three-vessel view intervessel distance measurements in fetuses without congenital cardiac defects [J]. J Clin Ultrasound, 2025, 53(5): 1012-1016.
15	Lv J, Yang T, Gu X, et al. Differential diagnosis of fetal large ventricular septal defect and tetralogy of Fallot based on big data analysis [J]. Echocardiography, 2020, 37(4): 620-624.
16	Cantinotti M, McMahon CJ, Marchese P, et al. Echocardiographic parameters for risk prediction in borderline right ventricle: review with special emphasis on pulmonary atresia with intact ventricular septum and critical pulmonary stenosis [J]. J Clin Med, 2023, 12(14): 4599.
17	沈珍珍, 沈双双, 施如勇. 三血管切面联合肺动脉血流速度对胎儿先天性心脏病的预测价值 [J]. 中国妇幼保健, 2024, 39(3): 556-560.
18	Hashim L, Vari D, Bhat AM, et al. Adaptive growth of the ductus arteriosus and aortic isthmus in various ductus-dependent complex congenital heart diseases [J]. Pediatr Cardiol, 2024, 45(7): 1588-1595.
19	Jani VP, Kachenoura N, Redheuil A, et al. Deep learning-based automated aortic area and distensibility assessment: the multi-ethnic study of atherosclerosis (MESA) [J]. J Digit Imaging, 2022, 35(3): 594-604.
20	邓涵予, 阮燕萍, 谷孝艳, 等. 母胎医学多学科诊疗模式下胎儿心脏超声异常孕妇妊娠结局及产后结果分析 [J]. 中国实用妇科与产科杂志, 2024, 40(4): 448-452.

[1]	Xin Du, Lianghao Zhang, Zixuan Fu, Shuxian Wang, Jinquan Liu, Yuan Guo, Chuanshen Xu, Jinzhen Cai, Jianhong Wang. Appliation value of ultrasound in dynamic monitoring of bridging vessels in adult right half liver transplantation [J]. Chinese Journal of Transplantation(Electronic Edition), 2025, 19(04): 226-231.
[2]	Hongjuan Zhu, Cancan Huang, Shu Xu. Ultrasonographic features and differential diagnostic value of indirect inguinal hernia, direct inguinal hernia and femoral hernia [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(02): 155-157.
[3]	Chen Zhang, Ming Qin, Juan Dong, Yulong Chen. Diagnostic value of ultrasound in ischemic changes of intestinal volvulus in children [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(06): 565-568.

Please choose a citation manager

Content to export