Objective To explore the application value of tissue Doppler imaging (TDI) and echocardiography in the evaluation of cardiac function and prognosis of fetuses with congenital cystic adenomatoid malformation (CCAM). Methods A total of 106 fetuses diagnosed with CCAM by prenatal ultrasound were selected as the study group, and 110 healthy fetuses who underwent prenatal examination during the same period as the control group. TDI and echocardiography were performed on all fetuses in both groups. TDI parameters (Tei index) and echocardiographic parameters in terms of right ventricle to left ventricle longitudinal diameter ratio (RV/LV⁃L), right ventricle to left ventricle transverse diameter ratio (RV/LV⁃T), pulmonary valve opening to pulmonary annulus diameter ratio (PV⁃O/PA⁃D), and tricuspid valve to mitral valve annulus diameter ratio (TV/MV) were compared between fetuses of the two groups. The fetuses in the study group were followed up for 6 months after delivery to observe fetuses' prognosis and analyze the factors affecting fetuses' prognosis. Receiver operating characteristic (ROC) curve was plotted to analyze the value of TDI and echocardiographic parameters for predicting CCAM fetuses' prognosis. Results The Tei index of the study group was higher than that of the control group, and RV/LV⁃L, RV/LV⁃T, PV⁃O/PA⁃D, and TV/MV were lower than those of the control group (P<0.05). Compared to CCAM fetuses with favorable prognosis, those with poor prognosis obtained higher proportions of disease classification in type Ⅱ/Ⅲ, cystic volume ratio (CVR) ≥1.6, and Tei index, whereas lower PV⁃O/PA⁃D and TV/MV (P<0.05). The results of multivariate stepwise Logistic regression analysis revealed that disease classification, CVR, Tei index were the risk factors for prognosis of CCAM fetuses, while TV/MV and PV⁃O/PA⁃D were the protective factors for prognosis in CCAM fetuses (P<0.05). The results of ROC curve analysis indicated that areas under the curve of Tei index, TV/MV, and PV⁃O/PA⁃D for alone and jointly predicting CCAM fetuses' prognosis were 0.804, 0.764, 0.788, and 0.889, respectively, with greater area under the curve of the combined prediction than of the single prediction (P<0.05). Conclusion Both TDI and echocardiography can favorably evaluate cardiac function of fetuses with CCAM. Among them, the Tei index is a risk factor for prognosis in fetuses with CCAM, while TV/MV and PV⁃O/PA⁃D are protective factors. The combination of the three can better predict CCAM fetuses' prognosis.

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