论文部分内容阅读
目的通过观察三血管系列切面(s-3VV)的声像图特征,探讨其在筛查胎儿心脏畸形尤其是大血管异常中的临床价值。方法回顾性分析2011年1月~2014年6月行产前超声心动图检查,产后经新生儿心脏超声复查或引产后病理解剖证实的心脏畸形153胎。常规心脏超声检查后,在四腔心切面(FCV)基础上,通过对胎儿上纵隔偏转、平移探头连续扫查分别获取s-3VV,包括:三血管-右房切面(3VRA)、三血管切面(3-VV)、三血管-肺动脉分叉切面(PAB)、三血管-气管切面(3-VT)、三血管-动脉导管切面(TDA)、主动脉弓斜切面(TAA),同时观察彩色多普勒血流显像及频谱多普勒,发现异常后对切面的声像图特征进行分析。结果胎儿心脏异常153胎,其中s-3VV表现异常109胎,异常检出率为71.2%.其中室间隔缺损(VSD)3例(9.4%)、法洛四联症(TOF)10例(90.1%)、肺动脉/瓣狭窄4例(80.0%)、右室双出口(DORV)5例(83.3%)、右心发育不良综合征7例(87.5%)、三尖瓣下移畸形1例(33.3%);而永存动脉干、完全性大动脉转位(TGA)、右室双出口合并肺动脉狭、主动脉狭窄/缩窄、肺动脉瓣缺如、肺动脉闭锁、动脉导管瘤、血管环及永存左上腔静脉等心脏畸形检出率为100%.结论 s-3VV可作为产前筛查胎儿大血管及涉及左右室流出道异常的重要切面,具有重要的临床意义。
Objective To investigate the clinical value of s-3VV in screening fetal heart malformations, especially macrovascular abnormalities. Methods Retrospective analysis of January 2011 ~ June 2014 prenatal echocardiography, postnatal neonatal echocardiography or pathological anatomy confirmed after abortion 153 cases of cardiac malformations. After conventional echocardiography, s-3VV was acquired by serial scanning of the mediastinum and panning probe on the basis of four-chamber heart plane (FCV), including three-vessel-right atrium (3VRA) 3-VV, PAB, 3-VT, TDA and TAA were observed at the same time. Lebronchial flow imaging and spectral Doppler, after the abnormalities were found on the section of the sonographic features were analyzed. Results There were 153 fetuses with abnormal fetal heart, of which 109 were abnormal s-3VV and 71.2% were abnormal. Among them, VSD (9.4%), TOF (TOF) 10 (90.1 ), Pulmonary artery / stenosis in 4 cases (80.0%), right ventricular double outlet (DORV) in 5 cases (83.3%), right ventricular dysplasia in 7 cases (87.5%), tricuspid regurgitation 33.3%); and permanent trunk, complete aortic transposition (TGA), right ventricular double outlet with pulmonary stenosis, aortic stenosis / constriction, pulmonary valve absent, pulmonary atresia, arterioles, vascular rings and the permanent left upper The detection rate of ventricular malformations such as vena cava was 100% .Conclusion s-3VV can be used as an important section for prenatal screening of large blood vessels in the fetus and involved in the abnormalities of the left and right ventricular outflow tract, which has important clinical significance.