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目的:探讨胎儿期心内膜垫缺损的超声声像图特征及诊断的临床意义。方法:回顾性分析10例诊断为心内膜垫缺损的胎儿超声声像图特点,并与产前诊断中心的超声心动报告或引产后病理相比较。首先确定胎儿心脏的位置,二维图像显示四腔心、三血管、左右室流出道、心底短轴、主动脉弓、动脉导管弓切面,重点观察四腔心切面房间隔(原发隔)、室间隔的连续性,二尖瓣、三尖瓣的形态及瓣叶数目,可加用彩色多普勒血流显像观察房室瓣的血流情况。结果:①产前共诊断10例胎儿心内膜垫缺损,其中完全型8例,部分型2例。②单一心内膜垫缺损2例,合并其他心脏畸形4例,合并心外畸形6例。③10例病例中8例引产,1例失访,1例继续妊娠。结论:产前超声心动图能较准确的诊断胎儿心内膜垫缺损。四腔心切面是诊断该病的主要切面,彩色多普勒血流显像可进一步明确诊断。
Objective: To investigate the echocardiographic features of fetal endocardial cushion defect and its clinical significance. Methods: A retrospective analysis of 10 cases of fetal ultrasound diagnosis of endocardial pad defect sonographic features and prenatal diagnostic center with echocardiographic reports or postpartum pathology compared. First determine the location of fetal heart, two-dimensional image shows the four-chamber heart, three vessels, left ventricular outflow tract, short axis of the heart, aortic arch, ductus arteriosus arch section, focusing on four-chamber view of the atrial septum (primary septum) Continuity, mitral, tricuspid valve morphology and the number of leaflets, color Doppler flow imaging can be used to observe the atrioventricular valve blood flow. Results: ① Prenatal diagnosis of 10 cases of fetal endocardial cushion defect, including 8 cases of complete type, partial type in 2 cases. ② single endocardial cushion defect in 2 cases, combined with other cardiac malformations in 4 cases, combined with extrahepatic deformities in 6 cases. ③ 10 cases of induced abortion in 8 cases, 1 case lost, 1 case of continued pregnancy. Conclusion: Prenatal echocardiography can diagnose fetal endocardial cushion defect more accurately. Four-chamber heart section is the main aspect of the diagnosis of the disease, color Doppler flow imaging can further confirm the diagnosis.