妊娠10至17周胎儿四腔心的超声检测研究

Ultrasound study of four - chamber view of normal fetal heart from 10 to 17 weeks of gestation

目的 研究妊娠10至17周正常胎儿心脏四腔结构,为早期宫内诊断胎儿心脏异常提供帮助。方法 应用彩色多谱勒超声检测137例孕10至17周的正常胎儿心脏四腔结构。结果 ①孕10周可探测到44％胎儿心脏腔图孕13周以后均能探测到心脏四腔图;②左右心室的内径、心脏的横径、心脏面积、室间隔厚度与孕周呈高度正相关。③右左心室内径之比为1;④心胸比例随孕周轻度增加,此孕期心脏占据胸腔面积的1/5～1/4。而不是孕晚期的1/3。结论 孕13周至17周胎儿心脏的左右心室基本均匀发展,未呈现右心优势现象;心胸比例小于孕晚期;应用高分辨率的超声仪在此期可以探测到胎儿四腔心,有助于早期诊断胎儿心脏异常。

Objective To study the four-chamber view of normal fetal heart from 10 to 17 weeks of gestation, so as to make early diagnoses of interuterine fetal heart malformation. Methods Computerized ultrasonic doppler system was used to study the four-chamber view of 137 fetal hearts from 10 to 17 weeks of gestation. Results (1)The four-chamber view could be demonstrated in 44% of the fetus in 10 weeks and in 100% of the fetus after 13 weeks of gestation. (2)With regarding to the gestational age, both ventricular dimensions, the total heart diameter, heart area, and septal thickness showed a high significant linear correlation respectively. (3)The ratio of the two ventricles was independent with gestational age in this period, which was 1 .(4)The heart occupied 1/5-1/4 of the thorax, but not 1/3, from 10 to 17 weeks. Conclusions Both of the ventricles of fetal heart developed symmetrically from 10 to 17 weeks of gestation. The area ratio of heart/thorax is smaller in this stage than in later gestational weeks. From 13 to 17 weeks of gestation the four-chamber view can be obtained by qualified ultrasound examination and this can help to diagnose the fetal heart malformations.