多普勒超声在胎儿先天性心脏病诊断中的应用

Study of diagnosis for fetal congenital heart dieases by Doppler echocardiography

目的探讨应用多普勒超声诊断胎儿先天性心脏病的方法和声像学特点.方法对37例先天性心脏病胎儿和61例正常胎儿进行多普勒超声心动图检查.结果1.单纯性间隔缺损多无四腔心异常,大血管十字交叉关系正常;复杂性心血管畸形多具有不同程度的四腔和心胸比例异常.2.多普勒血流显示缺损分流及狭窄区域的高速血流束和三尖瓣返流.3.脐动脉PI值升高,外周动脉PI值降低和峰值流速下降(P<0.01).结论1.胎儿复杂性心血管畸形的识别应采用顺序分段法.2.继发孔型房间隔缺损需根据卵园孔的形态、直径及彩色血流束分流的方向、宽度等项指标来诊断.3.单纯性室间隔缺损中肌部较膜部缺损易于检出.

Objective To investigate the diagnosis metheds of fetal congenital heart diseases by Doppler echocardiography and their sonographic feartures. Methods 37 fetuses of congenital heart dieases and 61 normal fetuses were examined by Doppler echocardiographic Results (1)The four-chamber view and the crossed relation of aorta and pulmonary artery were normal in the most of fetuses of isolated septal defect. The four-chamber view and the cardiothoracic ratio were abnormal in different levels in the fetuses of complex cardiovascular malfrmation. (2)The high velocity blood flow through the septal defect and the stenosis and the tricuspid regurgitation can be showed by color Doppler. (3)The PI value of umbilical artery increased and both the PI and peak velocity decreased(P<0.01)in the peripheral artery. Conclusion (1)To distinguish the fetal complex cardiovascular malformation the fractional methed in order should be used. (2)The diagnosis of secondary artial septal defect must be done according to the shape, diameter, width of foramen ovale and the direction of color blood flow shunt. (3)The defect of muscular septum is easier to be detected than it of membranous septum in the isolated ventricular sptal defect.