四腔心平面头侧偏斜法快速筛查胎儿先天性心脏畸形

Prenatal ultrasonographic screening for fetal congenital heart disaese using four chamber view with probe tilting craniad slightly technique

目的探讨四腔心平面头侧偏斜法在诊断胎儿心脏畸形中的价值.方法应用彩色多普勒超声仪对在我院产前检查的妊娠 18～40 周连续病例 15 608 例,进行胎儿心脏四腔心平面头侧偏斜法检测,即横切胎儿胸腔获取四腔心切面,观察心房与心室及其连接关系、房室间隔、左右房室瓣以及肺静脉与左房的连接关系,然后将探头声束平面略向胎儿头侧偏斜,依次显示左心室与主动脉的连接关系及右心室与肺动脉的连接关系,且实时动态扫查时观察主、肺动脉起始部的交叉及主、肺动脉相对大小,从而对心脏的主要结构及连接关系作出快速评价.结果 15 608 例胎儿中,经产后或引产证实的各种心脏畸形126例, 四腔心平面头侧偏斜法检出各种心脏畸形117例,漏诊9例.结论四腔心平面头侧偏斜法是显示胎儿心脏结构及产前筛查胎儿心脏畸形的重要影像诊断方法.

Objective To evaluate the value of the ultrasonographic method of fetal congenital heart disease using four chamber view with probe tilting craniad slightly technique （FCPTC） in screening fetal congenital heart malformations antenatally. Methods Fifty-five thousands six hundreds and eight successive cases,gestational age 18-40 weeks,were screened for fetal congenital heart disease by using FCPTC technique. This technique can be demonstrated as following： firstly getting four-chamber view by using probe across fetal thoracic cavity,atrium, ventricle,the atrioventricular septum, atrioventricular valves and connection between left atrium and pulmonary veins can be displayed. Then tilting ultrasonic plane slightly towards the fetal head, size of aorta, pulmonary artery, the connection between left ventricle and aorta,connection right ventricle and pulmonary artery were all shown. The appearance of the crossing part between the beginning of aorta and that of pulmonary artery were shown clearly simultaneously dynamic titling the probe to and fro. So a quickly evaluation could be drawn on the major formation of the heart and their connection. Results In 15 608 fetal eases,126 cases with heart disaese were confirmed by post-natal evaluation or abortion,in which 117 cases with various kinds of heart disaese were found out by FCPTC. Nine cases were missed diagnosis. Conclusions FCPTC was an important method to screen fetal congenital cardiac disaese.