正常胎儿心脏的二维超声检查

Study on bi-dimension Ultrasound of normal fetal cardiac anatomy

目的:建立不同孕周正常胎儿心脏左心房、右心房、左心室、右心室、卵圆孔、主动脉、主肺动脉、动脉导管、上腔静脉、下腔静脉内径的正常参考值范围.方法:应用二维实时超声显像检查358例孕龄在18～30周的胎儿,分别获得胎儿心脏的四腔心断面在舒张末期即心室充盈到最大程度,二、三尖瓣刚关闭成一直线,卵圆孔活瓣即将开放的时相冻结图像测量左心房、右心房、左心室、右心室的最大横径,在卵圆孔活瓣开放到最大程度的时相冻结图像测量卵圆孔孔径;左室流出道断面(左室长轴断面)在主动脉瓣开放到最大程度的时相冻结图像在主动脉瓣瓣尖处测量主动脉起始段内径;右室流出道断面(大血管短轴断面)在肺动脉瓣开放到最大程度的时相冻结图像在肺动脉瓣瓣尖处测量主肺动脉起始段内径;肺动脉/动脉导管长轴断面在肺动脉瓣开放到最大程度的时相冻结图像测量动脉导管内径;上、下腔静脉长轴断面测量上腔静脉、下腔静脉入口处内径.采用SPSS 12.0软件包处理所有获得的数据.结果:经统计学分析可获得不同孕周正常胎儿心脏各结构内径的正常参考值范围((-x)±s).结论:该研究建立的正常胎儿心脏各结构内径正常参考值范围为超声工作者提供了判断不同孕周胎儿心脏各结构大小是否正常的参考标准.

Objective： To define the values of the transverse diameters of the left atrium （LA） , right atrium （ RA ）, left ventricle （ LV ） , right ventricle （ RV）, foramen ovale （ FO）, aorta （ AO）, main pulmonary artery （ MPA）, ductus arteriosus （DA） , superior vena cava （SVC） and inferior vena cava （IVC） of normal fetus in different pregnant period. Methods： The study was a prospective crosssectional evaluation of 358 male and female fetuses between 18 and 30 weeks of normal singleton pregnancies. Transverse diameter of the LA, RA, LV, RV, FO, AO, PA, DA, SVC and IVC were conducted by using conventional transabdominal bi -dimensional ultrasound, through the four chamber view, left ventricle outflow view, right ventricle outflow view, ductus arteriosus view or superior vena cava and inferior vena cava view respectively. The data collected were analyzed using SPSSI2. 0 software. Results： The measurements of the transverse diameters of the cardiac chambers and main vessels were obtained in 358 normal fetuses. The normal mean was defined. Conclusion： Our data present the normal range of the fetal cardiac chambers and main vessels diameters during gestation. They may allow intrauterine assessment of their development and a useful reference index in the detection and evaluation of congenital heart disease.