大动脉交叉切面图在胎儿复杂先天性心脏病诊断中的应用价值

The clinical value of crossed-relation view between aorta and pulmonary artery in fetus with congenital heart disease

目的探讨超声心动图的大动脉交叉切面图在胎儿复杂先天性心脏病诊断中的重要性。方法对已检出的103例复杂先天性心脏病胎儿和110例正常胎儿心脏的大动脉交叉切面图进行对比分析,显示大血管排列、内径、数量、大动脉瓣病变、瓣上及瓣下情况,并行彩色多普勒和频谱多普勒检测,同时显示三血管平面图。结果先天性心脏病组103例大动脉交叉切面图显示率为98.1%,检出大血管及瓣膜异常率86.4%,其中大动脉交叉关系消失23例,大动脉交叉关系正常内径异常36例,主动脉瓣及肺动脉瓣狭窄14例;三血管平面图显示血管内径、数量及排列异常69例(66.9%)。正常组大血管交叉切面显示率100.0%,三血管平面显示率98.7%。结论连续动态显示大动脉交叉切面图在胎儿复杂先天性心脏病诊断中极为关键,可明确胎儿大动脉有无畸形和清晰显示左右心室流出道,特别对大动脉狭窄部位的诊断优于三血管平面图。

Objective To explore the importance of the crossed-relation of aorta and pulmonary artery view by fetal echocardiography in fetus with congenital heart disease. Methods To evaluate and analyze the crossed-relation of aorta and pulmonary artery view in the 103 fetus with complicated congenital heart disease （CHD） and the 110 fetus with healthy heart. The size, arrangement, number of vessels, location of the great artery on these views were shown to compare the three-vessel views of fetal heart simultaneously. Results The crossed-relation of aorta and pulmonary artery view were 98.1% in the fetus with the congenital heart disease group. The percentage of abnormal great vessels and valvula was 86.4%. Twenty-three had abnormal crossed-relation;36 had abnormal crossed-relation and abnormal inside diameter; 14 had stenosis in the valve of aorta or pulmonary artery. Sixty-nine fetus （66.9%） from the congenital heart disease group had abnormal inside diameter, quantity and arrangement by the three-vessel view of echo- cardiography. The percentage of crossed-relation of aorta and pulmonary artery view were 100.0% in fetus with normal heart and the three-vessel view were 98.7%. Conclusions Crossed-relation of aorta and pulmonary artery view is the key to detect fetal congenital heart disease, which is helpful for the diagnosis of abnormal fetal main artery. Right ventricular and left ventricular outflow tract also could be displayed clearly, especially in diagnosing stenosis of main artery.