胎儿动脉导管的超声观测及其意义

Ultrasonic survey of fetal ductus arteriosus

目的:了解胎儿发育过程中动脉导管(DA)的发育变化规律,为进一步探索其异常改变时是否与某些类型先天性心脏病存在相关性积累资料。方法:使用高分辨率彩超仪对1100例20～40孕周胎儿DA的形态结构进行观察并测量其内径,统计不同孕周DA内径正常值范围。结果:1100例观察结果DA显示956例,显示率为86.91%。根据DA开口部位可分为独立型占68.59%(190/277)和共干型占31.41%(87/277);根据DA是否发出左肺动脉分支又可分为有分支型占15.16%(42/277)和无分支型84.84%(235/277)。随孕周增大DA内径逐渐增大,并且其数值离散度也相应增大。结论:高分辨率彩超对中晚孕胎儿DA大多数可以显示其形态结构及内径大小,可作为评估DA发育状况的有效检测手段。

Objective： To explore the development of fetal ductus arteriosus （DA）under ultrasonoscope, and provide data for ultrasonic diagnosis of congenital heart diseases. Methods： 1100 cases of foetus with gestational age of 20-40 weeks were selected in this study. Under the high resolution color ultrasound equipment, the morphologic features and the internal diameter of DA were observed and measured, and the range of normal values of the internal diameter of DA at different gestational ages was analyzed. Results：For 956 cases, DA can be demonstrated, with the display rate of 86.91%. According to the outlet location, DA could be divided into the type of independent origin with the rate of 68.59% （190/277） and of the origin of common stem with left pulmonary artery （LPA） with the rate of 31.41%（87/277）; According to its branch to LPA, into the ramification type with the rate of 15.16%（42/277） and no-ramification type with the rate of 84.84% （235/277）. The internal diameter of DA increased gradually with the growth of foetus, as well the dispersity of the diameter values. Conclusions：For most of foetus during the middle and later gestational ages, high resolution color ultrasonoscope is reliable to demonstrate the structures and the internal diameter of DA, which is helpful for evaluating the developmental state of fetal DA.