超声心动图评价动脉导管对胎儿先天性心脏病的诊断价值

Value of ductus arteriosus in the diagnosis of fetal congenital heart disease by echocardiography

目的探讨超声心动图评价动脉导管在胎儿先天性心脏病中的诊断价值。方法以三节段诊断法进行胎儿超声心动图检查，依胎位不同在不同切面检查动脉导管，切面包括动脉导管与右肺动脉形成的“V”形征切面，动脉导管与主动脉弓峡部形成的“V”形征切面，动脉导管与左、右肺动脉形成的“三指征”切面，左肺动脉、动脉导管、主动脉弓峡部形成的“Z”形征切面，测量动脉导管的内径及流速。结果检出先天性心脏病胎儿31例，13例经尸体解剖得到证实，其中动脉导管狭窄者4例，均为右心梗阻性疾病；动脉导管增宽3例，均为左心梗阻性疾病；动脉导管内测及反向血流者2例；动脉导管流速增高者5例，其中包括4例右心梗阻性疾病、1例左心梗阻性疾病，5例胎儿动脉导管未见异常；1例胎儿动脉导管缺如。结论超声心动图评价动脉导管是筛查胎儿先天性心脏病的重要内容，有助于快速确定诊断。

Objective To explore the value of ductus arteriosus in ultrasound diagnosis of fetal congenital heart disease by echocardiography. Methods The fetal eehocardiography was performed with three segments diagnosis method. According to the fetal position, the ductus arteriosus was examined in different sections which include the ＂V＂ shape sign section formed by ductus arteriosus and right pulmonary artery,the ＂V＂ shape sign section formed by ductus arteriosus and the gorge of aortic arch,the three fingers sign section formed by ductus arteriosus,left and right pulmonary artery, the ＂Z＂ shape sign section formed by left pulmonary artery, ductus arteriosus and the gorge of aortic arch. The flow velocity and the inner diameter of the ductus arteriosus were measured. Results Thirty-one cases with congenital heart disease were evaluted. Thirteen cases were approved by autopsy. Among those fetus, 4 cases went with ductus arteriosus stenosis and they all accompanied with right heart obstructing disease,3 cases went with dilated ductus arteriosus and they all accompanied with left heart obstructing disease. Retrograde were explored in 2 fetus. The flow velocity of 5 fetus ductus arteriosus were higher than the normal fetus and 4 cases of them with right heart obstruction, 1 cases with left heart obstruction. Five fetal ductus arteriosus were normal. One fetal ductus arteriosus was absent. Conclusions Assessant of ductus arteriosus by echocardiography is an important content in screening fetal congenital heart disease. It can help us to diagnose quickly.