产前超声检查对胎儿心脏大动脉畸形的诊断价值

Application value of prenatal ultrasonography in diagnosis of fetal heart great artery malformations

目的探讨胎儿心脏大动脉畸形产前超声诊断的操作技巧,提高产前超声诊断符合率。方法回顾分析我院诊断并经产后证实的20例心脏大动脉畸形胎儿的超声图像,总结不同类型大动脉畸形的声像图特征。结果 20例心脏大动脉畸形胎儿均经产后新生儿超声心动图检查或引产后尸体解剖证实,大动脉畸形在三血管气管(3VT)切面上均呈阳性特征,分别表现为大动脉内径异常10例,包括肺动脉狭窄7例,主动脉狭窄1例,主动脉弓离断1例及主动脉弓缩窄1例;永存动脉干4例;大动脉交叉关系消失5例,包括右室双出口3例,大动脉转位2例;右位主动脉弓1例。17例胎儿合并心内其他结构异常。结论 3VT切面是诊断胎儿心脏大动脉异常敏感且有效的切面,其他切面可作为诊断和鉴别诊断的辅助切面。

Objective To explore the operating skills of prenatal ultrasonography in diagnosis of fetal heart great artery malformations, and improve the diagnosis accuracy. Methods Prenatal sonograms of 20 fetuses diagnosed as fetal heart great artery malformations and confirmed by postpartum echocardiography were analyzed retrospectively. Different types of prenatal ultrasonic features were summarized. Results Twenty cases with fetal heart great artery malformations were detected by postpartum ultrasonography or confirmed by autopsy after labor. All the great artery anomalies definitely showed positive in three vessel trachea （3VT） view, including 7 cases of pulmonary artery stenosis, 1 case of aortic stenosis, 1 case of interrupted aortic arch, 1 case of coaretation of the aorta, 4 cases of persistent truncus arteriosus, 5 cases of disappeared cross-relationship of great arteries and 1 case of right aortic arch. 17 cases combined with other cardiac anomalies. Conclusion 3VT view is sensitive and effective for diagnosing fetal heart great artery malformations.Other views are supplementary in its diagnosis and differential diagnosis.