产前超声诊断胎儿法洛四联症的价值及体会

Value and insight of echocardiography in prenatal diagnosis of fetal Tetralogy of Fallot

目的探讨胎儿超声心动图对单纯及复杂法洛四联症(TOF)的产前诊断价值。方法回顾性分析23例经超声心动图诊断为胎儿TOF的声像图表现及随访资料。结果单纯TOF 19例,表现为室间隔缺损、肺动脉狭窄和主动脉骑跨。复杂TOF 4例,包括:①TOF合并肺动脉闭锁2例:表现为右室流出道为盲端,肺动脉细窄、不易显示,肺动脉及动脉导管内逆向血流;②TOF合并肺动脉瓣缺如2例:表现为肺动脉主干、分支瘤样扩张,肺动脉瓣反流等。结论超声心动图产前诊断胎儿TOF及其分型具有较大的临床价值,并可动态观察其右室流出道梗阻、肺动脉及其瓣膜的发育及进展情况。

Objective To explore the value of fetal echocardiography in prenatal diagnosis of simple and complex Tetralogy of Fallot （TOF）. Methods The two-dementional echocardiography features, color Doppler manifestation and follow-up data of 23 cases of TOF diagnosed by echocardiography were retrospectively reviewed. Results Ninteen cases of fetal TOF were simple TOF without other malformations, characterized by ventricular septal defect, ptdmonary stenosis and overriding aortic. 4 cases were complex TOF, including： 0）2 cases with pulmonary atresia, characterized by a thin and tiny pulmonary which was difficult to show,reverse flow in pulmonary and ductus arteriosus; ~）2 cases with absence of pulmonary valve, characterized by dilated pulmonary artery and pulmonary regurgitation. Conclusion Echocardiography has great value in prenatal diagnosis and classification of TOF. The progress and development of right ventrieular outflow tract obstruction, pulmonary stenosis and its valve can be followed up regularly by echocardiography.