超声心动图在早期妊娠胎儿心脏检查中的应用

Application of echocardiography for fetal heart examination in early pregnancy

目的：探讨超声心动图在检查妊娠11-14＋6周内正常胎儿心脏结构和血流情况的应用价值。方法对150例孕妇在妊娠11-14＋6周时进行常规经腹超声检查,观察胎儿心脏各切面结构和血流并进行测量,同时在各切面对3种超声方法[二维超声、彩色血流显像及增强型血流成像技术（ e-flow）]的显像满意率进行对比分析。结果二维超声检查中胎儿心脏各切面显示率不同,其中四腔心切面显示率最高。妊娠13周以后胎儿心脏结构超声可清晰显示。妊娠11-12周e-flow血流显像较二维超声和彩色血流显像各切面的显示满意率高。结论由于在妊娠13周以后胎儿心脏结构能够清晰显示,e-flow血流显像超声方法有助于优化超声显像,因此,可以将胎儿心脏筛查时间提前至妊娠早期,有利于胎儿严重先天性心脏畸形的早期诊断。

Objective To discuss the application value of echocardiography in examination of normal cardiac structure and blood flow situations for fetal during the 11th＋0 -14th＋6 week of gestation. Methods 150 pregnant women during the 11th＋0 - 14th＋6 week of gestation were examined by abdominal ultrasound, the fetal cardiac structure in each section were observed and the blood flow were measured. Meanwhile, imaging satisfaction rate in each section of three kinds of ultrasonic method（ two dimensional ultrasound,color doppler flow imaging and e-flow imaging） were compared. Results The detection rate of two-dimensional ultrasound differed in each section of fetal heart,while the four-chamber view showing the highest detection rate. After 13 weeks of pregnancy,ultrasound could clearly show the fetal cardiac structure. The e - flow imaging showed higher imaging satisfaction in each section compared with two-dimensional ultrasound and color doppler flow imaging during the 11th-12th week of gestation. Conclusion As the fetal cardiac structure could be clearly displayed after 13 weeks of gestation ,e-flow helps to optimize the ultrasonic imaging. Therefore, fetal heart screening could be advanced to early trimester of pregnacy, which is helpful for early diagnosis of severe congenital heart malformation fetus.