胎儿动脉导管早闭的超声心动图诊断及鉴别诊断

Diagnosis and differential diagnosis of antenatal closure of the Ductus Arteriosus by ultrasonography

目的探讨产前超声心动图诊断胎儿动脉导管早闭的价值及其鉴别诊断。方法对孕32-38周的12例动脉导管早闭的胎儿超声影像学资料进行回顾性分析,并对出生后胎儿进行超声随访,总结其异常声像图特点并与其他可引起胎儿右心增大的疾病鉴别。结果产前超声心动图明确诊断10例,其中8例动脉导管狭窄,收缩期血流速度〉170.0 cm/s,2例动脉导管近乎闭合,导管内未见血流信号;漏诊2例。12例胎儿均出现不同程度肺动脉高压的超声表现。结论完整的超声心动图分析法可准确诊断胎儿动脉导管早闭,需与胎儿三尖瓣下移畸形、肺动脉狭窄或闭锁、右室心肌病、卵圆孔早闭等右心增大的疾病鉴别。

【Objective】To analyze the value of prenatal diagnosis and differentiating diagnosis ultrasonographic of fetal closure of the Ductus Arteriosus（DA）.【Methods】Twelve patients with antenatal closure of the DA of fetal ultrasonography prenatal and postnatal were retrospectively analyzed. Sum up the key markers of the disease and differential diagnosis with other diseases which can cause fetal enlargement of the right heart.【Results】Tencases with antenatal closure of the DA were diagnosed by prenatal ultrasonography. Among eight cases of DA were contracted.Peak velocity is greater than 170 cm/s in systolic. The remaining two cases were completed closure nearly. CDFI did not show any flow signal in DA. Two cases were misdiagnosed. All the patients show various degrees of pulmonary hypertension. 【Conclusions】The complete ultrasonography analysis can accurately diagnose of antenatal closure of the DA. The differential diagnosis includes congenital Ebstein＇s Anomaly, pulmonary atresia or stenosis, right ventricular cardiomyopathy, foramen ovale closure.