超声心动图检查在胎儿房室间隔缺损诊断中的应用价值

Fetal echocardiography in the diagnosis of complete atrioventricular septal defect deformity

目的 探讨超声心动图检查在胎儿完全性房室间隔缺损畸形（CAVSD）诊断中的临床应用价值.方法 2011年1月～2013年12月,应用GE-E8型彩色超声诊断仪对所有受检胎儿行四腔心切面及四腔心平面头侧偏转法获得左、右室流出道、主动脉长轴切面、心底短轴切面及三血管切面,再沿降主动脉上行检测主动脉弓切面及动脉导管弓切面.对产前诊断的CAVSD声像图特征及引产后尸检结果进行对比分析.结果 共检出11例CAVSD胎儿,均经引产后尸检证实,产前超声诊断CAVSD的准确率为100％.典型的超声声像图表现为：心脏增大,十字交叉结构消失,房间隔下部与室间隔上部缺损,仅见一组共同房室瓣;CDFI：四个心腔间血流相互沟通.常伴发右室双出口、房室传导阻滞、肺动脉闭锁及法乐四联症等心内畸形.结论 超声心动图检查对诊断胎儿CAVSD具有重要的诊断价值,该病特有的声像图特征有助于本病的诊断与鉴别.

Objective To explore the diagnostic and differential value of fetal echocardiography in complete atrioventricular septal defect （CAVSD）. Methods The fetuses were checked with GE-E8-type color Doppler ultrasound. Left, right ventricular outflow tract, aortic long axis view, the basal short axis view and the three vessel view, aortic arch section and arterial arch section were got with the four chamber head lateral deflection method. Prenatal sonographic features of CAVSD diagnosis and autopsy results were analyzed after induction. Results Fetuses were detected in 11 cases with CAVSD, which were confirmed by autopsy confirmed after induction. The accuracy of prenatal ultrasound diagnosis for CAVSD was 100%. The typical sonographic manifestations included cardiac enlargement, cross structure disappeared, atrial septal defect the lower and upper septal see only one set of common atrioventricular valve, CDFI： mutual communication between the four chambers of the heart blood flow. Conclusion Echocardiography has an important value oin the diagnosis of fetal CAVSD.