超声心动图诊断胎儿心肌病

Echocardiography in diagnosis of fetal cardiomyopathy

目的探讨胎儿超声心动图诊断胎儿心肌病(FCM)及其并发症的价值。方法对11 360胎胎儿进行超声心动图检查;对其中诊断为胎儿心肌病或可疑心肌原发病变者进行分析,并与大体病理结果及出生后超声心动图表现进行对照分析。结果 11 360胎中检出FCM 19胎,检出率为0.167%(19/11 360)。其中扩张型心肌病10胎(累及双心室4胎、右心室4胎、左心室1胎、右心房1胎)、肥厚型心肌病2胎(累及双心室1胎,室间隔1胎)、心内膜弹力纤维增生症4胎(原发型1胎、继发型3胎)、心肌致密化不全3胎(累及双心室2胎、右心室1胎),FCM累及心室中以双心室为著。结论胎儿超声心动图可对FCM做出诊断及分型,且可评估胎儿心脏功能及血流动力学的变化,并判断FCM的预后。

Objective To explore the value of fetal echocardiography in diagnosis of fetal cardiomyopathy（FCM）and its complications.Methods Fetal echocardiography was carried on 11 360 fetuses.The results of fetus diagnosed with cardiomyopathy or suspected with primary myocadial lesions were analyzed,and compared with the results of autopsy and outcomes after birth.Results There were 19 fetuses were diagnosed with FCM,the detection rate of FCM was 0.167%（19/11 360）.There were 10 fetuses with dilated cardiomyopathy（biventricular 4fetuses,right ventricle 4fetuses,left ventricle1 fetus and right atrium 1fetus）,2fetuses with hypertrophic cardiomyopathy（biventricular1fetus,septal 1fetus）,4fetuses with endocardial fibroelastosis（primary type 1fetus,secondary type 3fetuses）,3fetuses with non-compaction of the ventricular myocardium（biventricular 2fetuses,right ventricular 1fetus）.The biventricular was the easiest to be implicated in fetus with FCM.Conclusion Fetal echocardiography can make the diagnosis of FCM and definite its classification accurately,and can also assess the changes of fetal cardiac function and hemodynamics,estimate the prognosis.