超声对胎儿心室强回声斑的检测及出生后追踪分析

Detection of Fetal Echogenic Intracardiac Focus and Tracking Analysis after Birth

目的探讨胎儿心室强回声斑（echogenic intracardiac focus,EIF）的超声心动图检测的临床意义。方法应用胎儿超声心动图对5800例胎龄18~40周胎儿进行心脏筛查。观察EIF的发生率及相关超声心动图表现;综合胎儿系统筛查伴发其它系统畸形,并对单纯性EIF胎儿进行出生后追踪分析。结果共检出EIF胎儿130例（2.24%）,其中左心室内1个强回声斑97例（74.62%）,2个强回声斑10例（7.69%）,多发强回声斑6例（4.61%）;右心室1个强回声斑5例（3.85%）,多发强回声斑3例（2.31%）,双心室强回声斑9例（6.92%）。EIF合并其它部位畸形11例（8.46%）。对18例出生后单纯性EIF进行追踪随访,发现光斑消失10例,光斑继续存在8例;其中6例为腱索强回声,2例为乳头肌强回声斑。结论通过超声心动图探查发现的胎儿EIF位置、数量与胎儿心脏结构畸形相关性不大,合理评估胎儿EIF需结合产科系统筛查。单纯性EIF无其它系统畸形,预后良好,不提倡不合理的终止妊娠。

Objective To investigate the clinic significance of prenatal ultrasonic cardiogram in fetal echogenic int- racardiac focus（EIF）. Methods A total of 5800 fetuses with a gestational age of 18 to 40 weeks were screened for heart disease by ultrasonic cardiogram. The EIF incidence rate and relative ultrasonic cardiogram characteristics were observed, together with comprehensive screening to find the other system abnormalities, and the tracking analysis were taken in pure EIF fetuses after their birthing. Results A total of 130 （2. 24%） fetuses were found to have an EIF by ultrasonic cardio- gram. There were 97 （74. 62%）, 10 （7. 69%）,6 （4. 62%）fetuses found having 1,2, sevral EIF in left-heart respectively, 5 （3. 85 %）, 3 （2. 31%）fetuses in right-heart with 1, sevral EIF. A total of 9 （6. 92 %）fetuses had EIF both in left and right ventricular. ElF combination of other system abnormalities in 11 （8. 46 %）fetuses. Follow-up tracking analysis were taken in 18 pure EIF fetuses and found 10 light spots of ElF were disappeared and 8 continued to exist, those were 6 chordae tendineae echo and 2 papillary muscle echo. Conclusion There are poor redationship between the location, quanity in fetu- ses EIF and cardiac structure abnormality reasonable evaluation of EIF must combine with systemic obstetrics screening. Pure EIF fetuses have a good prognosis and unreasonable termination of pregnance is not advocated.