产前超声对矫正型大动脉转位的诊断价值

The Value of Prenatal Diagnosis of Corrected Transposition of the Great Arteries by Echocardiography

目的探讨产前超声应用心脏三节段分析法对诊断矫正型大动脉转位(CTGA)的价值。方法采用心脏三节段分析法对胎儿进行筛查,检出或疑似CTGA胎儿6例,对其超声病例资料进行回顾性分析。结果 6例检出或疑似CTGA的胎儿中,经生后超声心动图或尸检证实有1例为单纯性CTGA,3例为CTGA合并室间隔缺损,1例为CTGA合并室间隔缺损、肺动脉狭窄,1例为CTGA合并室间隔缺损、主动脉弓缩窄,其中1例漏诊肌部室间隔缺损,1例漏诊主动脉弓缩窄。结论房室连接不一致和心室-大动脉连接不一致是诊断CTGA的关键,仔细观察四腔心切面和左、右室流出道切面是诊断CTGA的重要步骤。心脏三节段分析法是产前超声诊断胎儿CTGA的可靠方法,具有很好的临床应用价值。

Objective To investigate the value of prenatal ultrasound in the diagnosis of corrected transposition of the great arteries（ CTGA） by using the method of three segments of heart.Methods Cases of fetal were screened by the method of Three segment heart anatomy concept analysis and 6 cases were detected or suspected CTGA,whose ultrasonic data were analyzed retrospectively.Results Of the 6 cases which were detected or suspected CTGA,after birth echocardiography or autopsy,confirming one case of simple CTGA,3 cases of CTGA ventricular septal defect,1 case of CTGA ventricular septal defect,pulmonary stenosis,1 CTGA case with ventricular septal defect,aortic coarctation,including one case of misdiagnosis muscular ventricular septal defect,1 case of missed diagnosis of aortic arch.Conclusion The key to the diagnosis of CTGA is the inconsistency of the atrioventricular connection and the ventricular arterial connection.A careful observation of the four chamber view and left and right ventricular outflow tract is an important step in the diagnosis of CTGA.Three segment heart anatomy concept analysis is a reliable method of prenatal Ultrasonographic diagnosis of fetal CTGA,which has a good clinical application value.