永存左上腔静脉的产前超声诊断评价

Prenatal Ultrasound Diagnosis of Permanent Left Superior Vena Cava

目的探讨超声检查应用于胎儿永存左上腔静脉(PLSVC)诊断中的价值。方法回顾性分析2016年1月～2017年12月曾于仁寿县妇幼保健院行产前超声筛查的24例PLSVC形成胎儿的超声图像特征,并随访临床结果。结果共计24例PLSVC(Ⅰ型21例、Ⅱ型3例),产前超声检出22例,误诊2例,均经引产后病解或分娩后超声检查予以证实。典型的声像图表现:三血管切面上,肺动脉左侧可见"第四血管"征,追踪发现该血管经扩张的CS汇入右心房。10例属于孤立性PLSVC,另14例合并其它结构异常(7例合并心内结构异常、3例合并心外结构异常、4例同时合并心内外结构异常)。结论超声检查能准确诊断胎儿PLSVC,三血管切面是最主要的筛查切面,早期诊断PLSVC有利于孕妇作出优生优育选择。

Objective To investigate the value of ultrasonography in the diagnosis of fetal permanent left superior vena cava (PLSVC). Methods A retrospective analysis of 24 cases of PLSVC prenatal ultrasound screening in Renshou County Maternal and Child Health Hospital from January 2016 to December 2017 was performed to analyze the ultrasound characteristics of the fetus, and the clinical results were followed up. Results A total of 24 cases of PLSVC (21 cases of type I and 3 cases of type II), 22 cases of prenatal ultrasound were detected, and 2 cases were misdiagnosed. All cases were confirmed by post-induction or post-partum ultrasound examination. Typical sonogram: On the three-vessel cut surface, the "fourth blood vessel" sign is visible on the left side of the pulmonary artery, and it is traced that the expanded CT of the blood vessel merges into the right atrium. Ten patients were isolated PLSVC, and the other 14 patients had other structural abnormalities (7 patients with intracardiac structural abnormalities, 3 patients with extracardiac structural abnormalities, and 4 patients with intracardiac and extracardiac structural abnormalities). Conclusion Ultrasonography can accurately diagnose fetal PLSVC. The three-vessel section is the most important screening section. Early diagnosis of PLSVC is beneficial to the choice of prenatal and postnatal care for pregnant women.