超声对胎儿永存左上腔静脉的诊断价值

Clinical value and prognosis analysis of ultrasound diagnosis for fetal persistent left superior vena cava

目的分析胎儿永存左上腔静脉(PLSVC)的超声图像特征、合并畸形及预后情况,评价彩色多普勒超声(CDFI)对PLSVC的诊断价值。方法选取经笔者医院超声诊断的60例PLSVC胎儿作为研究对象,回顾性分析其产前和产后超声心动图特征或病理结果,并对其合并相关畸形情况做预后随访分析。结果超声诊断的60例PLSVC胎儿中,单纯PLSVC45例,合并心内畸形9例,合并心外畸形4例,同时合并心内、心外畸形2例。产前超声:四腔心切面左房室交界处见冠状静脉窦(CS)增宽,三血管气管切面见肺动脉左侧多一圆形无回声。产后复查超声:左室长轴切面见左房室交界处CS扩张,胸骨上窝切面主动脉弓左前方见一根自上而下向心静脉血管。结论产前CDFI是诊断胎儿PLSVC的重要方法,可作为胎儿预后评估及产前咨询依据。

Objective To evaluate the value of color Doppler flow imaging(CDFI) in the diagnosis of fetal persistent left superior vena cava(PLSVC) and analyze the ultrasonographic features,malformations and prognosis.Methods 60 cases of fetal PLSVC diagnosed by ultrasound in our hospital were selected as the research objects,The echocardiographic characteristics or pathological results before and after delivery were analyzed retrospectively,and the prognosis analysis of its associated malformations were made. Results Among these 60 cases with PLSVC,45 cases of PLSVC alone,9 cases with intracardiac malformation,4 cases with extracardiac malformation,and 2 cases with intracardiac and extracardiac malformation. Prenatal ultrasound:the coronary sinus(CS) is widened at the left atrioventricular junction on the four chamber section,and the left of pulmonary artery is an anechoic round area on the three vessel trachea section;postpartum ultrasound:CS is expanded at the left atrioventricular junction on the long axis section of the left ventricle,and a top-down cardiovascular vein is seen at the left anterior side of the aortic arch on the upper sternal fossa section. Conclusion Prenatal CDFI is an important method for the diagnosis of fetal PLSVC,and can be used as a basis for fetal prognosis and prenatal consultation.