完全型肺静脉异位引流胎儿超声肺静脉频谱特征

Pulmonary vein spectral characteristics of fetal total anomalous pulmonary venous connection

目的探讨胎儿完全型肺静脉异位引流(TAPVC)的肺静脉频谱特征表现。方法回顾性分析2017年2月至2021年6月经山东省潍坊市妇幼保健院产前超声心动图诊断的TAPVC胎儿的肺静脉频谱表现,总结不同类型TAPVC肺静脉的频谱特征。结果共诊断19例TAPVC(11例单纯型,8例复合型)胎儿,其中心上型11例,心内型和心下型各4例,合并垂直静脉梗阻8例。心上型及心下型TAPVC(不区分单纯型及复合型)肺静脉频谱表现为:无论是否合并垂直静脉梗阻,频谱均呈匀速、无周期搏动性的低速血流,心内型(冠状静脉窦明显扩张)肺静脉频谱表现与正常肺静脉频谱一致。结论胎儿肺静脉频谱改变在TAPVC分型中有一定的价值,但无法区分心上型及心下型,在进行TAPVC诊断时应常规进行肺静脉频谱的扫查,以进一步增加诊断信心。

Objective To explore the pulmonary vein spectral characteristics of fetal total anomalous pulmonary venous connection(TAPVC).Methods Fetal pulmonary vein spectral characteristics were analyzed retrospectively in cases with the prenatal diagnosis of TAPVC in the Ultrasound Department,Weifang Maternal and Child Health Hospital from February 2017 to June 2021.The fetal pulmonary vein spectral characteristics of TAPVC were summarized.Results We enrolled 19 patients diagnosed with TAPVC(11 isolated types and 8 complex types)in the antenatal period,including 11 supra-cardiac cases,4 cardiac cases,4 infra-cardiac cases,and 8 cases combined with vertical vein obstruction.Whether the vertical vein obstruction was involved or not,the pulmonary vein spectrum of supra-cardiac and infra-cardiac types(including both isolated and complex types)was featured by a continuous low-velocity pattern with aperiodic pulsation.The pulmonary vein spectrum of the intra-cardiac type(coronary sinus dilation)was consistent with that of normal pulmonary veins.Conclusion Fetal pulmonary vein spectral changes have some value in TAPVC classification,but cannot be used to distinguish between supra-cardiac and infra-cardiac types.The pulmonary vein spectrum should be routinely scanned for TAPVC fetal diagnosis to further increase diagnostic confidence.