冠状动脉瘘的产前超声心动图诊断价值

The prenatal diagnostic value of coronary artery fistula by Doppler echocardiography

目的探讨产前诊断冠状动脉瘘(coronary artery fistula,CAF)的超声心动图特征及相关合并畸形情况,产前超声检查诊断CAF的价值。方法选取16例经尸体解剖结果及产后超声心动图诊断为CAF的产前超声心动图资料。结果16例胎儿产前彩色多普勒超声均发现心腔内异常血流束,4例出现瘘入心腔增大,10例冠状动脉增宽。产前超声心动图诊断正确13例,占81.3%;漏误诊3例,占18.7%;其中2例漏诊,1例误诊为肌部室间隔缺损。结论产前超声心动图可以通过心腔内异常血流束诊断CAF,需要注意是否存在其他合并心内畸形,对预后进行评估,为出生后诊断及治疗提供帮助。

Objective To investigate the value of prenatal diagnosis of coronary artery fistula(CAF) by Doppler echocardiography. Methods We conducted a retrospective echocardiography review of 16 fetuses with CAF confirmed by postnatal echocardiography and autopsy. Results The abnormal intracardiac blood flow was found in all 16 fetuses. In the 16 fetuses, the cardiac cavity was dilation in 4 cases and the coronary artery was widened in 10 cases. 13 cases(81.3%) were diagnosed correctly by prenatal echocardiography;3 cases(18.7%) were missed or misdiagnosed. Conclusion Prenatal diagnosis of coronary artery fistula through the abnormal blood flow is of great significance in postnatal diagnosis and treatment. Meanwhile, we need to pay attention to whether there are other cardiac malformations and evaluate the prognosis.