超声心动图检查在胎儿完全性肺静脉异位引流畸形诊断中的应用
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摘要
目的探讨超声心动图检查在胎儿完全性肺静脉异位引流(TAPVC)诊断中的临床价值。方法回顾性分析11例TAPVC胎儿的超声心动图特征以及产后超声心动图检查或引产后尸检的结果。结果 11例TAPVC胎儿(心上型7例,心内型3例,心下型1例),3例属于单发畸形,8例并发其他心内外畸形。超声心动图正确诊断9例,准确度约为81.82%(9/11),漏诊2例。典型的声像图特征:四腔心切面左心稍小于右心,左房顶壁光滑,无肺静脉开口,4条肺静脉在左房后方汇入共同肺静脉干,并经引流血管汇入右房,相应引流血管扩张。结论超声心动图检查是产前诊断TAPVC的可靠方法,有利于孕妇作出优生优育选择,具有较高的临床应用价值。
Objective To explore the clinical value of echocardiography in the diagnosis of fetal total anomalous pulmonary venous connection(TAPVC).Methods A retrospective analysis was made on the ultrasonographical features of 11 cases with TAPVC and then follow-up of fetal results autopsy after induction or postnatal echocardiography.Results There were a total of 11 cases TAPVC fetus(including:seven cases of supracardiac type,three cases of the intracardiac type,one case of infracardiac type).3 cases are belong to a single malformation,the other 8 cases complicated by intracardiac or cardiac malformations.9 cases were correctly diagnosed by echocardiography,the accuracy rate of which is about 81.82%(9/11),two cases missed.The typical image features:four-chamber view showing left ventricular slightly smaller than the right heart,smooth the top of the left atrium,pulmonary veins without opening the rear of the four pulmonary veins in the left atrium import total pulmonary vein,total pulmonary venous drainage through the different blood vessels and finally into right atrium,corresponding drainage vessel diameter expansion.Conclusions Echocardiography is a reliable method for the diagnosis of fetal TAPVC deformity,which is conducive to prenatal and postnatal care for pregnant women to make choices,with a high clinical value.
Objective To explore the clinical value of echocardiography in the diagnosis of fetal total anomalous pulmonary venous connection(TAPVC).Methods A retrospective analysis was made on the ultrasonographical features of 11 cases with TAPVC and then follow-up of fetal results autopsy after induction or postnatal echocardiography.Results There were a total of 11 cases TAPVC fetus(including:seven cases of supracardiac type,three cases of the intracardiac type,one case of infracardiac type).3 cases are belong to a single malformation,the other 8 cases complicated by intracardiac or cardiac malformations.9 cases were correctly diagnosed by echocardiography,the accuracy rate of which is about 81.82%(9/11),two cases missed.The typical image features:four-chamber view showing left ventricular slightly smaller than the right heart,smooth the top of the left atrium,pulmonary veins without opening the rear of the four pulmonary veins in the left atrium import total pulmonary vein,total pulmonary venous drainage through the different blood vessels and finally into right atrium,corresponding drainage vessel diameter expansion.Conclusions Echocardiography is a reliable method for the diagnosis of fetal TAPVC deformity,which is conducive to prenatal and postnatal care for pregnant women to make choices,with a high clinical value.
引文
[1]邓学东.产前超声诊断与鉴别诊断.北京:人民军医出版社,2013:122-124.
[2]梁俏虹,郑冬明,龚炜,等.节段分析法联合九平面连续扫查法在胎儿心脏超声检查中的应用.中国当代医药,2011,18(21):54-56.
[3]徐红亮,范顺阳,王峰峰,等.影响完全性肺静脉异位引流术病死率的危险因素.中华实用儿科学杂志,2013,28(6):474-476.
[4]郭珊,林晓文,刘敏,等.完全性肺静脉异位引流诊断中超声心动图的应用.山东医药,2014,54(3):57-59.
[5]腾想,郭雪,朱倩如,等.超声心动图在胎儿肺静脉异位引流诊断中的应用.临床超声医学杂志,2013,15(4):284-285.
[6]程红,黄松带,陈清华,等.胎儿完全性肺静脉异位引流超声诊断及尸解对照.中国超声医学杂志,2010,26(2):186-187.
[7]周丽霞,卢冬敏,杨雪辉.增强型血流成像技术在胎儿肺静脉超声检查中的探讨.中国临床医学影像杂志,2013,24(1):62-63.
[8]潘琦,邓学东,张俊,等.胎儿超声心动图在产前诊断完全型肺静脉异位引流中的应用.中华医学超声杂志(电子版),2013,10(10):44-48.
[9]袁振茂,刘洪军.彩色多普勒超声检查排除胎儿完全性肺静脉异位引流的临床价值.中国现代医生,2011,49(31):95-96.
[2]梁俏虹,郑冬明,龚炜,等.节段分析法联合九平面连续扫查法在胎儿心脏超声检查中的应用.中国当代医药,2011,18(21):54-56.
[3]徐红亮,范顺阳,王峰峰,等.影响完全性肺静脉异位引流术病死率的危险因素.中华实用儿科学杂志,2013,28(6):474-476.
[4]郭珊,林晓文,刘敏,等.完全性肺静脉异位引流诊断中超声心动图的应用.山东医药,2014,54(3):57-59.
[5]腾想,郭雪,朱倩如,等.超声心动图在胎儿肺静脉异位引流诊断中的应用.临床超声医学杂志,2013,15(4):284-285.
[6]程红,黄松带,陈清华,等.胎儿完全性肺静脉异位引流超声诊断及尸解对照.中国超声医学杂志,2010,26(2):186-187.
[7]周丽霞,卢冬敏,杨雪辉.增强型血流成像技术在胎儿肺静脉超声检查中的探讨.中国临床医学影像杂志,2013,24(1):62-63.
[8]潘琦,邓学东,张俊,等.胎儿超声心动图在产前诊断完全型肺静脉异位引流中的应用.中华医学超声杂志(电子版),2013,10(10):44-48.
[9]袁振茂,刘洪军.彩色多普勒超声检查排除胎儿完全性肺静脉异位引流的临床价值.中国现代医生,2011,49(31):95-96.