产前超声横断面连续扫查三血管气管上多切面诊断胎儿心血管异常
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摘要
目的探讨产前超声横断面连续扫查三血管气管上多切面诊断胎儿心血管异常的价值。方法采用横断面连续扫查三血管气管上多切面方法,观察502胎正常胎儿和521胎异常胎儿的三血管气管上多切面声像图特点。结果由三血管气管切面开始向胎儿头侧移动探头,依次获得三血管气管切面;头臂静脉切面可显示头臂静脉、主动脉横弓;头臂动脉起始段切面可显示头臂动脉、左颈总动脉、左锁骨下动脉起始段横断面;双侧锁骨下动静脉切面可显示双侧锁骨下动脉及双侧锁骨下静脉长轴、双侧颈总动脉起始段横断面。502胎正常胎儿三血管气管上多切面均可通过连续扫查获得显示。521胎异常胎儿中,三血管气管上多切面扫查检出头臂静脉异常236胎,头臂动脉异常277胎,心上型肺静脉异位引流7胎,颈位主动脉弓1胎。结论三血管气管上多切面连续扫查有助于产前超声诊断胎儿心血管异常。
Objective To explore the value of transverse continuous scanning on multiple sections above three vessels and trachea view in prenatal ultrasonic detection of fetal cardiovascular anomalies. Methods Using transverse continuous scanning on multiple sections above three vessels and trachea view, 502 normal fetus and 521 abnormal fetuses were observed, and ultrasonographic features of multiple sections above three vessels and trachea view were recorded. Results Four sections could be obtained by moving probe from the three-vessel tracheal section to the cephalic side of fetus. Section of three-vessel tracheal was firstly observed, then section of brachiocephalic vein which could show brachiocephalic vein and transverse aortic arch was screened, section of initial segment of brachiocephalic artery which could show the cross section planes of brachiocephalic artery, left common carotid artery and left subclavian artery was observed, and finally section of bilateral subclavian artery and subclavian vein which could show long axis planes of bilateral subclavian artery, bilateral subclavian vein and cross section of bilateral common carotid artery was screened. Multiple sections above three vessels and trachea view could be displayed by continuous scanning in all 502 normal fetuses. Among 521 ultrasonographic abnormal fetuses, 236 fetuses were found with abnormal brachiocephalic vein, 277 with abnormal brachiocephalic artery, 7 with abnormal pulmonary vein drainage at the heart and 1 with aortic arch at the neck. Conclusion Transverse continuous scanning sections above three vessels and tracheal view are helpful for prenatal ultrasonic diagnosis of fetal cardiovascular anomalies.
Objective To explore the value of transverse continuous scanning on multiple sections above three vessels and trachea view in prenatal ultrasonic detection of fetal cardiovascular anomalies. Methods Using transverse continuous scanning on multiple sections above three vessels and trachea view, 502 normal fetus and 521 abnormal fetuses were observed, and ultrasonographic features of multiple sections above three vessels and trachea view were recorded. Results Four sections could be obtained by moving probe from the three-vessel tracheal section to the cephalic side of fetus. Section of three-vessel tracheal was firstly observed, then section of brachiocephalic vein which could show brachiocephalic vein and transverse aortic arch was screened, section of initial segment of brachiocephalic artery which could show the cross section planes of brachiocephalic artery, left common carotid artery and left subclavian artery was observed, and finally section of bilateral subclavian artery and subclavian vein which could show long axis planes of bilateral subclavian artery, bilateral subclavian vein and cross section of bilateral common carotid artery was screened. Multiple sections above three vessels and trachea view could be displayed by continuous scanning in all 502 normal fetuses. Among 521 ultrasonographic abnormal fetuses, 236 fetuses were found with abnormal brachiocephalic vein, 277 with abnormal brachiocephalic artery, 7 with abnormal pulmonary vein drainage at the heart and 1 with aortic arch at the neck. Conclusion Transverse continuous scanning sections above three vessels and tracheal view are helpful for prenatal ultrasonic diagnosis of fetal cardiovascular anomalies.
引文
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[12] Zhang Y,Shao Q,Sun L,et al.Prenatal diagnosis of total anomalous pulmonary venous connection by 2D and 3D fetal echocardiography.Echocardiography,2017,34(12):1852-1857.
[13] Kao CC,Hsieh CC,Cheng PJ,et al.Total anomalous pulmonary venous connection:From embryology to a prenatal ultrasound diagnostic update.J Med Ultrasound,2017,25(3):130-137.
[2] 易艳,刘涛,熊奕,等.胎儿上纵隔左右锁骨下动脉切面及其应用研究.中国超声医学杂志,2017,33(2):150-152.
[3] Gardiner H,Chaoui R.The fetal three-vessel and tracheal view revisited.Semin Fetal Neonatal Med,2013,18(5):261-268.
[4] Chen KB,Gu Q,Xia T,et al.Three-vessel-trachea view in the diagnosis of fetal cardiac great vessel malformation.J Biol Regul Homeost Agents,2018,32(2):351-355.
[5] 许燕,接连利,姜志荣,等.三血管观多切面扫查对胎儿先天性血管环的超声诊断价值.中国超声医学杂志,2015,31(9):807-809.
[6] 廖姗姗,陈昌宇,刘彩霞.产前超声测量正常胎儿左头臂静脉.中国医学影像技术,2014,30(6):893-896.
[7] Shiekh Eldin G,El-Segaier M,Galal MO.High prevalence rate of left superior vena cava determined by echocardiography in patients with congenital heart disease in Saudi Arabia.Libyan J Med,2013,8:21679.
[8] Kula S,Cevik A,Sanli C,et al.Persistent left superior vena cava:Experience of a tertiary health-care center.Pediatr Int,2015,53(6):1066-1069.
[9] Razon Y,Berant M,Fogelman R,et al.Prenatal diagnosis and outcome of right aortic arch without significant intracardiac anomaly.J Am Soc Echocardiogr,2014,27(12):1352-1358.
[10] Wójtowicz A,Respondek-Liberska M,Slodki M,et al.The significance of a prenatal diagnosis of right aortic arch.Prenat Diagn,2017,37(4):365-374.
[11] 张烨,何怡华,孙琳,等.胎儿孤立完全性血管环常见类型产前超声诊断研究.中华医学超声杂志(电子版),2016,13(8):577-581.
[12] Zhang Y,Shao Q,Sun L,et al.Prenatal diagnosis of total anomalous pulmonary venous connection by 2D and 3D fetal echocardiography.Echocardiography,2017,34(12):1852-1857.
[13] Kao CC,Hsieh CC,Cheng PJ,et al.Total anomalous pulmonary venous connection:From embryology to a prenatal ultrasound diagnostic update.J Med Ultrasound,2017,25(3):130-137.