上腹部横切面在产前超声诊断心房异构综合征中价值.docVIP

上腹部横切面在产前超声诊断心房异构综合征中的价值 　　[摘要]目的 分析胎儿上腹部大血管及脏器相对位置改变与异构畸形的关系，探讨上腹部横切面在产前超声诊断心房异构综合征中的价值。方法 对2013年3月～2016年9月在徐州市妇幼保健院进行胎儿超声心动图检查中诊断为心房异构综合征病例的胎儿的上腹部横切面声像特点进行回顾性分析，分析内容包括腹部大血管的位置及其相对关系、胃泡位置、胆囊位置、肝脏的形态及门静脉窦的特点。结果 23例胎儿心房异构胎儿均存在上腹部横切面的声像改变，其中9例左房异构综合征均合并肾上段下腔静脉离断，奇静脉或半奇静脉与腹主动脉并列（占左房异构的100%）；14例右房异构均表现为下腔静脉与腹主动脉并列位于脊柱同侧（占右房异构的100%）。22例存在中位肝并出现胃泡和胆囊位置改变（占心房异构的95.7%）；1例左房异构胃泡胆囊位置正常（占心房异构的4.3%，占左房异构的11.1%）。结论 胎儿上腹部横切面声像改变，尤其是上腹部大血管排列关系改变，对提示胎儿心房异构综合征具有重要价值。 　　[关键词]超声检查；心房异构；产前；腹部横切面；大血管排列关系 　　[中图分类号] R445.1 [文献标识码] A [文章编号] 1674-4721（2016）10（c）-0121-04 　　[Abstract]Objective To explore the clinical value of the upper abdominal transection in antenatal sonographic diagnosis of atrial heterogeneous syndrome，so as to analyse the prenatal sonographic characteristics of fetal upper abdominal transverse section and its relationship with heterogeneous deformity.Methods Ultrasonographic characteristics of upper abdominal transverse section according to the fetal echocardiography diagnosed as left or right atrial heterogeneous syndrome in Materal and Child Health Hospita of Xuzhou city from March 2013 to September 2016 were retrospectively analysed，analysis included the relative relation and position of abdominal large vessels，the position of the stomach，the position of the gallbladder，morphology of liver and the characteristics of portal venous sinus.Results All the 23 cases of atrial heterogeneous fetus had changes in the upper abdominal transverse section，9 cases of left isomerism had interrupted IVC and broadened azygos vein （100% in the 9 cases of the left arial syndrome），14 cases of right isomerism with juxtaposition of the abdominal aorta and inferior vena cava （100% in the 14 cases of the right arial syndrome）.22 cases showed the level of liver and the position changes of stomach and gallbladder （95.7% in the 23 cases of arial syndrome），1 case of left isomerism showed stomach bullle and gallbladder normal position （4.3% in the arial syndrome，11.1% in the left arial synd