胎儿超声心动图在诊断法洛四联症中价值.docVIP

胎儿超声心动图在诊断法洛四联症中价值 　　【摘要】 目的：探讨超声心动图在诊断胎儿法洛四联症中的价值及诊断技巧，提高此畸形的产前检出率。方法：对15例经引产病理检查或者产后超声心动图确诊为法洛四联症的胎儿超声心动图进行回顾性的分析，总结各扫查切面（四腔心切面、左右室流出道切面、三血管切面、主肺动脉长轴切面、主动脉弓切面、心底短轴切面）的声像图特征及诊断价值。结果：15例中胎儿超声心动图诊断正确13例，占比86.67%，误诊右室双出口1例，漏诊1例。法洛四联症胎儿超声心动图声像图基本特征：室间隔缺损15例，主动脉骑跨14例，肺动脉不同程度的狭窄12例或闭锁1例。右室前壁增厚不明显0例，右室流出道及肺动脉血流速度增快不明显，仅有4例超过1.0 m/s。合并心内畸形（右位主动脉弓）2例，合并其他系统畸形4例。结论：胎儿超声心动图检查对胎儿TOF具有明确的诊断价值，为改善预后和进行及时有效的干预提供了可靠的临床依据。 　　【关键词】 胎儿； 超声心动图； 法洛四联症 　　【Abstract】 Objective：To explore the value of echocardiography and diagnostic techniques in the diagnosis of fetal tetralogy of Fallot in，improve the detection rate of this deformity in prenatal.Method：15 cases confirmed by pathological examination or induction of postpartum echocardiography for fetal tetralogy of Fallot echocardiography were retrospectively analyzed，summarized the sections（four chamber view，left ventricular outflow tract view and three vessels view and main pulmonary artery long axis view，aortic arch section and basal short axis view）the sonographic characteristics and diagnostic value.Result：15 cases of fetal echocardiography in the correct diagnosis of 13 cases，accounting for 86.67%，1 case was diagnosed as double outlet right ventricle，1 case of misdiagnosis.Tetralogy of Fallot fetal echocardiography basic feature map sonogram：15 cases of ventricular septal defect，aorta in 14 cases，12 cases of pulmonary artery stenosis or 1 case of atresia.Right ventricular anterior wall thickening not obvious.Right ventricular outflow tract and pulmonary artery blood flow velocity increase not obvious，there were 4 cases of more than 1.0 m/s.Combined cardiac malformation（right aortic arch） in 2 cases，4 cases with other system abnormalities.Conclusion：Fetal echocardiography has definite diagnostic value for fetal TOF，which provides a reliable clinical basis for the improvement of prognosis and timely and effective intervention. 　　【Key words】 Fetus； Ultrasonic echocardiography； Tetralogy of Fallot 　　Fist-author’s address：Zhenjiang