产前胎儿超声检查.ppt

* 070109心内膜垫缺损-唇裂-赵志艳 小脑延髓池宽，细通道 CARDIAC AXIS. To assess that the cardiac axis is normal, the following three step procedure should be employed. First, check the position of the spine, as shown; Second, draw a line along the inter-ventricular septum, which represents the axis of the heart; Third, draw a sagittal line joining the spine posteriorly with the sternum, anteriorly. The acute angle between the two lines should be 45 degrees +/- 20 degrees. 4-CHAMBER VIEW CRITERIA. The anatomic details which are included in the previously shown checklist are displayed here with the help of the ultrasound image. WHile looking at a 4-chamber view, the following structures should be identified: two atria of approximately equal dimensions; these should be separated by the flap of the foramen ovale, opening into the left atrium and by the septum primum, which is visible just above the atrio-ventricular plane. Then, the existence of two separate atrio-ventricular valves with normal systodiastolic movement should be confirmed, bearing in mind that the septal leaflet of the tricuspid valve attaches slightly closer to the cardiac apex than that of the mitral valve. Then, two ventricles of similar size should be present, with the moderator band at the apex of the right one. Due to the presence of the moderator band, the right ventricle is somewhat rounder than the left one, which forms the apex of the heart. The presence of an intact inter-ventricular septum separating the two ventricles should then be seen. Finally, the myocardium should be assessed. Neither cardiac wall hypertrophy nor ventricular disproportion should be present.The rim of the pericardium can be seen as a thin echoic line adjacent to the myocardium. LVOT CRITERIA. WHile assessing the left outflow tract, the following anatomic structures should be checked: 1) That the ventricle on the left has the morphology of the left ventricle and reaches the apex; 2) that there is a semilunar valve which moves freely during th