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中华医学超声杂志(电子版) ›› 2016, Vol. 13 ›› Issue (05) : 361 -365. doi: 10.3877/cma.j.issn.1672-6448.2016.05.008

所属专题: 文献

妇产科超声影像学

产前超声心动图诊断胎儿主肺动脉间隔缺损
徐燕1,(), 茹彤1, 朱湘玉1, 徐学翠1   
  1. 1. 210008 江苏省南京市南京大学医学院附属鼓楼医院产前诊断中心
  • 收稿日期:2016-01-27 出版日期:2016-05-01
  • 通信作者: 徐燕
  • 基金资助:
    江苏省卫生厅科技项目(H201340)

Fetal echocardiography for diagnosis of aortopulmonary septal defect

Yan Xu1,(), Tong Ru1, Xiangyu Zhu1, Xuecui Xu1   

  1. 1. Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical College, Nanjing 210008, China
  • Received:2016-01-27 Published:2016-05-01
  • Corresponding author: Yan Xu
  • About author:
    Corresponding author: Xu Yan, Email:
引用本文:

徐燕, 茹彤, 朱湘玉, 徐学翠. 产前超声心动图诊断胎儿主肺动脉间隔缺损[J/OL]. 中华医学超声杂志(电子版), 2016, 13(05): 361-365.

Yan Xu, Tong Ru, Xiangyu Zhu, Xuecui Xu. Fetal echocardiography for diagnosis of aortopulmonary septal defect[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(05): 361-365.

目的

探讨超声心动图诊断胎儿主肺动脉间隔缺损的价值,总结其超声心动图特征。

方法

对5例2013年6月至2015年11月在南京大学医学院附属鼓楼医院产前诊断中心行胎儿超声心动图检查诊断为主肺动脉间隔缺损胎儿的超声图像特征进行分析,并追踪妊娠过程和临床结局。

结果

5例主肺动脉间隔缺损胎儿超声心动图有共同声像特征:三血管观声像图显示主动脉与主肺动脉之间出现回声失落即缺损(大小1.5~3.9 mm),左心室流出道和右心室流出道观显示缺损部位及其距半月瓣和(或)肺动脉分叉的距离,彩色多普勒超声显示缺损处为双向或肺动脉流向主动脉的彩色血流信号,频谱多普勒可见相应的血流流向及分布频谱。5例胎儿引产尸检均证实为主肺动脉间隔缺损。

结论

胎儿超声心动图可早期发现主肺动脉间隔缺损,对指导产科和出生后临床处理、降低畸形胎儿的出生率及提高出生患儿的生存质量均有重要临床价值。

Objective

To investigate the prenatal echocardiography manifestation of aortopulmonary septal defect (APSD) and clinical significance.

Methods

Imaging characteristics for 5 fetuses with APSD who underwent fetal echocardiography at our hospital from June 2013 to November 2015 were retrospectively reviewed. All cases were followed up for pregnancy process and clinical results.

Results

Echocardiographic characteristics of APSD were a defect between the ascending aorta and the trunk of the pulmonary artery in the three vessels view. The defect sizes were ranged from 1.5 to 3.9 mm. The defect location to semilunar valve and /or pulmonary artery bifurcation could be displayed in the left and right ventricular outflow tract views. Color and pulse Doppler showed bidirectional or pulmonary-to-aorta shunt flow pattern. All the five APSD cases were confirmed by autopsy.

Conclusions

APSD can be diagnosed by fetal echocardiography. Prenatal diagnosis is important for obstetrical management, early surgical intervention and prognosis.

图1~6 胎儿主肺动脉间隔缺损产前超声声像图。图1三血管观显示主动脉与肺动脉之间见回声失落(箭头所示),大小2.6 mm;图2 左心室流出道观显示主动脉瓣(右侧箭头所示)上1.6 mm处主动脉与肺动脉之间见回声失落(左侧箭头所示);图3 右心室流出道观显示肺动脉瓣(箭头所示)上2.2 mm处主动脉与肺动脉之间见回声失落(箭头所示);图4 胎儿主动脉与肺动脉之间回声失落处见红色血流信号(箭头所示为肺动脉流向主动脉);图5 胎儿主动脉与肺动脉之间回声失落处见蓝色血流信号(箭头所示为主动脉流向肺动脉);图6 频谱多普勒显示主动脉与肺动脉之间回声失落处为双向血流频谱,以主动脉流向肺动脉为主
表1 5例主肺动脉间隔缺损胎儿产前超声检查及引产后尸检结果
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